2013-11-12T14:13:24-06:00 2012-12-31 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 2000 INDIANAPOLIS IN 462045108 990 2012-01-01 341880767 PROMEDICA PHYSICIANS AND CONTINUUM SERVICES PROM 4198247200 5855 MONROE ST SYLVANIA OH 43560 LEE W HAMMERLING 4194693842 2013-11-12 1 SHAWNA M JIMENEZ P01222873 3174648600 2012 2016-02-24 21:20:13Z LEE W HAMMERLING 1801 RICHARDS RD TOLEDO OH 43607 38138447 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. 21 14 159 14 0 0 13156737 17580373 42025213 20534168 82358 21722 0 1245 55264308 38137508 400000 1700450 0 0 22341519 16982353 0 0 0 32888038 17419639 55629557 36102442 -365249 2035066 27818129 29374048 17389898 16910751 10428231 12463297 X PROMEDICA PHYSICIANS AND CONTINUUM SERVICES IS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC. WE WILL BE THE PREMIER COMMUNITY-BASED MANAGEMENT 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 1 23788159 1700450 16935457 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. 5067516 3599956 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. 28855675 1 1 0 0 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 1 202 0 1 159 1 0 0 0 0 0 0 0 0 0 0 X 21 14 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 OH X BRIAN HANSEN 4198918505 5901 MONCLOVA RD MAUMEE OH 43537 EDWARD BARDI PHD 1.00 6.00 X 0 289 0 STEPHEN BAZELEY MD 1.00 46.00 X 0 29158 5920 JAMES BRENNAN JR 1.00 6.00 X 0 0 0 GREGORY DENNY 1.00 6.00 X 0 0 0 PATRICK FARVER 1.00 8.00 X 0 0 0 LYNN FRUTH 1.00 6.00 X 0 315 0 ROBERT GRAY 1.00 6.00 X 0 0 0 THEODORE HAHN 1.00 6.00 X 0 0 0 JONATHAN HARDING 1.00 6.00 X 0 0 0 JILL KEGLER 1.00 6.00 X 0 0 0 RANDALL OOSTRA 1.00 51.00 X 0 1309341 256213 EMILY OSTROWSKI MD 1.00 45.00 X 0 168029 10188 KEVIN RAHE 1.00 6.00 X 0 0 0 ALLAN RUBIN MD 1.00 45.00 X 0 464717 25259 BRUCE RUMPF 1.00 6.00 X 0 0 0 DEBRA SCHAEFER 1.00 6.00 X 0 0 0 EMORY SCHMIDT 1.00 8.00 X 0 0 0 C MICHAEL SMITH 1.00 7.00 X 0 0 0 STEPHEN STAELIN 1.00 10.00 X 0 479 0 JAMES VAN DOREN 1.00 6.00 X 0 0 0 RONALD WAINZ MD 1.00 45.00 X 0 533743 23500 LEE HAMMERLING MD 1.00 47.00 X X 0 728567 74310 ROBERT CHIRDON 1.00 7.00 X X 0 0 0 KATHLEEN HANLEY 0.50 51.50 X 0 675864 105620 JEFFREY KUHN 0.50 51.00 X 0 531308 62161 ANNEMARIE HAINEN 40.00 0.50 X 0 168627 31846 KHURRAM KAMRAN 40.00 0.50 X 0 377832 28818 KIM MCCLURE 40.00 3.50 X 0 194615 33696 WILLIAM MUELLER 40.00 0.50 X 0 391020 38327 JULIE TOME 40.00 0.50 X 0 314231 30954 CYNTHIA J KRAUSE 40.00 0.00 X 114413 0 19460 MICHAEL E MCKELVEY 40.00 0.00 X 126194 0 24196 RITA L RODRIGUEZ 40.00 0.00 X 109027 0 3276 RITA A ROTH 40.00 0.00 X 108350 0 18008 GREGORY J STANG 40.00 0.00 X 118351 0 37922 GARY AKENBERGER 0.00 45.00 X 0 321867 69112 DAWN BUSKEY 0.00 41.00 X 0 292528 47905 MARTIN DANSACK 0.00 41.00 X 0 209696 34272 DAVID DEWEY 0.00 40.00 X 0 182390 36268 ROBERT FREDRICK MD 0.00 40.50 X 0 447584 66235 DAVID JAMES MD 0.00 40.00 X 0 436702 29261 576335 7778902 1112727 6 1 1 0 KOBOR MED SEARCH LLC PO BOX 1931 DAWSONVILLE GA 30534 PHYSICIAN COVERAGE 818780 TUSK ENTERPRISES LLC 2000 EAST LAMAR BLVD STE 250 ARLINGTON TX 76006 PHYSICIAN COVERAGE 807497 ATHENA HEALTH INC 311 ARSENAL ST WATERTOWN MA 02472 BILLING SERVICES 683384 MEDICAL MARKETING MANAGEMENT 21415 CIVIC CENTER DR STE 211 SOUTHFIELD MI 48076 PHYSICIAN COVERAGE 539428 ALLSCRIPTS PO BOX 751585 CHARLOTTE NC 28275 BILLING SERVICES 492582 19 17283373 297000 17580373 SUPPORT FEES 621111 16934212 16934212 NET PATIENT SERVICES 621610 3599956 3599956 20534168 22661 22661 939 -939 -939 -939 MEDICAL RECORDS 900099 1245 1245 1245 38137508 20535413 0 21722 1700450 1700450 13738259 10981134 2757125 641546 517582 123964 1642231 1345407 296824 960317 796189 164128 306876 306876 114036 114036 2824938 2748459 76479 1626355 1515214 111141 744195 705383 38812 1885895 1885895 238345 108908 129437 449026 325642 123384 16250 16250 1751325 1751325 4393270 4162104 231166 CONTINGENT LIAB. ADJ. 1261777 1261777 INTERCOMPANY SERVICES 692209 681 691528 0 DRUGS 405766 405766 0 0 EQUIPMENT RENTAL 44820 22434 22386 0 664556 490970 173586 36102442 28855675 7246767 0 1093770 0 1567228 1956986 43009 30412 10458529 8023392 2670516 2435137 6703072 6272585 15740534 18678928 27818129 29374048 4888374 4741340 12501524 12169411 17389898 16910751 X 10426147 12383212 2084 80085 0 10428231 12463297 27818129 29374048 2035066 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 781577 599661 181916 9676952 7423731 2253221 2435137 DUE FROM AFFILIATES 18343553 INVESTMENT IN AFFILIATES -79971 CERTIFICATE OF DEPOSIT 42117 OTHER RECEIVABLES 373229 18678928 DUE TO AFFILIATES 8337156 CONTINGENT LIABILITIES 3832255 12169411 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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, 2012 AND 2011. FOR THE YEARS ENDED DECEMBER 31, 2012 AND 2011, A TAXABLE SUBSIDIARY OF PHS RECOGNIZED A LIABILITY FOR UNCERTAIN TAX POSITIONS OF $1,552,000 AND $2,080,000, RESPECTIVELY. THE SUBSIDIARY RECOGNIZED A CREDIT FOR INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS OF ($117,000) AS OF DECEMBER 31, 2012 AND AN EXPENSE OF $308,000 AS OF DECEMBER 31, 2011 WITHIN THE INCOME TAX EXPENSE LINE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS. PROMEDICA PHYSICIANS AND CONTINUUM SERVICES DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2012 AND 2011. 1 PROMEDICA CENTRAL CORPORATION OF MI INC 5855 MONROE ST SYLVANIA OH 43560 383322278 1700000 OPERATING GRANT 0 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, 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. 0 1 0 0 0 0 1 0 0 RANDALL OOSTRA 0 846000 0 433200 0 30141 0 244878 0 11335 0 1565554 0 0 EMILY OSTROWSKI MD 0 157694 0 0 0 10335 0 8303 0 1885 0 178217 0 0 ALLAN RUBIN MD 0 442217 0 9616 0 12884 0 17000 0 8259 0 489976 0 0 RONALD WAINZ MD 0 533743 0 0 0 0 0 17000 0 6500 0 557243 0 0 LEE HAMMERLING MD 0 509392 0 212125 0 7050 0 61661 0 12649 0 802877 0 0 KATHLEEN HANLEY 0 473484 0 195800 0 6580 0 88731 0 16889 0 781484 0 0 JEFFREY KUHN 0 353206 0 170216 0 7886 0 46771 0 15390 0 593469 0 0 ANNEMARIE HAINEN 0 133381 0 32860 0 2386 0 25322 0 6524 0 200473 0 0 KHURRAM KAMRAN 0 357110 0 20722 0 0 0 12083 0 16735 0 406650 0 0 KIM MCCLURE 0 151355 0 34835 0 8425 0 32564 0 1132 0 228311 0 0 WILLIAM MUELLER 0 240011 0 144620 0 6389 0 27846 0 10481 0 429347 0 70714 JULIE TOME 0 274133 0 40098 0 0 0 14324 0 16630 0 345185 0 0 MICHAEL E MCKELVEY 106253 0 0 0 19941 0 13973 0 10223 0 150390 0 0 0 GREGORY J STANG 112108 0 0 0 6243 0 20286 0 17636 0 156273 0 0 0 GARY AKENBERGER 0 244078 0 68605 0 9184 0 51390 0 17722 0 390979 0 0 DAWN BUSKEY 0 213304 0 70921 0 8303 0 39173 0 8732 0 340433 0 0 MARTIN DANSACK 0 150645 0 56079 0 2972 0 23100 0 11172 0 243968 0 20228 DAVID DEWEY 0 150356 0 28966 0 3068 0 26345 0 9923 0 218658 0 0 ROBERT FREDRICK MD 0 335308 0 110786 0 1490 0 60253 0 5982 0 513819 0 0 DAVID JAMES MD 0 353437 0 81896 0 1369 0 25064 0 4197 0 465963 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 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. NO PAYMENTS WERE MADE TO LISTED PERSONS ON PART VII UNDER THE VARIOUS NON-QUALIFIED DEFERRED COMPENSATION PLANS DURING THE YEAR. SUPPLEMENTAL INFORMATION PART III PART I, LINE 6B: CERTAIN LISTED PERSONS RECEIVE INCENTIVES BASED ON INDIVIDUAL PRODUCTIVITY NET EARNINGS. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 PROMEDICA PHYSICIANS AND CONTINUUM SERVICES TRANSFERRED THE PROGRAM SERVICE LINE PROVIDING PHARMACY, DURABLE MEDICAL EQUIPMENT, AND SUPPLIES TO A RELATED ORGANIZATION. 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, AS WELL AS AN ATTACHMENT WITH A FULL LISTING OF THE BOARD MEMBER'S DISCLOSURES AND THE TOTAL AMOUNT OF FINANCIAL ACTIVITY IN THE PRECEDING 12 MONTHS BETWEEN PHS AND THE BOARD MEMBERS/AFFILIATES. 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 THE CHIEF HUMAN RESOURCES OFFICER 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. 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 MANAGMENT 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 2012 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 306 SITES, AND APPROXIMATELY 1,798 PHYSICIANS AND 15,368 EMPLOYEES AND VOLUNTEERS. DURING 2012, PROMEDICA DISCHARGED 70,961 INPATIENTS AND SERVED MORE THAN 1,374,110 OUTPATIENTS, WHILE HANDLING 276,718 EMERGENCY VISITS SYSTEM-WIDE. AMONG THE REGION'S LARGEST EMPLOYERS, PROMEDICA PLAYS A SIGNIFICANT ROLE IN ECONOMIC DEVELOPMENT AND STABILITY IN OUR REGION. DURING 2012, FOR EVERY ONE DOLLAR OF REVENUE, ANOTHER 33 CENTS WAS CREATED IN OUR SERVICE-AREA ECONOMY, WITH A TOTAL ECONOMIC OUTPUT OF $2.81 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 2012, PROMEDICA ALSO PROVIDED INTEGRATED SERVICES, COMPRISED OF: - PROMEDICA CONTINUING CARE SERVICES CORPORATION, PROVIDING REHABILITATION, HOME CARE, AMBULATORY AND SENIOR SERVICES, COMMUNITY HEALTH, MEDICAL TRANSPORTATION SERVICES, AND CARE COORDINATION. - PROMEDICA PHYSICIAN GROUP (PROMEDICA PHYSICIANS), WITH MORE THAN 500 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, WITH EXCELLENT MEMBER SATISFACTION RATINGS AMONG ALL PATIENT POPULATIONS. IN 2012, THE OHIO DEPARTMENT OF JOB AND FAMILY SERVICES CHOSE PARAMOUNT ADVANTAGE TO PROVIDE MEDICAID COVERAGE IN ALL OF OHIO'S 88 COUNTIES BEGINNING IN 2013. - 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 2012 THAT HAD VALUES AND MISSIONS SIMILAR TO OURS. 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 2012 INCLUDE THE FOLLOWING: - IN COLLABORATION WITH MANY OTHER NONPROFIT COMMUNITY ORGANIZATIONS, PROMEDICA OPENED AN AUTISM CENTER THAT PROVIDES EARLY DIAGNOSIS AND INTERVENTION, MULTIDISCIPLINARY RESOURCES AND FAMILY SUPPORT. - PROMEDICA WAS SELECTED AS ONE OF 13 NATIONAL SHARE OUR STRENGTH: NO KID HUNGRY ALLIES TO ADDRESS CHILDHOOD HUNGER. - PROMEDICA'S SUMMER YOUTH EMPLOYMENT PROGRAM PARTNERED 35 CENTRAL-CITY TEENS AGES 16 19 WITH MENTORS IN DEPARTMENTS SUCH AS HUMAN RESOURCES, RADIOLOGY, DIETARY, AND INFORMATION TECHNOLOGY, WHERE THEY WORKED A TOTAL OF 7,000 HOURS IN SUMMER 2012 TO LEARN SKILLS INCLUDING CUSTOMER SERVICE, PUNCTUALITY AND BEING ACCOUNTABLE TO OTHERS. - PROMEDICA SYSTEM GRANTS CONTINUED TO AGGRESSIVELY PURSUE GRANT FUNDING FOR HEALTH-RELATED COMMUNITY PROGRAMS, SUCH AS SECURING A $66,035 GRANT FROM THE U.S.D.A. MARKETING SERVICE FOR A FARMERS MARKET PROGRAM, WHICH ENABLES LOCAL GROWERS TO REACH RESIDENTS OF LENAWEE COUNTY, MICHIGAN, WHO HAVE LIMITED ACCESS TO HEALTHY PRODUCE. - PROMEDICA ENTERED INTO A COLLABORATIVE BUSINESS RELATIONSHIP WITH CLEVELAND CLINIC AS PART OF A NATIONAL INNOVATION ALLIANCE NETWORK TO HELP COMMERCIALIZE MEDICAL INNOVATIONS FOR FUTURE PATIENT TECHNOLOGY, MEDICAL DEVICES AND OTHER TREATMENT ADVANCEMENTS. - PROMEDICA ICARE, THE FOUNDATION FOR OUR ELECTRONIC MEDICAL RECORD, COMPLETED 71 GO-LIVE EVENTS, TOTALING 197 ACROSS OUR HEALTHCARE SYSTEM IN 2012. - PROMEDICA PHYSICIANS WAS SELECTED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO PARTICIPATE IN ITS MEDICARE SHARED SAVINGS PROGRAM, WHICH REWARDS PROVIDERS FOR MEETING SPECIFIC QUALITY AND COST-SAVING METRICS THROUGH ACCOUNTABLE CARE ORGANIZATIONS. - ALL OF OUR PROMEDICA PHYSICIANS' PRIMARY CARE SITES RECEIVED NCQA RECOGNITION IN 2012 AS PATIENT-CENTERED MEDICAL HOMES; THIS TOTALED 24 SITES AND 70 PHYSICIANS. - TOLEDO HOSPITAL OPENED A NEW $10-MILLION NEURO ICU AND DEDICATED STROKE UNIT. - PROMEDICA HEART AND VASCULAR INSTITUTES BEGAN OFFERING A NEW, NONSURGICAL HEART VALVE REPLACEMENT PROCEDURE - TAVR. - NEW DAVINCI ROBOTIC SYSTEMS WERE INSTALLED, AND TRAINING PROVIDED, IN SEVERAL OF PROMEDICA HOSPITALS TO OFFER THE LATEST SURGICAL TECHNIQUES TO APPROPRIATE PATIENTS; THIS WILL HELP TO REDUCE LENGTH OF STAY AND RECOVERY TIMES. - PROMEDICA'S TRANSITIONAL CARE UNIT RECEIVED A FIVE-STAR QUALITY RATING FROM CMS, PLACING IT AMONG THE TOP 20% OF NURSING HOMES IN OHIO. - PROMEDICA CONTINUED ITS INITIATIVE TO FIGHT OBESITY LOCALLY THROUGH ITS FIELDS OF GREEN CAMPAIGN, BY ADDRESSING THE PROBLEM OF HUNGER AS A HEALTH ISSUE IN ITS ANNUAL SCHOLARSHIP COMPETITION FOR HIGH SCHOOL STUDENTS. - 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 60 NEW PRIMARY CARE PHYSICIANS AND SPECIALISTS IN 2012. - PROMEDICA PARTICIPATED IN DOZENS OF COMMUNITY HEALTH FAIRS THAT INCLUDED APPROXIMATELY 11,125 FREE PUBLIC SCREENINGS FOR HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, BODY MASS INDEX AND BONE DENSITY. - AS PART OF ITS HUNGER-FREE INITIATIVE, PROMEDICA PARTNERED WITH UNITED WAY OF GREATER TOLEDO AND THE YMCA TO PROVIDE A SUMMER FEEDING PROGRAM FOR MORE THAN 1,000 METRO-TOLEDO SCHOOL CHILDREN. - PROMEDICA CANCER INSTITUTE'S COMMUNITY OUTREACH INCLUDED SCREENINGS FOR SKIN AND PROSTATE CANCERS, A ROBUST SURVIVORSHIP PROGRAM AND SPONSORSHIP OF THE ANNUAL SUSAN G. KOMEN(R) RACE 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 $500,000 IN 2012. - PROMEDICA EMPLOYEES PLEDGED MORE THAN $514,000 TO THE UNITED WAY CAMPAIGN IN 2012, NEARLY 50% MORE THAN IN 2011. - PROMEDICA PRESENTED A $100,000 GRANT TO TOLEDO PUBLIC SCHOOLS FOR A FOUR-YEAR SCIENCE, TECHNOLOGY, ENGINEERING, MATH, AND MEDICINE (STEMM) TRACK FOR HIGH SCHOOL STUDENTS. IN 2012, PROMEDICA CONTRIBUTED $130,403,000 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 $51,786,000 IN 2012. 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 $25,710,000 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 2012 WAS $24,721,000. THIS AMOUNT IS NOT INCLUDED IN THE COMMUNITY BENEFIT AMOUNT OF $130,403,000 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 COLLEGE OF MEDICINE, 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 2012, PROMEDICA PROVIDED $52,907,000 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 2012 WAS $89,828,000 AND IS NOT REFLECTED IN THE COMMUNITY BENEFIT AMOUNT OF $130,403,000 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 PROVIDES 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 2012, PPCS TREATED MORE THAN 1.32 MILLION PATIENTS IN NEARLY 125 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 2012, 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 136 JOBS THROUGH DIRECT EMPLOYMENT, THEREBY CONTRIBUTING TO THE ECONOMIC STABILITY OF NORTHWEST OHIO. A TOTAL OF $4,480,000 IN NET PAYROLL WAS EXPENDED IN THE NORTHWEST OHIO REGION IN 2012; $287,000 WAS WITHHELD FROM PROMEDICA PHYSICIANS AND CONTINUUM SERVICES 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 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 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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