UPPER VALLEY MEDICAL CENTER: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: UPPER VALLEY MEDICAL CENTER (EIN 31-0537095)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-11-08
IRS object ID: 202143129349302099
Schema version: 2020v4.1
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 M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-11-08T11:32:45-06:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	346565596	PreparerFirmEIN

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	2020-01-01	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)
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	BOARD TREASURER & COO	PersonTitleTxt
Phone	9374999942	PhoneNum
Signature	2021-11-08	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	TIMOTHY	PersonFirstNm
Person Last	SNIDER	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

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

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	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	$277,162,795	GrossReceiptsAmt
Group Return For Affiliates	0	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	1143	TotalEmployeeCnt
Total Volunteers	120	TotalVolunteersCnt
Total Gross UBI	$4,828	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$122,348	PYContributionsGrantsAmt
CY Contributions Grants	$8,688,738	CYContributionsGrantsAmt
PY Program Service Revenue	$157,511,735	PYProgramServiceRevenueAmt
CY Program Service Revenue	$134,596,681	CYProgramServiceRevenueAmt
PY Investment Income	$5,695,870	PYInvestmentIncomeAmt
CY Investment Income	$6,655,922	CYInvestmentIncomeAmt
PY Other Revenue	$1,358,709	PYOtherRevenueAmt
CY Other Revenue	$1,596,121	CYOtherRevenueAmt
PY Total Revenue	$164,688,662	PYTotalRevenueAmt
CY Total Revenue	$151,537,462	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,386,261	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$8,065,982	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$66,189,175	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$62,223,640	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$60,499,768	PYOtherExpensesAmt
CY Other Expenses	$61,913,777	CYOtherExpensesAmt
PY Total Expenses	$129,075,204	PYTotalExpensesAmt
CY Total Expenses	$132,203,399	CYTotalExpensesAmt
PY Revenues Less Expenses	$35,613,458	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$19,334,063	CYRevenuesLessExpensesAmt
Total Assets BOY	$176,594,804	TotalAssetsBOYAmt
Total Assets EOY	$184,385,472	TotalAssetsEOYAmt
Total Liabilities BOY	$93,696,478	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$99,733,905	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$82,898,326	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$84,651,567	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	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$124,378,266	ExpenseAmt
Grant	$8,065,982	GrantAmt
Revenue	$134,596,681	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	$124,378,266	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	58	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1143	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	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	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	J MICHAEL SIMS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
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 (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MARY H BOOSALIS
PREMIER PRESIDENT & CEO	0.50	39.50	Yes (X)	$0	$2,150,189	$41,653
THOMAS R PARKER
PRESIDENT & CEO (TO JUL)	38.00	2.00	Yes (X)	$686,531	$0	$57,139	Yes (X)
FAYEZ D ABBOUD MD
PRES MEDICAL STAFF	0.50	39.50	Yes (X)	$0	$749,156	$34,505
RAFAY ATIQ MD
TRUSTEE	0.50	39.50	Yes (X)	$0	$478,018	$38,424
SCOTT B KANAGY DO
TRUSTEE / VP OPERATIONS & CMO	40.00	0.00	Yes (X)	$394,906	$0	$51,384
KEVIN W HARLAN
PRESIDENT & CEO (FROM SEP)	38.00	2.00	Yes (X)	$112,095	$0	$3,954	Yes (X)
SCOTT SWABB DO
TRUSTEE	0.50	0.00	Yes (X)	$0	$85,085	$0
ROWAN R NICKOL MD
BOARD CHAIR	0.50	2.50	Yes (X)	$0	$0	$0	Yes (X)
TIMOTHY D SNIDER
BOARD TREASURER & COO	37.50	2.50		$336,468	$0	$58,632	Yes (X)
BENJAMIN A WATSON ESQ
BOARD SECRETARY (TO JAN)	0.50	39.50		$0	$187,718	$15,994	Yes (X)
ANDREA L FLAUTE
BOARD SECRETARY (FROM JAN)	0.50	39.50		$0	$83,482	$12,029	Yes (X)
GEOFFREY P WALKER
SYSTEM VP -CHIEF LEGAL OFFICER	8.00	32.00		$0	$834,993	$50,821		Yes (X)
GARY G GINTER
VP & PREMIER CHIEF INFO OFFICER	10.00	30.00		$0	$545,293	$90,857		Yes (X)
MARC R BELCASTRO DO
VP MEDICAL AFFAIRS & PREMIER CMO	10.00	30.00		$0	$667,457	$39,724		Yes (X)
MARGARET W MARK
VP NURSING SERVICE / PREMIER CNO	10.00	30.00		$0	$530,877	$47,367		Yes (X)
THOMAS R CURTIN
VP-REVENUE CYCLE	10.00	30.00		$0	$494,429	$67,304		Yes (X)
J MICHAEL SIMS
SYSTEM VP - TREASURER & CORP CONTROLLER	10.00	30.00		$0	$505,791	$52,141		Yes (X)
ELAINE M DEAN
SYSTEM VP - BUSINESS DEVELOPMENT	10.00	30.00		$0	$457,787	$24,516		Yes (X)
KIM K STRAHL
VICE PRESIDENT & CPO	10.00	30.00		$0	$363,757	$33,262		Yes (X)
BILLIE L LUCENTE-BAKER
SYSTEM VP - HR OPERATIONS	10.00	30.00		$0	$283,148	$32,159		Yes (X)
TRISHA L WACKLER
CNO & PREMIER VP EDUCATION	40.00	0.00		$228,269	$46,273	$29,553		Yes (X)
DUANNA R OSTING
UVMC FOUNDATION PRES / EXEC DIR	20.00	0.00		$163,329	$0	$18,946			Yes (X)
MELISSA M TALLMADGE
DIR NURSING - SURGERY/ED	40.00	0.00		$181,085	$0	$68,941			Yes (X)
RYAN E MCELDOWNEY
STAFF PHARMACIST	40.00	0.00		$157,002	$0	$38,762			Yes (X)
ALLISON E WENTLAND
DIR QUALITY & SYS INFECTION CTRL	40.00	0.00		$163,519	$0	$27,578			Yes (X)
PAMELA L CORNETT
DIR - REHAB SERVICES	40.00	0.00		$150,641	$0	$29,355			Yes (X)
DIANE L PLEIMAN
FORMER OFFICER	0.00	40.00		$0	$722,830	$32,955				Yes (X)
JENNA M DOWNEY ESQ
FORMER OFFICER	0.50	39.50		$0	$232,761	$19,568				Yes (X)
SCOTT A SHELTON
FORMER KEY EMPLOYEE	0.00	40.00		$0	$1,342,217	$46,962				Yes (X)
JENNIFER J HAULER DO
FORMER KEY EMPLOYEE	0.00	40.00		$70,345	$806,774	$85,663				Yes (X)
BARBARA A JOHNSON
FORMER KEY EMPLOYEE	0.00	40.00		$0	$968,394	$27,115				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,644,190	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$12,536,429	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,177,263	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	40	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
WENCO CONSTRUCTION CO LLC
1807 DALTON DR	NEW CARLISLE	OH	45344	CONSTRUCTION	$4,203,067
COMMONSPIRT HEALTH
3900 OLYMPIC BLVD 400	ERLANGER	KY	41018	CLINICAL ENGINEERING	$1,829,331
PULMONARY & CRITICAL CARE
1520 S MAIN ST SUITE 2	DAYTON	OH	45409	MEDICAL SERVICES	$1,237,469
HEALOGICS WOUND CARE & HYPERBARIC SVC
28525 NETWORK PLACE	CHICAGO	IL	60673	MEDICAL SERVICES	$834,125
HICUITY HEALTH INC
ONE CITYPLACE DR 570	SAINT LOUIS	MO	63141	MEDICAL SERVICES	$660,492

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	21	CntrctRcvdGreaterThan100KCnt
Related Organizations	$177,330	RelatedOrganizationsAmt
Government Grants	$8,511,408	GovernmentGrantsAmt
Noncash Contributions	$135,573	NoncashContributionsAmt
Total Contributions	$8,688,738	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE	621110	$68,719,328	$68,719,328
MEDICARE / MEDICAID	621110	$65,498,110	$65,498,110
HOSP FRANCHISE TAX RECOVERIES	900099	$297,900	$297,900
ATHLETIC TRAINING	900099	$53,273	$53,273
MEDICAL RECORDS	900099	$28,070	$28,070

Field	Value	IRS element (for citing)
Total Program Service Revenue	$134,596,681	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$937,661	TotalRevenueColumnAmt
Exclusion	$937,661	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,705,119	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$3,025,032	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$680,087	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$680,087	TotalRevenueColumnAmt
Exclusion	$680,087	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$127,846,617	SecuritiesAmt
Other	$409,884	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$122,301,022	SecuritiesAmt
Other	$237,218	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$5,545,595	SecuritiesAmt
Other	$172,666	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,718,261	TotalRevenueColumnAmt
Exclusion	$5,718,261	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$103,977	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$62,061	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$41,916	TotalRevenueColumnAmt
Exclusion	$41,916	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA SALES	722514	$392,284	$392,284
FEMA REVENUE	900099	$375,552	$375,552
STERILE PROCESSING	900099	$14,418	$14,418

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$91,864	TotalRevenueColumnAmt
Unrelated Business Revenue	$4,828	UnrelatedBusinessRevenueAmt
Exclusion	$87,036	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$874,118	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$151,537,462	TotalRevenueColumnAmt
Related Or Exempt Func Income	$134,596,681	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,828	UnrelatedBusinessRevenueAmt
Exclusion	$8,247,215	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$8,065,982	TotalAmt
Program Services	$8,065,982	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,952,790	TotalAmt
Program Services	$1,093,071	ProgramServicesAmt
Management And General	$859,719	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$47,315,005	TotalAmt
Program Services	$43,434,023	ProgramServicesAmt
Management And General	$3,880,982	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$4,192,434	TotalAmt
Program Services	$3,789,025	ProgramServicesAmt
Management And General	$403,409	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,847,086	TotalAmt
Program Services	$4,847,086	ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,916,325	TotalAmt
Program Services	$3,198,504	ProgramServicesAmt
Management And General	$717,821	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$118,690	TotalAmt
Program Services	$118,690	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$6,728	TotalAmt
Management And General	$6,728	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$4,117	TotalAmt
Management And General	$4,117	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$184,089	TotalAmt
Management And General	$184,089	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$22,890,724	TotalAmt
Program Services	$22,312,731	ProgramServicesAmt
Management And General	$577,993	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$416,951	TotalAmt
Program Services	$416,951	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$511,338	TotalAmt
Program Services	$371,709	ProgramServicesAmt
Management And General	$139,629	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$704,861	TotalAmt
Program Services	$573,756	ProgramServicesAmt
Management And General	$131,105	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,413,836	TotalAmt
Program Services	$2,110,914	ProgramServicesAmt
Management And General	$302,922	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$35,406	TotalAmt
Program Services	$32,020	ProgramServicesAmt
Management And General	$3,386	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,643,339	TotalAmt
Program Services	$1,643,339	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$9,106,867	TotalAmt
Program Services	$9,106,867	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$102,864	TotalAmt
Program Services	$69,758	ProgramServicesAmt
Management And General	$33,106	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
OPERATING SUPPLIES	$18,662,624	$18,662,624	$0
HOSPITAL FRANCHISE TAX	$2,812,858	$2,812,858	$0
REPAIRS AND MAINTENANCE	$1,048,948	$939,423	$109,525
EQUIPMENT RENTAL	$426,177	$426,177	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$823,360	TotalAmt
Program Services	$352,758	ProgramServicesAmt
Management And General	$470,602	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$132,203,399	TotalAmt
Program Services	$124,378,266	ProgramServicesAmt
Management And General	$7,825,133	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,310	BOYAmt
EOY	$3,860	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$10,036,164	BOYAmt
EOY	$8,247,599	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$21,035,708	BOYAmt
EOY	$18,215,785	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$73,500	BOYAmt
EOY	$679,167	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,079,571	BOYAmt
EOY	$1,250,086	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$387,315	BOYAmt
EOY	$428,549	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$211,922,052	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$137,764,003	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$75,138,859	BOYAmt
EOY	$74,158,049	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$48,187,394	BOYAmt
EOY	$57,660,941	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$19,894,133	BOYAmt
EOY	$21,836,144	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$757,850	BOYAmt
EOY	$1,905,292	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$176,594,804	BOYAmt
EOY	$184,385,472	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$12,608,818	BOYAmt
EOY	$12,027,320	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$5,824,782	BOYAmt
EOY	$7,486,583	EOYAmt

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$54,673,726	BOYAmt
EOY	$54,408,717	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$685,833	BOYAmt
EOY	$1,013,224	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$19,850,020	BOYAmt
EOY	$24,798,061	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$93,696,478	BOYAmt
EOY	$99,733,905	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	$82,898,326	BOYAmt
EOY	$84,651,567	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$82,898,326	BOYAmt
EOY	$84,651,567	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$176,594,804	BOYAmt
EOY	$184,385,472	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$19,334,063	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$2,190,952	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$19,771,774	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	0	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)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$4,117	GrantsOtherOrganizationsAmt
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$4,117	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,144,680	OtherCostOrOtherBasisAmt
Book Value	$2,144,680	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$138,105,994	OtherCostOrOtherBasisAmt
Depreciation	$81,509,655	DepreciationAmt
Book Value	$56,596,339	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$68,461,228	OtherCostOrOtherBasisAmt
Depreciation	$56,254,348	DepreciationAmt
Book Value	$12,206,880	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,210,150	OtherCostOrOtherBasisAmt
Book Value	$3,210,150	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$74,158,049	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	ALTERNATIVE INVESTMENTS	Desc
Book Value	$21,836,144	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$21,836,144	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)

DescDesc	AmtAmt
ACCRURED MEDICARE ADVANCED PAYMENT	$11,009,505
PENSION OBLIGATION	$6,202,368
MALPRACTICE INSURANCE	$2,430,356
LOAN GUARANTEE & OTHER LTL	$1,611,870
DEFERRED COMPENSATION	$1,202,367
DUE TO AFFILIATES	$1,134,399
SETTLEMENT - 3RD PARTY PAYOR	$715,248
WORKER'S COMP RESERVE	$225,671
OTHER	$266,277

Field	Value	IRS element (for citing)
Total Liability	$24,798,061	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 2020 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), *GOOD SAMARITAN HOSPITAL, UVMC MANAGEMENT CORPORATION (SUBSIDIARIES OF PHP) AND AFTER-HOURS FAMILY CARE, INC. (SUBSIDIARY OF UVPC). MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS.	ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	CENTRAL AMERICA AND THE CARIBBEAN	RegionTxt
Offices	0	OfficesCnt
Employee	0	EmployeeCnt
Type Of Activities Conducted	PROGRAM SERVICES	TypeOfActivitiesConductedTxt
Specific Services Provided	INSURANCE	SpecificServicesProvidedTxt
Region Total Expenditures	$25,000	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$25,000	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$25,000	TotalSpentAmt
Transfer To Foreign Corp	0	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	0	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART III ACCOUNTING METHOD:	FormAndLineReferenceDesc

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,085,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,329,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,756,000	NetCommunityBenefitExpnsAmt
Total Expense	0.01330	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$69,066,900	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$56,366,900	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,700,000	NetCommunityBenefitExpnsAmt
Total Expense	0.09610	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,007,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,432,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$575,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00430	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$74,158,900	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$59,127,900	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,031,000	NetCommunityBenefitExpnsAmt
Total Expense	0.11370	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$427,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$106,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$321,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00240	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,383,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,383,000	NetCommunityBenefitExpnsAmt
Total Expense	0.02560	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,776,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,776,000	NetCommunityBenefitExpnsAmt
Total Expense	0.05130	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,586,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$106,000	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,480,000	NetCommunityBenefitExpnsAmt
Total Expense	0.07930	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$84,744,900	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$59,233,900	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,511,000	NetCommunityBenefitExpnsAmt
Total Expense	0.19300	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$6,277,741	BadDebtExpenseAmt
Reimbursed By Medicare	$26,668,000	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$31,221,000	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$4,553,000	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 (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	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	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	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 (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	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 (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	20	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	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 (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	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 (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION A, LINE 1:	THE STATE OF OHIO DOES NOT LICENSE HOSPITALS, BUT THE OHIO DEPARTMENT OF HEALTH DOES REGISTER HOSPITALS. AS PART OF THIS REGISTRATION PROCESS, HOSPITALS IN THE STATE OF OHIO ARE REQUIRED TO COMPLETE AND SUBMIT THE ANNUAL HOSPITAL REGISTRATION AND PLANNING REPORT (AHR) EACH CALENDAR YEAR. 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 ALLACE, 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 SERVICESCHRONIC DISEASEHEALTHY BEHAVIORSSUBSTANCE ABUSE AND MENTAL HEALTHACCESS TO CARE/SERVICES ER VIRTUAL CARE METRICS: NUMBER OF NEW SITES, NUMBER OF RESIDENTS SERVED, REASON FOR CONSULTATIONS, EMERGENCY DEPARTMENT TRANSFERS/HOSPITALIZATION RATES, AND PATIENT AND CLINICIAN SATISFACTION.HEALTH ISSUE: AS NURSING FACILITIES ARE CALLED UPON TO CARE FOR HIGHER-ACUITY PATIENTS AND DRIVE BETTER OUTCOMES AT A FRACTION OF THE COST OF A HOSPITALIZATION, SYSTEMS ARE REQUIRED THAT DELIVER QUALITY PHYSICIANS TO THE BEDSIDE AT TIMES OF CHANGE OF CONDITION.INTERVENTION'S GOAL: THE GOAL OF THE PROGRAM IS TO FACILITATE EARLY TREATMENT OF CONDITIONS, REDUCE EMERGENCY ROOM TRANSFERS AND HOSPITALIZATIONS, AND REDUCE CARE COSTS FOR RESIDENTS. THE LONG-TERM PLAN IS TO EXPAND ER VIRTUAL CARE TO NURSING FACILITIES ACROSS OUR MARKET AND EXPAND SERVICE OFFERINGS TO INCLUDE SPECIALTIES SUCH AS NEUROLOGY, WOUND CARE, AND BEHAVIORAL HEALTH.DESCRIPTION: VIDEO CONSULTATION WITH A DOCTOR CAN EXPEDITE EVALUATION OR TREATMENT FOR PATIENTS AT NURSING FACILITIES OR AT HOME. ER VIRTUAL CARE USES REAL-TIME VIDEO AND AUDIO FOR AN EMERGENCY MEDICINE PHYSICIAN TO TREAT A PATIENT REMOTELY. BY REMOVING GEOGRAPHICAL BOUNDARIES, THE HOSPITAL CAN LEVERAGE AVAILABLE PROVIDERS FROM A DISTANCE TO PROVIDE SUPPORT AND TREAT PATIENTS. THIS TELEMEDICINE SOLUTION CAN HELP ADDRESS UNNECESSARY TRANSFER OF NURSING HOME AND ASSISTED LIVING RESIDENTS TO HOSPITALS BY ALLOWING ACCESS TO EMERGENCY MEDICINE SPECIALISTS FOR AFTER HOUR AND WEEKEND COVERAGE.BACKGROUND: THE CLOSURE OF GOOD SAMARITAN HOSPITAL LED TO AN INCREASED DEMAND IN SERVICES AT MVH-NORTH. CLINICAL AND OPERATIONAL LEADERSHIP IDENTIFIED AN OPPORTUNITY TO LEVERAGE TELEMEDICINE AND HELP TREAT PATIENTS THAT PRESENT WITH LOW ACUITY SYMPTOMS TO EXPEDITE TREATMENT AND REDUCE WAIT TIMES. INITIAL RESULTS ON UTILIZATION AND PATIENT SATISFACTION WERE POSITIVE AND EXPANDED PREMIER HEALTH'S SCOPE FOR INCLUSION OF COMMUNITY PARTNER FACILITIES. NURSING FACILITIES ARE CHALLENGED WITH CARING FOR HIGHER ACUITY PATIENTS. THE SERVICE PROMOTES PREMIER HEALTH'S MISSION IN PROVIDING HIGHEST QUALITY OF CARE AT THE RIGHT TIME AND RIGHT PLACE.PARTNERS: MIAMI VALLEY EMERGENCY SPECIALISTS, SPRINGMEADE HEALTH CENTER, AND KOESTER PAVILION.
PART V, SECTION B, LINE 11: (CONTINUED)	ACCESS TO CARE/SERVICES SUPPORT FOR MIAMI COUNTY DENTAL CLINICHEALTH ISSUE: MIAMI COUNTY HAS ABOUT 50% FEWER DENTISTS PER CAPITA THAN THE NATION. NOT ALL DENTISTS ACCEPT PATIENTS WITH MEDICAID AND/OR MEDICARE, FURTHER NARROWING THE OPTIONS.INTERVENTION'S GOAL: THE GOAL IS TO ENSURE ORAL HEALTH CARE FOR UNDERSERVED AND UNINSURED OR UNDER-INSURED RESIDENTS. DESCRIPTION: THE MIAMI COUNTY DENTAL CLINIC IS DEDICATED TO PROVIDING QUALITY DENTAL CARE AND ORAL HEALTH EDUCATION TO THOSE IN THE COMMUNITY BENEFITING FROM AFFORDABLE, COMPASSIONATE AND ACCESSIBLE DENTAL SERVICES. SERVICES ARE FREE FOR THOSE WITH MEDICAID OR UNINSURED.BACKGROUND: UPPER VALLEY MEDICAL CENTER HAS FUNDED A NEW VAN FOR A TRAVELING DENTAL UNIT. IT OFFERS A FULL RANGE OF ORAL HEALTH CARE AND EDUCATION, TRAVELING TO SCHOOLS DURING THE ACADEMIC YEAR. THE VAN TRAVELS TO COMMUNITY LOCATIONS, SUCH AS SOUP KITCHENS, WHEN SCHOOL IS NOT IN SESSION.PARTNERS: UPPER VALLEY MEDICAL CENTER AND MIAMI COUNTY DENTAL CLINIC
PART V, SECTION B, LINE 11: (CONTINUED)	ACCESS TO CARE/SERVICES AND CHRONIC DISEASECOMMUNITY HEALTH VOUCHER PROGRAM METRICS: FOR THE 3-YEAR PERIOD, A PROJECTED 275 WOMEN SYSTEM-WIDE WILL BE SERVED BY THE PROGRAM. AT UPPER VALLEY MEDICAL CENTER, IT IS ESTIMATED THAT 22 WOMEN WILL BE SERVED BY THE PROGRAM. THE ENROLLMENT NUMBERS FOR CLIENTS WHO RECEIVE SERVICES AT UPPER VALLEY MEDICAL CENTER HAS REMAINED STEADY REGARDLESS OF CHANGES IN BCCP ELIGIBILITY AND THE HEALTHCARE MARKETPLACE. HOWEVER, PREMIER HEALTH IS CURRENTLY TRYING TO ESTABLISH CONTRACTS WITH PROVIDERS AT UPPER VALLEY MEDICAL CENTER FOR CERVICAL SERVICES. IF THIS IS ACCOMPLISHED, THE NUMBER OF WOMEN SERVED MAY INCREASE. HEALTH ISSUE: THIS PROGRAM SUPPLEMENTS THE STATE OF OHIO'S FUNDING TO ENCOURAGE WOMEN TO BE SCREENED FOR BREAST CANCER AND CERVICAL CANCER. IT PROVIDES FINANCIAL ASSISTANCE TO WOMEN WHO ARE NOT ELIGIBLE FOR THE STATE PROGRAM, AND IT ALSO COVERS DIAGNOSTIC TESTING AND BIOPSIES.INTERVENTION'S GOAL: THE MISSION OF THE VOUCHER PROGRAM IS TO PROVIDE FINANCIAL ASSISTANCE TO DETECT BREAST AND CERVICAL CANCERS AT THE EARLIEST STAGE TO UNINSURED AND UNDER-INSURED COMMUNITY RESIDENTS.DESCRIPTION: THE FOLLOWING SERVICES ARE COVERED BY THIS PROGRAM: SCREENING MAMMOGRAMS; DIAGNOSTIC MAMMOGRAMS; BREAST ULTRASOUNDS; BREAST BIOPSY; SURGICAL CONSULT (BREAST); PAP TESTS; CLINICAL BREAST EXAMS; COLPOSCOPIES; AND EDUCATIONAL MATERIALS.BACKGROUND: THIS PROGRAM IS FUNDED THROUGH THE UPPER VALLEY MEDICAL CENTER FOUNDATION AND OTHER COMMUNITY DONATIONS. CLIENTS MUST BE UNINSURED OR UNDERINSURED (COPAYMENT, DEDUCTIBLE, COINSURANCE) WITH INCOME AT OR BELOW 400% OF FEDERAL POVERTY LEVEL.PARTNERS: ATRIUM MEDICAL CENTER, GOOD SAMARITAN FOUNDATION-DAYTON, UPPER VALLEY MEDICAL CENTER FOUNDATIONS, MIAMI VALLEY HOSPITAL FOUNDATION (HELP HER FIGHT), KROGER, BREAST CANCER FOUNDATION, AND KUHNS BROTHERS
PART V, SECTION B, LINE 11: (CONTINUED)	INFANT MORTALITYHEALTHCARE COPE (COST OF POVERTY EXPERIENCE) TRAININGMETRICS: PRE-, POST- AND FOLLOW-ON-SURVEYS ARE ADMINISTERED TO PARTICIPANTS AND VOLUNTEERS TO EVALUATE THEIR PERCEPTIONS OF POVERTY. THE PRE- AND POST-SURVEYS OCCUR AS PEOPLE ENTER THE EVENT AND THEN FOLLOWING THE DEBRIEF. THE FOLLOW-ON SURVEY IS SENT LATER.HEALTH ISSUE: INFANT MORTALITY FOR BLACK INFANTS IN MONTGOMERY COUNTY IS DISPROPORTIONATELY HIGHER THAN FOR WHITE INFANTS. THIS IS THE FIFTH WORSE RATE IN OHIO. PREMATURITY ACCOUNTS FOR 50% OF THE DEATHS OF BLACK INFANTS. MATERNAL STRESS IS A SIGNIFICANT FACTOR IN PREMATURE LABOR, AND BLACK MOTHERS FACE MULTIPLE STRESSORS FROM DAILY ENCOUNTERS WITH RACISM. THE LACK OF PROGRESS IN THE REGION TO COMBAT INFANT MORTALITY LEADS TO THIS DEEPER LEVEL OF TRAINING FOR MATERNITY NURSING STAFF AND HOSPITAL LEADERS.INTERVENTION'S GOAL: THE GOAL IS TO IMPROVE INTERACTIONS WITH LOW-INCOME AND MINORITY FAMILIES TO ENSURE CULTURALLY APPROPRIATE AND TRAUMA-INFORMED CARE IS CONSISTENTLY DELIVERED.DESCRIPTION: PARTICIPATION DEEPENS THE UNDERSTANDING OF THE REALITIES OF POVERTY AND IMPLICIT BIAS; IMPROVES PROFESSIONAL APPROACH AND CONNECTIONS; DEVELOPS PRACTICES TO HELP BRIDGE THE HEALTH EQUITY GAP; AND BUILDS PARTNERSHIPS WITH THE COMMUNITY TO IMPROVE HEALTH OUTCOMES. TEN COPE TRAINING SESSIONS WILL INVOLVE 428 PARTICIPANTS, OF WHOM 85% WILL BE NURSES. THE PROGRAM STARTED IN JANUARY 2020 AND CONCLUDES IN APRIL 2020. PREMIER HEALTH CURRENTLY HAS TWO TRAINED COPE FACILITATORS AND THE NECESSARY EQUIPMENT. PART OF THE PROGRAM WILL BE TO TRAIN TWO MORE COPE FACILITATORS.BACKGROUND: COPE IS A TOOL THAT HELPS HOSPITALS BUILD A CULTURE AND INFRASTRUCTURE TO DELIVER CARE THAT IS EQUITABLE FOR ALL PATIENT POPULATIONS. A HEALTHCARE VERSION IS TARGETED FOR HEALTH PROFESSIONALS.PARTNER: THINK TANK AND SAMARITAN BEHAVIORAL HEALTH INC.
PART V, SECTION B, LINE 11: (CONTINUED)	CHRONIC DISEASE AND HEALTHY BEHAVIORS BARBERSHOP PROGRAMMETRICS: EXPANSION TO TWO ADDITIONAL SITES: MIDDLETOWN AND MIAMI COUNTYHEALTH ISSUE: THERE ARE HEALTH DISPARITIES, ESPECIALLY FOR CHRONIC DISEASES, FOR THE AFRICAN-AMERICAN COMMUNITY. ACCORDING TO THE CDC, "NEW ANALYSIS SHOWS THAT YOUNGER AFRICAN-AMERICANS ARE LIVING WITH OR DYING OF MANY CONDITIONS TYPICALLY FOUND IN WHITE AMERICANS AT OLDER AGES. CHRONIC DISEASES AND SOME OF THEIR RISK FACTORS MAY BE SILENT OR NOT DIAGNOSED DURING THESE EARLY YEARS. HEALTH DIFFERENCES ARE OFTEN DUE TO ECONOMIC AND SOCIAL CONDITIONS THAT ARE MORE COMMON AMONG AFRICAN-AMERICANS THAN WHITES. FOR EXAMPLE, AFRICAN-AMERICAN ADULTS ARE MORE LIKELY TO REPORT THEY CANNOT SEE A DOCTOR BECAUSE OF COST."INTERVENTION'S GOAL: THE GOAL IS TO INCREASE AWARENESS OF CHRONIC HEALTH CONDITIONS AND TO PROMOTE HEALTHY LIFESTYLE CHOICES WITHIN THE AFRICAN-AMERICAN COMMUNITY. DESCRIPTION: PARTNERING WITH THE LOCAL HEALTH DEPARTMENT, PUBLIC HEALTH-DAYTON & MONTGOMERY COUNTY, WILL HELP TO FURTHER EXPAND SERVICES FOR THE COMMUNITY. BARBERS (AND SALON OWNERS) HAVE A CLOSE BOND WITH THEIR CLIENTS. THEY CAN SERVE AS MODELS OF GOOD HEALTH AND/OR HELP CONNECT THEIR CLIENTS TO HEALTH SERVICES. THE PROGRAM PROVIDES FREE, VOLUNTARY, AND CONVENIENT HEALTH SCREENINGS ON SATURDAYS AT THE SHOPS. HEALTH FAIRS, EVENTS, AND FUN CHALLENGES ALSO OCCUR.BACKGROUND: PREMIER HEALTH DEVELOPED THE BARBERSHOP HEALTH PROGRAM, WHICH NOW HAS 5 LOCATIONS. ATRIUM MEDICAL CENTER IS INTERESTED IN EXPANDING TO INCLUDE ONE OR MORE LOCATIONS IN THE HAMILTON AND MIDDLETOWN AREAS, ALONG WITH EXPANSION TO MIAMI COUNTY FOR THE UPPER VALLEY MEDICAL CENTER. THE ORIGINAL 3 BARBERSHOPS RESULTED IN 249 SCREENINGS.PARTNERS: DEEEZ CUTTZ, SERENITY SALON, MAN UP
PART V, SECTION B, LINE 11: (CONTINUED)	SUBSTANCE ABUSE AND MENTAL HEALTHPRESTO (PROMOTING ENGAGEMENT FOR SAFE TRAINING OF OPIOIDS)METRICS: ATTRACT AT LEAST 38 PRIMARY CARE PROVIDERS TO PARTICIPATE IN THE RESEARCH STUDY. THEIR PARTICIPATION WILL HELP THE RESEARCHERS TEST AND DEVELOP AN EFFICIENT AND EFFECTIVE PROTOCOL TO GUIDE OTHER PROVIDERS.HEALTH ISSUE: OHIO IS ONE OF THE STATES HARDEST HIT BY THE NATION'S OPIOID CRISIS. OHIO'S RATE OF UNINTENTIONAL OPIOID OVERDOSE RATE WAS NEARLY THREE TIMES THE U.S. AVERAGE IN 2017. ACCORDING TO THE OHIO DEPARTMENT OF HEALTH, 80% OF OHIOANS WHO DIED FROM AN OVERDOSE IN 2016 HAD A HISTORY OF OPIOID PRESCRIPTIONS.INTERVENTION'S GOAL: PREMIER HEALTH WILL RECRUIT SYSTEM-WIDE TO ATTRACT AT LEAST 38 OF THE 150 PRIMARY CARE PROVIDERS THAT WRIGHT STATE UNIVERSITY WILL TRAIN IN HOW TO ENGAGE PATIENTS TO TAPER DOWN THEIR OPIOID PRESCRIPTION USE.DESCRIPTION: THE PRESTO PROTOCOL IS MODELED ON THE SBIRT APPROACH OF SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT. IT INCORPORATES CDC OPIOID PRESCRIBING GUIDELINES, USE OF OHIO'S PRESCRIPTION DRUG MONITORING PROGRAM, AND MOTIVATIONAL INTERVIEWING. PARTICIPATING PROVIDERS WILL AGREE TO PARTICIPATE IN THE OHIO AUTOMATED RX REPORTING SYSTEM (OARRS) AND HAVE DE-IDENTIFIED PRESCRIBING DATA SHARED WITH INVESTIGATORS. THEY WILL PARTICIPATE IN A 3- HOUR IN-PERSON TRAINING EVENT AS WELL AS A 1-HOUR FOLLOW-UP TRAINING ABOUT 4-6 WEEKS LATER. THEY WILL BE ENCOURAGED TO USE THE PRESTO PROTOCOL AND MOTIVATIONAL INTERVIEWING WITH APPROPRIATE PATIENTS. EACH PROVIDER WILL RECEIVE $1,000 FOR COMPLETION OF THE TWO TRAINING EVENTS TO ASSIST WITH THE COST OF ATTENDING. THEY WILL ALSO RECEIVE 3 HOURS OF CONTINUING EDUCATION CREDITS. FULL IMPLEMENTATION IS EXPECTED IN LATE 2020 OR EARLY 2021.BACKGROUND: THE OHIO DEPARTMENT OF HIGHER EDUCATION AWARDED FUNDING TO RESEARCH SUBSTANCE USE DISORDERS. WRIGHT STATE UNIVERSITY RECEIVED AN AWARD TO TRAIN PRIMARY CARE PROVIDERS IN A PRESCRIPTION-TAPERING PROTOCOL KNOWN AS PRESTO.PARTNERS: MERCY HEALTH, WRIGHT STATE UNIVERSITY
PART V, SECTION B, LINE 11: (CONTINUED)	SUBSTANCE ABUSE AND MENTAL HEALTHSUPPORT FOR HOPE HOUSE AND SAMARITAN BEHAVIORAL HEALTH INCMETRICS: NUMBER OF RESIDENTS ASSISTED THROUGH HOPE HOUSE. NUMBER OF PATIENTS SEEN BY SBHI NURSE PRACTITIONER OR PSYCHIATRIST.HEALTH ISSUE: THE STATE OF OHIO HAS ONE OF THE HIGHEST RATES OF OPIOID PRESCRIPTIONS IN THE NATION, ACCORDING TO THE NATIONAL INSTITUTE ON DRUG ABUSE. AS THE OPIOID CRISIS GREW, MIAMI COUNTY REALIZED THAT IT NEEDED TO UTILIZE ALL ITS RESOURCES AND WORK TOGETHER AS A COMMUNITY.INTERVENTION'S GOAL: TO CONNECT INDIVIDUALS WITH ADDICTION OR MENTAL ILLNESS WITH COMMUNITY RESOURCES AND APPROPRIATE LEVELS OF TREATMENT INSTEAD OF VISITING A HOSPITAL EMERGENCY DEPARTMENT.DESCRIPTION: UPPER VALLEY MEDICAL CENTER PARTNERS WITH MIAMI COUNTY RECOVERY COUNCIL (MCRC) TO PROVIDE SUPPORT FOR HOPE HOUSE, WHICH IS A RESIDENTIAL TREATMENT FACILITY WHERE ADULTS CAN STAY AS THEY TAKE THEIR FIRST STEPS TO RECOVERY. UPPER VALLEY MEDICAL CENTER HAS PARTNERED WITH MCRC TO SUPPORT A PART-TIME SOCIAL WORKER PRESENCE IN THE EMERGENCY DEPARTMENT WHOSE ROLE IS TO LINK IDENTIFIED DISCHARGED EMERGENCY DEPARTMENT PATIENTS WITH OUTPATIENT BEHAVIORAL PROVIDERS AND OTHER COMMUNITY SERVICES. UPPER VALLEY ALSO PROVIDES FINANCIAL SUPPORT TO SAMARITAN BEHAVIORAL HEALTH INC. TO EMPLOY A NURSE PRACTITIONER AND A CHILD PSYCHIATRIST TO MEET THE PHYSICAL AND MENTAL NEEDS OF PATIENTS.BACKGROUND: MCRC IS A NON-PROFIT AGENCY THAT PROVIDES SERVICES TO THOSE STRUGGLING WITH ADDICTION AND MENTAL HEALTH ISSUES. IT OPERATES HOPE HOUSE, A MEDICALLY-SUPERVISED RESIDENTIAL 10-14 DAY PROGRAM FOR THE ACUTE STAGES OF OPIATE WITHDRAWAL. SAMARITAN BEHAVIORAL HEALTH INC. IS A COMPREHENSIVE OUTPATIENT CENTER.PARTNERS: ADAMHS BOARD, SAMARITAN BEHAVIORAL HEALTH INC., MIAMI COUNTY RECOVERY COUNCIL, TRI-COUNTY BOARD OF RECOVERY AND MENTAL HEALTH SERVICES
PART V, SECTION B, LINES 16 A, B, AND C:	THE DIRECT WEBSITE ADDRESS WHERE A COPY OF THE FINANCIAL ASSISTANCE POLICY, THE APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY CAN BE ACCESSED IS:HTTPS://WWW.PREMIERHEALTH.COM/PATIENT-AND-VISITOR-GUIDE/PATIENT-GUIDE/COSTS-AND-INSURANCE/BILLING/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16J:	THE HOSPITAL WIDELY DISTRIBUTES INFORMATION ABOUT ITS FINANCIAL ASSISTANCE POLICY WITHIN THE AREA THAT IT SERVES. THIS INFORMATION INCLUDES THE METHOD OF APPLYING FOR AND ACCESSING FINANCIAL ASSISTANCE. NOTICES ARE PUBLICIZED IN PATIENTS' BILLS AND ARE POSTED IN THE EMERGENCY ROOM, ADMITTING AND REGISTRATION AREAS, AS WELL AS OTHER PUBLIC AREAS. THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED ON THE HOSPITAL'S WEBSITE. FINANCIAL COUNSELORS, PATIENT ADVOCATES, AND CUSTOMER SERVICE REPRESENTATIVES DISCUSS THE FINANCIAL ASSISTANCE POLICY WITH ALL UNINSURED PATIENTS, AND ANY PATIENT WHO EXPRESSES FINANCIAL HARDSHIP WITH PAYING THEIR BILL. APPLICATIONS FOR FINANCIAL ASSISTANCE POLICY ARE AVAILABLE IN BOTH ENGLISH AND SPANISH.

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
1 - HYATT CENTER
450 N HYATT ST	TIPP CITY	OH	45371	DIAGNOSTICS AND IMAGING, SPORTS MEDICINE, PEDIATRICS, OUTPATIENT SURGERY
2 - OUTPATIENT CARE CENTER NORTH
280 LOONEY RD	PIQUA	OH	45356	DIAGNOSTICS AND IMAGING, REHABILITATIVE THERAPY PEDIATRICS
3 - OUTPATIENT CARE CENTER SOUTH
998 S DORSET RD	TROY	OH	45373	DIAGNOSTICS AND IMAGING,OCCUPATIONAL HEALTH,REHABILITATIVE THERAPY
4 - STANFIELD PLACE
31 STANFIELD RD	TROY	OH	45373	IMAGING, ENT, LABORATORY RHEUMATOLOGY
5 - UVMC SIDNEY CENTER
1529 FAIR RD	SIDNEY	OH	45365	PHYSICAL THERAPY, WOMEN'S SERVICES

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	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 2020, THE AMOUNT PAID FOR CALL AND SUBSIDIES WAS $3,315,000.
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 $22,595,000 AND INCURRED COST OF $37,825,000, FOR AN ADDITIONAL NET SHORTFALL OF $15,230,000 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) $26,668,000MEDICARE REVENUE NOT REPORTED IN PART III, SECTION B $22,595,000TOTAL MEDICARE ASSOCIATED REVENUE $49,263,000ALLOWABLE MEDICARE COST PER MEDICARE COST REPORT (PART III, SECTION B) $31,221,000MEDICARE COST NOT REPORTED IN PART III, SECTION B $37,825,000TOTAL MEDICARE ASSOCIATED COST $69,046,000MEDICARE SHORTFALL PER PART III, SECTION B $ 4,553,000ADDITIONAL SHORTFALL NOT INCLUDED IN PART III, SECTION B $15,230,000TOTAL MEDICARE SHORTFALL $19,783,000
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 49.2% 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 ECONOMICALLYDISADVANTAGED, 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, LINE 4:	UPPER VALLEY SERVES THE NORTHERN MIAMI VALLEY AREA WITH ACUTE CARE SERVICES, COMMUNITY HEALTH AND WELLNESS PROGRAMS AND MORE. UPPER VALLEY IS LOCATED IN MIAMI COUNTY, OHIO AND IS THE SOLE HOSPITAL SYSTEM OPERATING WITHIN THE COUNTY. THE POPULATION OF UPPER VALLEY'S PRIMARY SERVICE AREA IS APPROXIMATELY 103,000 PEOPLE. INCLUDING THE ADJACENT COUNTIES, WHICH ARE ALSO SERVED (SHELBY, DARKE, AND CHAMPAIGN COUNTIES), UPPER VALLEY'S TOTAL PRIMARY AND SECONDARY SERVICE AREA POPULATION APPROACHES 245,000 RESIDENTS. THE OVERALL SERVICE AREA IS CATEGORIZED AS HAVING RELATIVELY SLOW GROWTH WITH AN AGING POPULATION, CONSISTENT WITH CURRENT TRENDS THROUGHOUT OHIO. THE MEDIAN HOUSEHOLD INCOME OF MIAMI COUNTY AND THE SURROUNDING AREA IS SLIGHTLY ABOVE $61,000 PER YEAR, WITH APPROXIMATELY 9.0% OF ITS CITIZENS LIVING BELOW THE FEDERAL POVERTY LEVEL. APPROXIMATELY 49.2% OF THE HOSPITAL'S GROSS REVENUES ARE GENERATED FROM MEDICARE PATIENTS, WHILE ANOTHER 16.9% OF THE REVENUES ARE GENERATED FROM EITHER UNINSURED PATIENTS OR MEDICAID RECIPIENTS. THE CURRENT UNEMPLOYMENT RATE OF MIAMI COUNTY IS APPROXIMATELY 5.2%.
PART VI, LINE 5:	UPPER VALLEY'S MOST VISIBLE CONTRIBUTION TO THE COMMUNITY IS IN THE FORM OF PROVIDING HIGH-QUALITY INPATIENT AND OUTPATIENT CARE TO OUR PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. OUR MISSION INCLUDES CONTINUALLY STRIVING TO ENRICH THE COMMUNITY BY TRAINING AND EDUCATING FUTURE HEALTHCARE WORKERS, OFFERING HEALTH AWARENESS AND EDUCATION TO THE COMMUNITY, SUCH AS PROMOTION OF BREAST CANCER SCREENINGS, WOMEN AND INFANT HEALTH, DIABETIC WELLNESS AND DRIVER SAFETY AWARENESS FOR HIGH-SCHOOL STUDENTS. THE HOSPITAL ALSO PROVIDES RELEVANT EDUCATION FOR EMS AND PRE-HOSPITAL CARE PROVIDERS THROUGHOUT THE REGION. THE TRAINING INCLUDES LOCAL CASE REVIEWS, LECTURES, HANDS-ON SIMULATION AND PANEL DISCUSSIONS PERTAINING TO THE EDUCATION ON USE OF TOOLS, PRIORITIES OF PATIENT CARE AND OTHER CRITICAL INFORMATION. UPPER VALLEY PARTNERS WITH MANY OF THE LOCAL SCHOOLS TO PROVIDE CERTIFIED AND LICENSED ATHLETIC TRAINERS AT THEIR CAMPUSES TO AID IN INJURY PREVENTION, RECOGNITION AND TREATMENT OF SPORTS-RELATED INJURIES. THE HOSPITAL ALSO SUPPORTS THE COMMUNITY THROUGH SPONSORSHIPS AND PARTICIPATION IN LOCAL FUNDRAISING EVENTS THAT PROMOTE HEALTHY LIFESTYLE CHOICES, PREVENTATIVE CARE, CHRONIC DISEASE MANAGEMENT AND GENERAL HEALTH EDUCATION. THE HEALTH SCIENCES LIBRARY AT UPPER VALLEY IS OPEN TO THE PUBLIC DURING NORMAL BUSINESS HOURS, OR BY MAKING SPECIAL ARRANGEMENTS WITH THE LIBRARIAN. A HEALTH EDUCATION CENTER, ADJACENT TO THE LIBRARY, OFFERS EDUCATION MATERIALS TO HELP PROMOTE WELLNESS AND UNDERSTANDING ABOUT DISEASES. INFORMATION IS AVAILABLE VIA COMPUTER, VIDEOS, AND PAMPHLETS. WITHIN THE HOSPITAL, INTERPRETERS ARE OFFERED TO PATIENTS AT NO COST AS A RESULT OF INCREASED VOLUMES OF NON-ENGLISH-SPEAKING PATIENTS. UPPER VALLEY PROVIDES SPIRITUAL AND EMOTIONAL SUPPORT AND SERVICES TO PATIENTS AND THEIR FAMILY MEMBERS UTILIZING 7 TRAINED PROFESSIONAL CHAPLAINS, 24 HOURS A DAY, 7 DAYS A WEEK.THE HOSPITAL HAS AN OPEN MEDICAL STAFF, PARTICIPATES IN MEDICAID AND MEDICARE, AND HAS AN ACTIVE CHARITY CARE PROGRAM. UPPER VALLEY'S MISSION REFLECTS A COMMITMENT TO PROVIDE HIGH-QUALITY COST-EFFECTIVE HEALTH SERVICES TO THE DIVERSE COMMUNITIES THAT IT SERVES. AT THE CORE OF THE COMMITMENT IS THE BELIEF THAT IN ORDER TO MEET OUR PATIENTS' EXPECTATIONS AND TO IMPROVE TREATMENT OUTCOMES, IT IS NECESSARY FOR US TO UNDERSTAND THE PATIENT'S FRAME OF REFERENCE. A DIVERSE WORKFORCE ALLOWS US TO DRAW UPON THE RICHNESS OF OUR HUMAN RESOURCES, CREATE A POSITIVE WORK ENVIRONMENT, AND MEET THE EXPECTATIONS OF THOSE WE SERVE. UPPER VALLEY'S COMMITMENT TO DIVERSITY IS ACCOMPLISHED BY:* TAKING A LEADERSHIP ROLE IN CREATING AND SUSTAINING AN ORGANIZATIONAL ENVIRONMENT THAT ACTIVELY SUPPORTS DIVERSITY,* POSITIONING DIVERSITY AS A LONG-TERM COMPREHENSIVE ORGANIZATIONAL STRATEGY,* ESTABLISHING AND SUPPORTING RELATIONSHIPS WITH MINORITY AND DIVERSITY FOCUSED ORGANIZATIONS AND* PROVIDING EMPLOYMENT AND EDUCATION OPPORTUNITIES FOR INDIVIDUALS WITH SIGNIFICANT DISABILITIES.
PART VI, LINE 6:	PREMIER HEALTH (PREMIER) IS THE SOLE MEMBER OF UPPER VALLEY MEDICAL CENTER, TWO OTHER HOSPITAL ENTITIES (FIVE TOTAL LOCATIONS), AND SEVERAL OTHER HEALTH CARE SERVICE SUBSIDIARIES. PREMIER HAS THE AUTHORITY TO OPERATE EACH HOSPITAL WITH RESPECT TO MATTERS SUCH AS BUDGETING, STRATEGIC PLANNING, MANAGED CARE CONTRACTING, EMPLOYEE COMPENSATION, TRANSFER/SALE OF MATERIAL ASSETS, ETC. AS AN INTEGRATED HEALTHCARE SYSTEM, PREMIER PROVIDES A CONTINUUM OF CARE FOR THE RESIDENTS OF SOUTHWEST OHIO. AS A SYSTEM, PREMIER IS A COMMUNITY LEADER IN SUPPORTING VARIOUS COMMUNITY BENEFIT PROGRAMS THAT ALIGN WITH ITS CURRENT CHNA. RESOURCES ARE LEVERAGED IN EACH ENTITY WITHIN THE PREMIER SYSTEM TO SUPPORT THESE PROGRAMS IDENTIFIED AT THE PREMIER SYSTEM LEVEL. THE POLICIES FOR BAD DEBT AND CHARITY COLLECTIONS ARE ESTABLISHED BY PREMIER.
PART VI, LINE 7:	OHIO

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (19 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
MIAMI COUNTY YMCA
223 W HIGH ST	PIQUA	OH	45356	310537179	501(C)(3)	$5,000,605	SUPPORT
LINCOLN COMMUNITY CENTER
110 ASH ST	TROY	OH	45373	310584315	501(C)(3)	$1,000,475	SUPPORT
ARBOGAST PERFORMING ARTS
700 S DORSET RD	TROY	OH	45373	830889260	501(C)(3)	$750,000	SUPPORT
CITY OF PIQUA OHIO
201 W WATER STREET	PIQUA	OH	45356	316000136	GOV	$283,000	SUPPORT
ONEFIFTEEN RECOVERY
6636 LONGSHORE ST 200	DUBLIN	OH	43017	833504845	501(C)(3)	$219,997	SUPPORT
FAMILY ABUSE SHELTER OF MIAMI COUNTY
16 E FRANKLIN ST	TROY	OH	45373	310966177	501(C)(3)	$200,600	SUPPORT
SAMARITAN BEHAVIORAL HEALTH
110 N MAIN ST SUITE 500	DAYTON	OH	45402	020633634	501(C)(3)	$106,000	SUPPORT
MIAMI COUNTY RECOVERY COUNCIL INC
1059 N MARKET ST	TROY	OH	45373	310917327	501(C)(3)	$105,000	SUPPORT
HEALTH PARTNERS FREE CLINIC
1300 N CO RD 25A	TROY	OH	45373	311596731	501(C)(3)	$96,540	SUPPORT
MIAMI COUNTY DENTAL CLINIC
70 TROY TOWN DR	TROY	OH	45373	204901192	501(C)(3)	$80,138	SUPPORT
MIAMI VALLEY HOSPITAL
110 N MAIN ST 500	DAYTON	OH	45402	310537504	501(C)(3)	$73,206	SUPPORT
ATRIUM MEDICAL CENTER
110 N MAIN ST 500	DAYTON	OH	45402	311079309	501(C)(3)	$17,466	SUPPORT
TROY COMMUNITY DEVELOPMENT
405 SW PUBLIC SQ 330	TROY	OH	45373	311736034	501(C)(3)	$15,000	SUPPORT
TROY AREA CHAMBER OF COMMERCE
405 SW PUBLIC SQ	TROY	OH	45373	310529268	GOV	$10,575	SUPPORT
MIAMI VALLEY HOSPITAL FOUNDATION
110 N MAIN ST 500	DAYTON	OH	45402	311040231	501(C)(3)	$7,233	SUPPORT
MIAMI COUNTY COMMISSIONERS
201 W MAIN ST	TROY	OH	45373	316000055	GOV	$5,574	SUPPORT
HOMEFULL
33 W FIRST ST 100	DAYTON	OH	45402	311236989	501(C)(3)	$5,500	SUPPORT
ATRIUM MEDICAL CENTER FOUNDATION
110 N MAIN ST 500	DAYTON	OH	45402	311079213	501(C)(3)	$5,473	SUPPORT
REACH OUT MONTGOMERY COUNTY
25 E FORAKER ST	DAYTON	OH	45409	311434282	501(C)(3)	$5,281	RX ASSISTANCE

Field	Value	IRS element (for citing)
Total501c3 Org	19	Total501c3OrgCnt
Total Other Org	0	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)
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (27 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
MARY H BOOSALIS
PREMIER PRESIDENT & CEO	$0	$1,521,403	$0	$589,975	$0	$38,811	$0	$21,458	$0	$20,195	$0	$2,191,842	$0	$0
SCOTT A SHELTON
FORMER KEY EMPLOYEE	$0	$539,248	$0	$376,065	$0	$426,904	$0	$14,812	$0	$32,150	$0	$1,389,179	$0	$0
BARBARA A JOHNSON
FORMER KEY EMPLOYEE	$0	$647,940	$0	$252,301	$0	$68,153	$0	$15,954	$0	$11,161	$0	$995,509	$0	$35,591
JENNIFER J HAULER DO
FORMER KEY EMPLOYEE	$20,275	$519,707	$50,000	$285,280	$70	$1,787	$3,103	$79,796	$126	$2,638	$73,574	$889,208	$0	$0
GEOFFREY P WALKER
SYSTEM VP -CHIEF LEGAL OFFICER	$0	$417,391	$0	$188,245	$0	$229,357	$0	$23,002	$0	$27,819	$0	$885,814	$0	$0
FAYEZ D ABBOUD MD
PRES MEDICAL STAFF	$0	$644,352	$0	$77,696	$0	$27,108	$0	$9,628	$0	$24,877	$0	$783,661	$0	$0
DIANE L PLEIMAN
FORMER OFFICER	$0	$405,795	$0	$189,426	$0	$127,609	$0	$24,480	$0	$8,475	$0	$755,785	$0	$0
THOMAS R PARKER
PRESIDENT & CEO (TO JUL)	$244,968	$0	$224,567	$0	$216,996	$0	$37,630	$0	$19,509	$0	$743,670	$0	$35,319	$0
MARC R BELCASTRO DO
VP MEDICAL AFFAIRS & PREMIER CMO	$0	$475,256	$0	$137,384	$0	$54,817	$0	$13,525	$0	$26,199	$0	$707,181	$0	$34,681
GARY G GINTER
VP & PREMIER CHIEF INFO OFFICER	$0	$396,542	$0	$144,812	$0	$3,939	$0	$62,814	$0	$28,043	$0	$636,150	$0	$0
MARGARET W MARK
VP NURSING SERVICE / PREMIER CNO	$0	$345,989	$0	$147,406	$0	$37,482	$0	$19,858	$0	$27,509	$0	$578,244	$0	$10,459
THOMAS R CURTIN
VP-REVENUE CYCLE	$0	$326,009	$0	$160,675	$0	$7,745	$0	$34,119	$0	$33,185	$0	$561,733	$0	$0
J MICHAEL SIMS
SYSTEM VP - TREASURER & CORP CONTROL	$0	$311,052	$0	$106,785	$0	$87,954	$0	$23,220	$0	$28,921	$0	$557,932	$0	$0
RAFAY ATIQ MD
TRUSTEE	$0	$378,469	$0	$96,993	$0	$2,556	$0	$10,973	$0	$27,451	$0	$516,442	$0	$0
ELAINE M DEAN
SYSTEM VP - BUSINESS DEVELOPMENT	$0	$315,881	$0	$120,665	$0	$21,241	$0	$11,103	$0	$13,413	$0	$482,303	$0	$0
SCOTT B KANAGY DO
TRUSTEE / VP OPERATIONS & CMO	$326,796	$0	$66,997	$0	$1,113	$0	$25,511	$0	$25,873	$0	$446,290	$0	$0	$0
KIM K STRAHL
VICE PRESIDENT & CPO	$0	$240,551	$0	$116,520	$0	$6,686	$0	$20,938	$0	$12,324	$0	$397,019	$0	$0
TIMOTHY D SNIDER
BOARD TREASURER & COO	$237,989	$0	$76,445	$0	$22,034	$0	$29,531	$0	$29,101	$0	$395,100	$0	$0	$0
BILLIE L LUCENTE-BAKER
SYSTEM VP - HR OPERATIONS	$0	$220,143	$0	$61,876	$0	$1,129	$0	$18,160	$0	$13,999	$0	$315,307	$0	$0
TRISHA L WACKLER
CNO & PREMIER VP EDUCATION	$174,986	$45,910	$49,034	$0	$4,249	$363	$12,999	$3,281	$10,413	$2,860	$251,681	$52,414	$0	$0
JENNA M DOWNEY ESQ
FORMER OFFICER	$0	$197,785	$0	$34,590	$0	$386	$0	$9,114	$0	$10,454	$0	$252,329	$0	$0
MELISSA M TALLMADGE
DIR NURSING - SURGERY/ED	$156,263	$0	$23,696	$0	$1,126	$0	$17,459	$0	$51,482	$0	$250,026	$0	$0	$0
BENJAMIN A WATSON ESQ
BOARD SECRETARY (TO JAN)	$0	$160,670	$0	$26,383	$0	$665	$0	$6,182	$0	$9,812	$0	$203,712	$0	$0
RYAN E MCELDOWNEY
STAFF PHARMACIST	$155,599	$0	$500	$0	$903	$0	$13,213	$0	$25,549	$0	$195,764	$0	$0	$0
ALLISON E WENTLAND
DIR QUALITY & SYS INFECTION CTRL	$134,877	$0	$27,857	$0	$785	$0	$9,413	$0	$18,165	$0	$191,097	$0	$0	$0
DUANNA R OSTING
UVMC FOUNDATION PRES / EXEC DIR	$117,859	$0	$44,931	$0	$539	$0	$2,443	$0	$16,503	$0	$182,275	$0	$0	$0
PAMELA L CORNETT
DIR - REHAB SERVICES	$124,367	$0	$20,719	$0	$5,555	$0	$10,269	$0	$19,086	$0	$179,996	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3	COMPENSATION FOR UPPER VALLEY'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH UPPER VALLEY IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15.
PART I, LINE 4A:	THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: THOMAS PARKER RECEIVED $163,848 IN 2020 AND WILL RECEIVE $49,154 IN 2021.
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 2020. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2020: DIANE L. PLEIMAN $124,338; SCOTT A. SHELTON $402,778; J MICHAEL SIMS $83,220; GEOFFREY P. WALKER $222,983. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PLAN PAYMENT 2020: MARC R. BELCASTRO $40,805; BARBARA A. JOHNSON $56,031; MARGARET W. MARK $10,459; THOMAS R. PARKER $35,319. IN ADDITION, THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED AND PAID TO THE SERP PARTICIPANTS: MARC R. BELCASTRO $4,243; THOMAS R. CURTIN $13,484; GARY R. GINTER $39,595; JENNIFER J. HAULER, D.O. $72,593; BARBARA A. JOHNSON $441; SCOTT B. KANAGY $15,735; MARGARET W. MARK $9,647; THOMAS R. PARKER $15,609; TIMOTHY D. SNIDER $7,337; TRISHA L. WACKLER $7,244. 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.

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	613520L06	CUSIPNum
Bond Issued	2020-09-24	BondIssuedDt
Issue Price	$24,859,875	IssuePriceAmt
Purpose	REFUND SERIES 2016B BONDS	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$24,859,875	TotalProceedsAmt
Issuance Costs From Proceeds	$228,930	IssuanceCostsFromProceedsAmt
Other Spent Proceeds	$24,630,944	OtherSpentProceedsAmt
Refunding Tax Exempt Bonds	Yes (1)	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	0	RefundingTaxableBondsInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	Yes (1)	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00070	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00070	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (1)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	Yes (1)	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
NOTE A PART I, LINE A, COLUMN E:	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

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Noncash Contributions Rpt F990	$350	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt
Yes (X)	COVID-19 PPE	31	$127,939
Yes (X)	EMPLOYEE FOOD	7	$7,284

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3	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, LINE 7A	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 A, LINE 7B	SEE EXPLANATION FOR LINE 7A.
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, LINE 15	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 DATA FOR KEY EXECUTIVES, VICE PRESIDENTS, AND DIRECTOR LEVEL POSITIONS. THE INDEPENDENT COMPARABILITY DATA IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THIS COMMITTEE CONTAINS THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CHIEF INTEGRATION OFFICER, CHIEF STRATEGY OFFICER, AND THE HOSPITAL CEOS. OTHER POSITIONS ARE REVIEWED AT A HIGH LEVEL FOR REASONABLENESS. ALL THE MEETING MINUTES ARE DOCUMENTED AND KEPT ON FILE ALONG WITH ANY COMPARABILITY DATA AND THE CONSULTANT REPORT. AFTER THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION ACTIONS, THE PROCESS IS AUDITED BY THE INTERNAL AUDIT DEPARTMENT. THE EXECUTIVE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION ACTIONS TO THE PREMIER BOARD ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G	PURCHASED LABOR: PROGRAM SERVICE EXPENSES 13,392,668. MANAGEMENT AND GENERAL EXPENSES 554,326. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,946,994. PROF/CONSULTING FEES: PROGRAM SERVICE EXPENSES 31,188. MANAGEMENT AND GENERAL EXPENSES 5,625. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,813. COLLECTION FEES: PROGRAM SERVICE EXPENSES 758,353. MANAGEMENT AND GENERAL EXPENSES 18,042. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 776,395. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 8,130,522. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,130,522.
FORM 990, PART XI, LINE 9:	EQUITY TRANSFERS TO AFFILIATES -35,480,564. FOUNDATION ADJUSTMENT -177,330. PENSION ADJUSTMENT 6,271,987. CAPITAL DONATIONS 9,614,133.
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.

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	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
PREMIER HEALTH
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311446699	PARENT	OH	501 (C) (3)	12B	N/A	0
MEDAMERICA HEALTH SYSTEMS CO
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311040228	SUPPORT ORG	OH	501 (C) (3)	12B	N/A	0
MIAMI VALLEY HOSPITAL
110 MAIN STREET SUITE 500	DAYTON	OH	45402	310537504	HOSPITAL	OH	501 (C) (3)	3		0	PREMIER HEALTH
MIAMI VALLEY HOSPITAL FOUNDATION
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311040231	FOUNDATION	OH	501 (C) (3)	7		0	PREMIER HEALTH
FIDELITY HEALTH CARE INC
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311075381	HOME HEALTH	OH	501 (C) (3)	10		0	PREMIER HEALTH
PREMIER COMMUNITY HEALTH
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311122883	HEALTH EDUCATION	OH	501 (C) (3)	10		0	FIDELITY HEALTH CARE
SAMARITAN HEALTH PARTNERS
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311107411	SUPPORT ORG	OH	501 (C) (3)	12B		0	PREMIER HEALTH
GOOD SAMARITAN FOUNDATION - DAYTON
110 MAIN STREET SUITE 500	DAYTON	OH	45402	237296923	FOUNDATION	OH	501 (C) (3)	7		0	PREMIER HEALTH
ATRIUM HEALTH SYSTEM
110 MAIN STREET SUITE 500	DAYTON	OH	45402	310537492	SUPPORT ORG	OH	501 (C) (3)	12B	N/A	0
ATRIUM MEDICAL CENTER
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311079309	HOSPITAL	OH	501 (C) (3)	3		0	PREMIER HEALTH
UVMC
110 MAIN STREET SUITE 500	DAYTON	OH	45402	341850683	SUPPORT ORG	OH	501 (C) (3)	12B	N/A	0
UPPER VALLEY PROFESSIONAL CORP
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311400963	HEALTH CARE	OH	501 (C) (3)	10		0	PREMIER HEALTH
UVPC SPECIALISTS
110 MAIN STREET SUITE 500	DAYTON	OH	45402	203687536	HEALTH CARE	OH	501 (C) (3)	10		0	UPPER VALLEY PROFESSIONAL CORP
UVMC NURSING CARE INC
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311224064	NURSING HOME	OH	501 (C) (3)	10		0	PREMIER HEALTH
COMPUNET CLINICAL LABORATORIES LLC
110 MAIN STREET SUITE 500	DAYTON	OH	45402	311258010	LAB	OH	501 (C) (3)	12B		0	PREMIER HEALTH
SAMARITAN BEHAVIORAL HEALTH INC
110 MAIN STREET SUITE 500	DAYTON	OH	45402	020633634	BEHAVIORAL HEALTH	OH	501 (C) (3)	7		0	PREMIER HEALTH

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
SWEITZER STREET LLC
110 N MAIN STREET SUITE 500	DAYTON	OH	45402	454700417	REAL ESTATE	OH	MVHE INC	EXCLUDED	0	0
SWEITZER MOB LLC
110 N MAIN STREET SUITE 500	DAYTON	OH	45402	474554657	REAL ESTATE	OH	MVHE INC	EXCLUDED	0	0

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	Controlled OrganizationControlledOrganizationInd
MVHE INC
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	311185270	PHYSICIAN SVCS	OH	PREMIER HEALTH HOLDING	C	0
PREMIER HEALTH SPECIALISTS
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	061744704	PHYSICIAN SVCS	OH	PREMIER HEALTH HOLDING	C	0
SAMARITAN FAMILY CARE
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	311299450	PHYSICIAN SVCS	OH	PREMIER HEALTH HOLDING	C	0
AFTER HOURS FAMILY CARE
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	311269483	HEALTH CARE	OH	UPPER VALLEY PROFESSIONAL CORP	C	0
UVMC MANAGEMENT CORP
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	311360489	MANAGEMENT COMPANY	OH	PREMIER HEALTH	C	0
PREMIER HEALTH URGENT CARE INC
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	822079409	URGENT CARE	OH	PREMIER HEALTH HOLDING	C	0
PREMIER HEALTH PLAN INC
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	463024049	HEALTH INSURANCE	OH	PREMIER HEALTH INSURING CO	C	0
GOOD SAMARITAN HOSPITAL
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	310536981	HOSPITAL	OH	PREMIER HEALTH	C	0
PREMIER HEALTH ACO OF OHIO
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	474049773	MEDICARE ACO	OH	PREMIER HEALTH	C	0
PREMIER HEALTH HOLDING
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	812419110	HOLDING CO	OH	PREMIER HEALTH	C	0
PREMIER HEALTH INSURING CO
110 NORTH MAIN STREET SUITE 500	DAYTON	OH	45402	464766841	HEALTH INSURANCE	OH	PREMIER HEALTH	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	Yes (1)	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd