2020-11-16T14:01:06-06:00 2019-12-31 990 2019-01-01 020633634 SAMARITAN BEHAVIORAL HEALTH INC SAMA 9372768333 110 N MAIN ST 500 DAYTON OH 45402 TIMOTHY D SNIDER BOARD TREASURER 9372768333 2020-11-16 184.57.171.100 2020-11-16 14:01:01 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 986CFAB4546D7DBDFBAA527D8BCEED6C2968A6DF 2019 2021-01-29 14:40:06Z BETH ESPOSITO 601 S EDWIN C MOSES BLVD DAYTON OH 45417 14256102 0 X WWW.SBHIHELP.ORG X 2002 OH TO PROVIDE MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES THAT TOUCH, TEACH AND HEAL 7 2 292 0 0 0 4530103 4111542 10218338 9875341 11760 55739 272560 213480 15032761 14256102 0 0 0 0 12778853 12695406 0 0 0 2558687 2493822 15337540 15189228 -304779 -933126 6238560 5089710 2976699 2751700 3261861 2338010 X TO PROVIDE MENTAL HEALTH AND ABUSE SERVICES THAT TOUCH, TEACH AND HEAL 0 0 2822010 1762218 SUBSTANCE ABUSE/115 PROGRAM: SAMARITAN BEHAVIORAL HEALTH'S SUBSTANCE ABUSE SERVICES OFFER THE FOLLOWING TO ANY ADULT LIVING IN MONTGOMERY COUNTY: MEDICATION ASSISTED TREATMENT (MAT) FOR OPIOID ADDICTION USING BUPRENORPHINE/NALOXONE (SUBOXONE) NALTREXONE (VIVITROL); ALL MAT SERVICES REQUIRE PARTICIPATION IN GROUP AND INDIVIDUAL COUNSELING; INDIVIDUAL, GROUP, AND FAMILY COUNSELING, AND CASE MANAGEMENT; SERVICES TO TREAT ABUSE AND ADDICTION TO ALCOHOL, COCAINE, BARBITURATES, MARIJUANA, HEROIN, AND OTHER ADDICTIVE SUBSTANCES; PROJECT DAWN - TRAINING IN THE USE AND DISTRIBUTION OF NALOXONE (NARCAN) KITS, COMBINED SUBSTANCE ABUSE AND MENTAL HEALTH COUNSELING. DURING 2019, 1,494 PATIENTS WERE ADMITTED FOR SERVICES. IN OCT. 2019, SBHI EXPANDED ITS DEPARTMENT TO INCLUDE 115/VERILY AND BECAME THE 115 PROGRAM. 2245392 1978228 INTEGRATED CARE SOLUTIONS: SAMARITAN BEHAVIORAL HEALTH'S YOUTH AND ADULT OUTPATIENT SERVICES OFFER THE FOLLOWING TO ADULTS, ADOLESCENTS AND CHILDREN LIVING IN MONTGOMERY COUNTY: BEHAVIORAL HEALTH ASSESSMENTS TO DETERMINE THE NATURE AND EXTENT OF MENTAL HEALTH PROBLEMS/CONCERNS; RECOMMENDATIONS REGARDING SERVICES THAT ADDRESS PROBLEMS/SYMPTOMS; AN INDIVIDUALIZED SERVICE PLAN WITH THERAPEUTIC GOALS DEVELOPED WITH THE PATIENT/FAMILY; INDIVIDUAL AND FAMILY COUNSELING; REFERRAL TO PSYCHIATRIC SERVICES IF IT APPEARS THAT MEDICATION MAY BE BENEFICIAL; ONGOING PSYCHIATRIC MEDICATION MANAGEMENT, CASE MANAGEMENT (COMMUNITY PSYCHIATRIC SUPPORTIVE TREATMENT) SERVICES TO FURTHER SUPPORT THERAPEUTIC INTERVENTIONS AND LINK PATIENT/FAMILY TO COMMUNITY RESOURCES. DURING 2019, 4,010 PATIENTS WERE SERVED. 1775088 768958 CRISISCARE: SAMARITAN BEHAVIORAL HEALTH'S CRISISCARE PROGRAM OFFERS THE FOLLOWING SERVICES TO ANY ADULT, ADOLESCENT OR CHILD REGARDLESS OF THEIR ABILITY TO PAY: 1) HOTLINE - 24-HOUR SUICIDE PREVENTION AND CRISIS COUNSELING TELEPHONE LINE, 2) WARMLINE - 24-HOUR SUPPORTIVE TELEPHONE COUNSELING SERVICE, 3) SCREENING & TRIAGE - EVALUATION OF CRISIS NEEDS WITH FOLLOW-UP RECOMMENDATIONS FOR SERVICE, 4) EMERGENCY WALK-INS - FACE-TO-FACE CRISIS INTERVENTION, 5) PRE-HOSPITAL SCREENING - HEALTH OFFICERS EVALUATE WHETHER A PERSON NEEDS TO BE HOSPITALIZED DUE TO LIFE THREATENING CIRCUMSTANCES, 6) MOBILE CRISIS SERVICES - CRISIS INTERVENTION SERVICES PROVIDED AT RESIDENCES AND/OR IN THE COMMUNITY FOR THOSE WHO ARE AT RISK OF HARM TO THEMSELVES OR OTHERS, 7) CRISIS COUNSELING - PROVIDES COUNSELING UP TO 4 SESSIONS FOR ACUTE STABILIZATION AND ON-GOING SUPPORT, 8) CRISIS DEBRIEFING - SERVICES ARE AVAILABLE FOR INDIVIDUALS OR GROUPS INVOLVED IN TRAUMATIC EVENTS. CRISISCARE ADMITTED 940 PATIENTS FOR SERVICES AND PROVIDED 5,566 HOURS OF SERVICES FOR 2019. 5963121 5581417 THIS NUMBER REPRESENTS THE BALANCE OF TOTAL EXPENDITURES OF TEMPORARILY RESTRICTED FUNDS FOR SAMARITAN BEHAVIORAL HEALTH (SBHI) NET OF PROGRAMS DESCRIBED IN SERVICE ACCOMPLISHMENTS. 5963121 5581417 12805611 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 20 0 1 292 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 2 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X J MICHAEL SIMS 9374999942 110 N MAIN ST 500 DAYTON OH 45402 ELOISE P BRONER BOARD CHAIR 0.50 39.50 X X 0 878127 30024 THOMAS R CURTIN FORMER TRUSTEE & OFFICER 0.00 40.00 X 0 407459 60214 TIMOTHY D SNIDER BOARD TREASURER 0.50 39.50 X 0 355991 51164 SUSAN F DAVIS-BROWN MD TRUSTEE 0.50 39.50 X 0 309243 30483 ELISABETH ESPOSITO VICE CHAIR-PRES&CEO 40.00 0.00 X X 246198 0 38501 NANCY J SMITH DO PSYCHIATRIST 40.00 0.00 X 253305 0 12713 V SUE MCGATHA FORMER OFFICER 0.00 0.00 X 238959 0 19117 JENNA M DOWNEY ESQ BOARD SECRETARY (TO NOV) 0.50 39.50 X 0 223359 21938 LUIS TELLEZ MD MEDICAL DIRECTOR-STAFF PSYCHIATRIST 40.00 0.00 X 192420 0 30701 ELLEN W BALLERENE MD PSYCHIATRIST 40.00 0.00 X 177122 0 39952 BENJAMIN W SUTHERLY TRUSTEE (FROM FEB) 0.50 39.50 X 0 174080 31323 BENJAMIN A WATSON ESQ BOARD SECRETARY (FROM NOV) 0.50 39.50 X 0 166716 16245 PHILIP S WHITECAR MD PSYCHIATRIST 40.00 0.00 X 125334 0 34342 KAREN D GAINES CFO 40.00 0.00 X 130399 0 14472 EVANTHIA STEFFENS TRUSTEE 0.50 0.00 X 0 39953 0 CAROL BAUER SC TRUSTEE 0.50 0.00 X 0 0 0 GINA MCFARLANE-EL TRUSTEE 0.50 0.00 X 0 0 0 1363737 2554928 431189 12 1 1 0 QUALIFACTS SYSTEMS INC 315 DEADERICK ST NASHVILLE TN 37238 MEDICAL SOFTWARE 227875 WRIGHT STATE PHYSICIANS 128 E APPLE ST DAYTON OH 45409 MEDICAL SERVICES 162561 2 1013 118530 3844859 147140 4111542 PROGRAM SERVICE REVENUE 900099 9875341 9875341 9875341 53739 53739 2000 0 2000 2000 2000 MISC REVENUE 900099 213480 213480 213480 14256102 10090821 0 53739 284699 256429 28270 10148602 9016479 1132123 127784 116824 10960 1366457 1126483 239974 767864 677218 90646 129 129 22846 22846 7869 1530 6339 368929 295096 73833 6560 6560 189595 153938 35657 279555 17574 261981 842131 750881 91250 84607 71364 13243 95083 95083 129242 129242 PURCHASED SERVICES 313126 89434 223692 OPERATING SUPPLIES 98027 98027 FLEET EXPENSE 19032 19032 MINOR EQUIPMENT 10092 1471 8621 26999 12059 14940 15189228 12805611 2383617 0 1973887 2268949 3203351 1783458 121960 49681 902990 617694 325329 285296 614033 702326 6238560 5089710 1432092 2118103 1544607 408823 0 0 224774 2976699 2751700 X 2647829 1635684 614032 702326 3261861 2338010 6238560 5089710 X -933126 44238 -34963 X 0 1 X 1 1 1 X 2243457 2699047 3740967 4530103 4111542 17325116 10239165 11018058 11104174 10490895 10092847 52945139 12482622 13717105 14845141 15020998 14204389 70270255 0 0 0 70270255 6469 -7559 41184 11760 55739 107593 6469 -7559 41184 11760 55739 107593 12489091 13709546 14886325 15032758 14260128 70377848 0.99850 0.99890 0.00150 0.00110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 614033 25280 97977 34963 702327 739591 -32999 92559 614033 655485 140048 41184 97126 739591 560623 121814 -8031 18921 655485 556820 5845 -603 1439 560623 0.63460 0.36540 0 1 1 375056 240868 134188 500510 376826 123684 27424 27424 285296 FUNDS HELD BY GOOD SAMARITAN FOUNDATION - DAYTON 702326 702326 INTERCOMPANY PAYABLE 224774 224774 X 14265374 44238 -34966 9272 14256102 0 14256102 15189228 0 15189228 0 15189228 PART V, LINE 4: SAMARITAN BEHAVIORAL HEALTH, INC. (SBHI) MAKES EVERY EFFORT TO FOLLOW THE INTENT AND WISHES OF ALL ITS DONORS. THE INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS AND/OR EARNINGS FROM ENDOWMENT FUNDS ARE DRIVEN BY THE WISHES/RESTRICTIONS PLACED ON THE FUNDS BY THE DONOR. PERMANENT ENDOWMENTS RESULT WHEN A DONATION IS RECEIVED WITH A RESTRICTION THAT THE PRINCIPAL OR GIFT AMOUNT IS TO BE RETAINED IN PERPETUITY AND CANNOT BE SPENT. THE EARNINGS FROM THE PERMANENT ENDOWMENTS ARE THEN USED FOR THE PURPOSE SPECIFIED BY THE DONOR. TEMPORARY ENDOWMENTS ARE FUNDS IN WHICH ALL OR PART OF THE PRINCIPAL MAY BE EXPENDED ONLY AFTER THE EXPIRATION OF A STATED PERIOD OF TIME OR OCCURRENCE OF A SPECIFIED EVENT, DEPENDING ON THE DONOR'S WISHES. EARNINGS FROM TEMPORARILY RESTRICTED ENDOWMENTS CAN BE EITHER UNRESTRICTED OR RESTRICTED. SBHI USES THE TEMPORARILY RESTRICTED ENDOWMENTS FOR THE INTENDED PURPOSE SET UP BY THE DONOR, ONLY AFTER THE PERIOD OF TIME OR SPECIFIED EVENT SET BY THE DONOR HAS BEEN MET. THE "CATEGORIES" OF RESTRICTED ENDOWMENTS ARE AS FOLLOWS: SBHI PROGRAM CONSORTIUM (59%); PROGRAM OPERATING EXPENSES (20%); MENTAL HEALTH (14%); AND MISCELLANEOUS (7%). PART X, LINE 2: THE FOLLOWING FOOTNOTE IS FROM THE 2019 CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR PREMIER HEALTH (PHP) AND AFFILIATES. PHP IS THE SOLE MEMBER OF SBHI. PHP HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE A TAX-EXEMPT NONPROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A TAX-EXEMPT ORGANIZATION, ITS INCOME IS EXEMPT FROM FEDERAL INCOME TAX EXCEPT TO THE EXTENT OF ANY UNRELATED BUSINESS ACTIVITIES. PHP CONSOLIDATES CERTAIN SUBSIDIARIES, WHICH ARE FOR-PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. THESE ARE: PREMIER HEALTH INSURING CO. (PHIC), AND PHHC (WHOLLY OWNED SUBSIDIARIES OF PHP), PREMIER HEALTH PLAN (PHPLAN) (A WHOLLY OWNED SUBSIDIARY OF PHIC), MVHE, INC., SAMARITAN FAMILY CARE, INC., PREMIER HEALTH SPECIALISTS, INC. AND PREMIER HEALTH URGENT CARE, INC. (SUBSIDIARIES OF PHHC), UVMC MANAGEMENT CORPORATION AND AFTER HOURS FAMILY CARE, INC. (SUBSIDIARIES OF PHP). THE TAX CUTS AND JOBS ACT (THE ACT) WAS ENACTED ON DECEMBER 22, 2017. FOR TAX-EXEMPT ENTITIES, THE ACT REQUIRES ORGANIZATIONS TO PAY AN EXCISE TAX ON REMUNERATION TO EXECUTIVES ABOVE CERTAIN THRESHOLDS AND REPORT INCOME OR LOSS FROM UNRELATED BUSINESS ACTIVITIES ON AN ACTIVITY-BY-ACTIVITY BASIS, AMONG OTHER PROVISIONS. PHP HAS RECORDED ESTIMATED LIABILITIES AND RELATED EXPENSES FOR ALL EXCISE AND UNRELATED BUSINESS INCOME TAXES IDENTIFIED AT DECEMBER 31, 2019. MANAGEMENT ANNUALLY REVIEWS THE TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: DISTRIBUTIONS - TEMPORARILY RESTRICTED -34,963. ROUNDING -3. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 64000 0 0 0 0 0 0 64000 0 64000 1 0 1 0 1 0 PART III ACCOUNTING METHOD: X X X X 1 1 0 0 0 0 0 0 0 ELOISE P BRONER BOARD CHAIR 0 454049 0 229601 0 194477 0 25936 0 4088 0 908151 0 0 THOMAS R CURTIN FORMER TRUSTEE & OFFICER 0 318812 0 80976 0 7671 0 26866 0 33348 0 467673 0 0 TIMOTHY D SNIDER BOARD TREASURER 0 255385 0 98141 0 2465 0 25016 0 26148 0 407155 0 0 SUSAN F DAVIS-BROWN MD TRUSTEE 0 229665 0 42950 0 36628 0 9247 0 21236 0 339726 0 0 ELISABETH ESPOSITO VICE CHAIR-PRES&CEO 219755 0 26358 0 85 0 7172 0 31329 0 284699 0 0 0 NANCY J SMITH DO PSYCHIATRIST 251778 0 0 0 1527 0 146 0 12567 0 266018 0 0 0 V SUE MCGATHA FORMER OFFICER 0 0 41316 0 197643 0 19117 0 0 0 258076 0 0 0 JENNA M DOWNEY ESQ BOARD SECRETARY (TO NOV) 0 190262 0 32305 0 792 0 8381 0 13557 0 245297 0 0 LUIS TELLEZ MD MEDICAL DIRECTOR-STAFF PSYCHIATRIST 191262 0 0 0 1158 0 6366 0 24335 0 223121 0 0 0 ELLEN W BALLERENE MD PSYCHIATRIST 176879 0 0 0 243 0 7236 0 32716 0 217074 0 0 0 BENJAMIN W SUTHERLY TRUSTEE (FROM FEB) 0 147755 0 26011 0 314 0 6297 0 25026 0 205403 0 0 BENJAMIN A WATSON ESQ BOARD SECRETARY (FROM NOV) 0 144706 0 21428 0 582 0 6180 0 10065 0 182961 0 0 PHILIP S WHITECAR MD PSYCHIATRIST 124720 0 0 0 614 0 1531 0 32811 0 159676 0 0 0 PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL WAS SELECTED TO PARTICIPATE IN A VOLUNTARY RETIREMENT PROGRAM AND RECEIVED THE FOLLOWING PAYMENT IN 2019: V. SUE MCGATHA $181,130 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, SAMARITAN BEHAVIORAL HEALTH (SBHI) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. SBHI 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 THE TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2019. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2019: ELOISE BRONER $170,828. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PAYMENT IN 2019: SUSAN DAVIS-BROWN $3,545. IN ADDITION, THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED AND PAID TO THE SERP PARTICIPANTS: THOMAS CURTIN $7,888; TIMOTHY SNIDER $3,843. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. ANY PAYMENTS MADE AFTER THE 2-1/2 MONTHS WERE PROPERLY REPORTED ON PRIOR YEARS' FILED IRS FORM 990 RETURNS, DISCLOSING COMPENSATION EARNED BY THESE INDIVIDUALS UNDER THE PLANS FOR EACH SUCH YEAR. FORM 990, PART VI, SECTION A, LINE 3 PREMIER HEALTH (PREMIER) AS THE OPERATOR OF SBHI DEVELOPS AND OVERSEES THE IMPLEMENTATION OF THE STRATEGIC PLAN FOR SBHI, WHICH INCLUDES (BUT IS NOT LIMITED TO) SUCH MATTERS AS LOCATION OF CLINICAL AND ADMINISTRATIVE EXPENSES AND THE CONSOLIDATION OF SUCH SERVICES. SBHI SHALL COMPLY WITH AND IMPLEMENT THIS PLAN AND SHALL NOT TAKE ANY ACTION THAT MATERIALLY DEPARTS FROM THIS PLAN WITHOUT PREMIER'S APPROVAL. SBHI SHALL IMPLEMENT ANY CAPITAL AND OPERATING BUDGET SO APPROVED AND/OR REVISED FOR IT BY PREMIER. SBHI SHALL IMPLEMENT THE BUSINESS PLAN APPROVED BY PREMIER. PREMIER IS THE SOLE AGENT TO NEGOTIATE ALL RELATIONSHIPS WITH PAYORS ON BEHALF OF SBHI WITH ALL THIRD-PARTY PAYORS AND ALTERNATIVE DELIVERY SYSTEMS INCLUDING, BUT NOT LIMITED TO, INSURERS. SBHI 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. SBHI MUST SEEK PREMIER'S APPROVAL FOR ANY ACQUISITIONS, SALE OR TRANSFER OF ANY MATERIAL ASSET USED IN SBHI'S ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6 SBHI 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 SBHI. 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 FORM 990, PART VI, SECTION A, LINE 7A. FORM 990, PART VI, SECTION B, LINE 11B THIS 990 FILING AND ATTACHED SCHEDULES (THE RETURN) ARE PREPARED BY A STAFF MEMBER IN THE TAX DEPARTMENT OF PREMIER, OF WHICH SBHI IS AN AFFILIATE. THE RETURN IS REVIEWED BY THE TAX MANAGER AND DIRECTOR OF TAX COMPLIANCE OF PREMIER. 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 THEN PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW. AT A BOARD OF TRUSTEES MEETING, THE VICE PRESIDENT/CONTROLLER OF PREMIER (OR DESIGNEE) SHARES DETAILED INFORMATION ON COMPENSATION AND OTHER KEY AREAS, AS WELL AS ADDRESSES ANY OTHER QUESTIONS FROM THE BOARD OF TRUSTEES, PENDING THEIR REVIEW. THE 990 FILING IS ALSO SHARED WITH THE AUDIT COMMITTEE OF PREMIER. FORM 990, PART VI, SECTION B, LINE 12C PREMIER, WITH WHICH SBHI 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 SBHI'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH SBHI IS AN AFFILIATE, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER FOLLOWS A MARKET BASED COMPENSATION PHILOSOPHY DESIGNED TO ATTRACT AND RETAIN THE EXECUTIVE TALENT REQUIRED TO MEET THE HIGH-PERFORMANCE STANDARDS OF OUR BOARD AND OUR COMMUNITY. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL PEER GROUP OF SYSTEMS AND HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO PREMIER AND ITS AFFILIATES. THE DATA FOR THE SURVEY IS PROVIDED BY A THIRD-PARTY CONSULTANT GROUP THAT IS INDEPENDENT OF PREMIER. THIS REPORT INCLUDES COMPARABILITY FOR KEY EXECUTIVES, VICE PRESIDENTS, AND DIRECTOR LEVEL POSITIONS. THE INDEPENDENT COMPARABILITY DATA IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THIS COMMITTEE IS COMPRISED OF THREE MEMBERS, ALL OF WHOM ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CHIEF INTEGRATION OFFICER, CHIEF STRATEGY OFFICER, AND THE HOSPITAL CEOS. OTHER POSITIONS ARE REVIEWED AT A HIGH LEVEL FOR REASONABLENESS. ALL THE MEETING MINUTES ARE DOCUMENTED AND KEPT ON FILE ALONG WITH ANY COMPARABILITY DATA AND THE CONSULTANT REPORT. AFTER THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION ACTIONS, THE PROCESS IS AUDITED BY THE INTERNAL AUDIT DEPARTMENT. THE EXECUTIVE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION ACTIONS TO THE PREMIER BOARD ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: DISTRIBUTIONS - TEMPORARILY RESTRICTED -34,963. 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