2025-05-14T10:01:37-05:00 2024-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2023-07-01 311438846 TRIHEALTH INC TRIH 5135696575 625 EDEN PARK DRIVE CINCINNATI OH 45202 MICHAEL CROFTON VP FINANCE 5135696577 2025-05-14 1 1 SHAWNA M JANSONS P01222873 3174648600 2023 2025-03-06 01:10:19Z MARK CLEMENT 625 EDEN PARK DRIVE CINCINNATI OH 45202 493691865 0 X WWW.TRIHEALTH.COM X 1994 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 13 9 1489 9 2776131 2416683 8228362 904022 307662197 348734627 2643768 118118597 4632049 5080392 323166376 472837638 792554 366203 0 0 161893471 303613882 0 0 0 171469632 170464069 334155657 474444154 -10989281 -1606516 1839339472 2115766841 138548915 146918778 1700790557 1968848063 X SEE SCHEDULE O 0 0 474444154 366203 353488299 SEE SCHEDULE O 474444154 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 1 1 0 0 0 0 0 1 1 1 1 0 1 239 0 1 1489 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 13 9 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL CROFTON - VP FINANCE 5135696577 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 X SR SALLY DUFFY SECRETARY 1.00 3.00 X X 0 0 0 RALPH MICHAEL VICE CHAIR 1.00 3.00 X X 0 0 0 ROBERT COLLINS MD TRUSTEE 1.00 3.00 X 0 0 0 MARK CLEMENT PRESIDENT/CEO 55.00 5.00 X X 2219557 0 72753 PHILLIP CASTELLINI TRUSTEE 1.00 3.00 X 0 0 0 KATHY KELLY CHAIR 1.00 3.00 X X 0 0 0 THEODORE TORBECK TREASURER 1.00 3.00 X X 0 0 0 PHILIP FOSTER TRUSTEE 1.00 3.00 X 0 0 0 QUINT STUDER TRUSTEE 1.00 3.00 X 0 0 0 RANCE DUKE TRUSTEE 1.00 3.00 X 0 0 0 CYNTHIA BOOTH TRUSTEE 1.00 3.00 X 0 0 0 KRISTIN COPPAGE MD MED STAFF PRES (END 12/23) 1.00 60.00 X 0 928405 92688 LORRAINE STEPHENS MD MED STAFF PRES (END 12/23) 1.00 60.00 X 0 292686 61827 KENNETH PATTON DO MED STAFF PRES (START 1/24) 1.00 3.00 X 0 15400 0 KASEY ROHLING MD MED STAFF PRES (START 1/24) 1.00 3.00 X 0 12000 0 ANDREW DEVOE ASST TREASURER/EVP CFO (END 2/24) 55.00 5.00 X 1121641 0 87483 STEVE GRACEY ASST SECRETARY/SVP LEGAL 55.00 5.00 X 744735 0 85799 WILLIAM GRONEMAN CHIEF HR OFFICER (10/23-1/24) 45.00 15.00 X 547014 0 83962 MICHAEL CROFTON INTERIM CFO (START 3/24) 55.00 5.00 X 464763 0 76772 JENNY SKINNER SVP-CHIEF NURSING EXECUTIVE 45.00 15.00 X 708635 0 75584 MARLA SILLIMAN SVP-GOOD SAM REGION 45.00 15.00 X 860815 0 68467 STEVE MOMBACH SVP - AMBULATORY SERVICES 55.00 5.00 X 704175 0 67421 HELEN KOSELKA MD CHIEF MEDICAL OFFICER 55.00 5.00 X 897845 0 87678 JOHN WARD SVP-BETHESDA REGION 45.00 15.00 X 850111 0 83260 TERRI HANLON-BREMER EVP-CHIEF OPERATING OFFICER 45.00 15.00 X 1023570 0 80108 THOMAS SHOCKLEY JR MD CHIEF HEALTH EQUITY OFFICER 30.00 30.00 X 589818 0 74322 DONNA PETERS SVP-CHIEF INFORMATION OFFICER 60.00 0.00 X 633398 0 76291 JERRI IRBY CHIEF HR OFFICER (END 10/23) 45.00 15.00 X 283355 0 7684 BRYAN STRADER MD PRESIDENT-TPP 0.00 60.00 X 865701 0 95217 VESTA JOHNS ADMIN EXECUTIVE-TPP 0.00 60.00 X 640576 0 126955 KELVIN HANGAR PRESIDENT & COO-GOOD SAM 0.00 60.00 X 535008 0 72994 GAYLE MATTSON PRES & CEO-HOSPICE OF CINTI 0.00 60.00 X 586377 0 54000 JEREMIAH KIRKLAND PRES & COO-MHMH/BUTLER 0.00 60.00 X 503436 0 95869 CATHY FRENCH FORMER KEY EMPLOYEE 0.00 0.00 X 448510 0 0 15229040 1248491 1627134 500 1 1 0 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 CLINICAL ENGINEERING 15501772 ASPIRION HEALTH RESOURCES 1506 6TH AVE SUITE 3 COLUMBUS GA 31902 REVENUE MANAGEMENT SERVICES 6378781 G & G ORGANIZATION LTD 2600 NORTH LOOP WEST SUITE 150 HOUSTON TX 77092 REVENUE MANAGEMENT SERVICES 6321039 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 TECHNOLOGY SUPPORT 5853637 MICROSOFT CORPORATION ONE MICROSOFT WAY REDMOND WA 98052 TECHNOLOGY SUPPORT 5082645 145 904022 904022 SHARED SERVICES REV 561000 295676819 295676819 AFFILIATED BILLING REV 561000 21797711 21797711 JOINT VENTURE REVENUE 900099 14317746 11541615 2776131 AFFILIATED IT REVENUE 561000 10101178 10101178 AFFILIATED RENTAL REV 531120 6436716 6436716 404457 404457 348734627 108127539 108127539 659535 332815 326720 326720 326720 30511470 1000 20521412 0 9990058 1000 9991058 9991058 VALUE BASED REVENUE 561000 2652777 2652777 PURCHASE CARD REBATES 561000 759682 759682 UNCLAIMED FUNDS 561000 384962 384962 956251 956251 4753672 472837638 344275452 2776131 124882033 X 366203 366203 12677016 12677016 1805775 1805775 120275374 120275374 127021315 127021315 31516774 31516774 10317628 10317628 2898042 2898042 814650 814650 29405 29405 318881 318881 66667494 66667494 9838304 9838304 9534505 9534505 37080247 37080247 9241882 9241882 691464 691464 171068 171068 950111 950111 24717935 24717935 3121323 3121323 ALLOCATIONS 1557132 1557132 MEDICAL/DIETARY SUPPLY 817002 817002 NON-PATIENT BAD DEBT 505238 505238 UBI TAX 195000 195000 1314386 1314386 474444154 474444154 0 0 2201 2502 42747309 76529320 9393091 1536113 22613826 35873765 27009426 34629413 1194 1194 19817992 9612898 346439638 250834432 102170943 95605206 89625632 124128586 20113406 19328301 17437500 16653000 4443750 3618750 1483963202 1698247793 1839339472 2115766841 64103203 76207961 8189808 9898739 65223456 59773602 1032448 1038476 138548915 146918778 X 1700790557 1968848063 1700790557 1968848063 1839339472 2115766841 X -1606516 2137706 267526316 X X 0 1 X 1 1 1 X X 2 BETHESDA HOSPITAL INC 310537122 3 1 0 125413944 GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 310537486 3 1 0 158713705 2 0 284127649 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 PART I, LINE 11G, COLUMN (VI) AMOUNT OF OTHER SUPPORT TRIHEALTH, INC. ("TRIHEALTH") WAS CREATED IN 1995 UNDER A JOINT OPERATING AGREEMENT BETWEEN BETHESDA HOSPITAL, INC. ("BETHESDA") AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO ("GOOD SAMARITAN"). TRIHEALTH'S PRIMARY PURPOSE IS TO OPERATE AND JOINTLY MANAGE BETHESDA, GOOD SAMARITAN AND THEIR VARIOUS SUBSIDIARIES AND AFFILIATES. IN CARRYING OUT ITS CHARITABLE PURPOSES, TRIHEALTH PROVIDES A COMPREHENSIVE AND INTEGRATED PROVIDER BASE TO OPTIMIZE THE HEALTH STATUS OF THE COMMUNITY. TRIHEALTH PROVIDES ADMINISTRATIVE SUPPORT SERVICES INCLUDING GENERAL ADMINISTRATION, INFORMATION SYSTEMS, FINANCE, HUMAN RESOURCES, AND OTHER GENERAL SUPPORT SERVICES TO ITS SUPPORTED ORGANIZATIONS. PART IV, SECTION A, LINE 1 THE AMENDED AND RESTATED ARTICLES OF INCORPORATION OF TRIHEALTH STATE THAT THE SPECIFIC PURPOSE FOR WHICH TRIHEALTH IS FORMED IS TO ACT FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF BETHESDA HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND TO CONDUCT ANY ACTIVITIES CONSISTENT WITH SUCH PURPOSE, THE NONPROFIT LAWS OF THE STATE OF OHIO AND INTERNAL REVENUE CODE SECTION 501(C)(3). THE MISSION OF EACH HOSPITAL IS TO IMPROVE THE HEALTH STATUS OF THE PEOPLE THEY SERVE. PART IV, SECTION A, LINE 6 SINCE ITS ESTABLISHMENT IN 1995, TRIHEALTH, AS THE OPERATING ORGANIZATION, HAS DEVELOPED AN INTEGRATED HEALTH CARE SYSTEM CONSISTING OF 5 HOSPITALS, 3 AMBULATORY LOCATIONS AND APPROXIMATELY 125 PRIMARY AND SPECIALIST PHYSICIAN LOCATIONS SERVING GREATER CINCINNATI AND THE SURROUNDING AREA. ALL OF THESE ORGANIZATIONS AND/OR LOCATIONS ARE PART OF ORGANIZATIONS THAT ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) (SEE SCHEDULE R, PART II). ALTHOUGH NOT SPECIFICALLY IDENTIFIED BY NAME IN TRIHEALTH'S GOVERNING DOCUMENTS, TRIHEALTH SUPPORTS RELATED ORGANIZATIONS AND ACTIVITIES OF SUCH RELATED ORGANIZATIONS IN FURTHERANCE OF ITS CHARITABLE PURPOSE AND CONSISTENT WITH INTERNAL REVENUE CODE SECTION 501(C)(3). WITH RESPECT TO THESE ORGANIZATIONS, TRIHEALTH PROVIDES SUPPORT SERVICES INCLUDING GENERAL ADMINISTRATION, INFORMATION SYSTEMS, FINANCE, HUMAN RESOURCES, AND OTHER GENERAL SUPPORT SERVICES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 29405 29405 0 PART II-B, LINE 1: DURING THE TAX YEAR, TRIHEALTH, INC, PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. 2886186 2886186 14502903 7130515 7372388 33864589 14516518 19348071 288245896 226797512 61448384 6940064 2389887 4550177 95605206 DUE FROM RELATED ORGANIZATIONS 1637198339 INVESTMENT IN UNCONSOLIDATED ORGANIZATIONS 33834920 RIGHT OF USE ASSETS - OPERATING 25626641 ESCROW DEPOSIT 557400 MALPRACTICE ASSET 1030493 1698247793 MALPRACTICE LIABILITY 1038476 1038476 X PART X, LINE 2: FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE AUDITED COMBINED FINANCIAL STATEMENTS OF TRIHEALTH THAT REPORTS ITS AND ITS SUBSIDIARIES AND AFFILIATES LIABILITY, IF APPLICABLE, FOR UNCERTAIN TAX POSITIONS UNDER ASC 740-10-25: TRIHEALTH COMPLETED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT JUNE 30, 2024 OR 2023. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, INVESTMENTS 36784191 0 0 0 0 0 0 36784191 0 36784191 1 0 1 0 0 0 1 AMERICAN CANCER SOCIETY INC 270 PEACHTREE ST NW SUITE 1300 ATLANTA GA 30303 131788491 501(C)(3) 10000 0 SPONSORSHIP AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 10000 0 SPONSORSHIP AMERICAN LUNG ASSOCIATION 55 W WACKER DRIVE CHICAGO IL 60601 131632524 501(C)(3) 10000 0 SPONSORSHIP CATHOLIC CHARITIES OF SOUTHWESTERN OHIO 7162 READING RD STE 600 CINCINNATI OH 45237 310536968 501(C)(3) 5500 0 SPONSORSHIP CINCINNATI MUSEUM CENTER 1301 WESTERN AVE CINCINNATI OH 45203 311212634 501(C)(3) 20000 0 CAPITAL SUPPORT CINCINNATI ZOO AND BOTANICAL GARDENS 3400 VINE ST CINCINNATI OH 45220 310537171 501(C)(3) 70000 0 SPONSORSHIP COVERD GREATER CINCINNATI 1400 STATE AVE CINCINNATI OH 45204 475175383 501(C)(3) 10000 0 GENERAL SUPPORT FOUND HOUSE - INTERFAITH HOUSING 990 NASSAU STREET CINCINNATI OH 45206 311335474 501(C)(3) 10000 0 GENERAL SUPPORT FRIAR'S CLUB INC 4300 VINE STREET CINCINNATI OH 45217 310537485 501(C)(3) 20000 0 GENERAL SUPPORT GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI INC 375 DIXMYTH AVE CINCINNATI OH 45220 311206047 501(C)(3) 10000 0 DOCTOR'S DAY SUPPORT HEALTHY MOMS & BABES INC 2270 BANNING ROAD NO 200 CINCINNATI OH 45239 311155292 501(C)(3) 105000 0 GENERAL SUPPORT MAYFIELD EDUCATION & RESEARCH FOUNDATION 3825 EDWARDS RD STE 300 CINCINNATI OH 45209 310921099 501(C)(3) 10000 0 SPONSORSHIP OVARIAN CANCER ALLIANCE OF GREATER CINCINNATI PO BOX 42277 CINCINNATI OH 45242 823862604 501(C)(3) 10000 0 GENERAL SUPPORT PEOPLE WORKING COOPERATIVELY INC 4612 PADDOCK ROAD CINCINNATI OH 45229 310859104 501(C)(3) 6591 0 HOME MODIFICATION SUPPORT REDI CINCINNATI LLC 3 EAST FOURTH STREET STE 301 CINCINNATI OH 45202 472090230 10000 0 GENERAL SUPPORT 14 1 PART I, LINE 2: TRIHEALTH OBTAINS AND STORES ALL NECESSARY INFORMATION FROM THE RECIPIENT ORGANIZATION RELATIVE TO HOW THE FUNDS WILL BE SPENT. X X 1 1 X X X X 1 1 0 0 0 0 0 0 0 MARK CLEMENT PRESIDENT/CEO 1575958 0 606615 0 36984 0 47735 0 25018 0 2292310 0 0 0 ANDREW DEVOE ASST TREASURER/EVP CFO (END 2/24) 786423 0 273587 0 61631 0 47606 0 39877 0 1209124 0 0 0 TERRI HANLON-BREMER EVP-CHIEF OPERATING OFFICER 738998 0 250230 0 34342 0 51543 0 28565 0 1103678 0 0 0 KRISTIN COPPAGE MD MED STAFF PRES (END 12/23) 0 870891 0 10001 0 47513 0 53788 0 38900 0 1021093 0 0 HELEN KOSELKA MD CHIEF MEDICAL OFFICER 632082 0 179312 0 86451 0 47735 0 39943 0 985523 0 0 0 BRYAN STRADER MD PRESIDENT-TPP 644654 0 180956 0 40091 0 57792 0 37425 0 960918 0 0 0 JOHN WARD SVP-BETHESDA REGION 618637 0 193011 0 38463 0 50543 0 32717 0 933371 0 0 0 MARLA SILLIMAN SVP-GOOD SAM REGION 630713 0 183544 0 46558 0 55871 0 12596 0 929282 0 0 0 STEVE GRACEY ASST SECRETARY/SVP LEGAL 537042 0 166459 0 41234 0 46545 0 39254 0 830534 0 0 0 JENNY SKINNER SVP-CHIEF NURSING EXECUTIVE 434273 0 123845 0 150517 0 50578 0 25006 0 784219 0 0 0 STEVE MOMBACH SVP - AMBULATORY SERVICES 515447 0 155346 0 33382 0 42118 0 25303 0 771596 0 0 0 VESTA JOHNS ADMIN EXECUTIVE-TPP 407028 0 97112 0 136436 0 125012 0 1943 0 767531 0 0 0 DONNA PETERS SVP-CHIEF INFORMATION OFFICER 402400 0 172126 0 58872 0 39652 0 36639 0 709689 0 0 0 THOMAS SHOCKLEY JR MD CHIEF HEALTH EQUITY OFFICER 451690 0 131368 0 6760 0 57896 0 16426 0 664140 0 0 0 GAYLE MATTSON PRES & CEO-HOSPICE OF CINTI 408424 0 149361 0 28592 0 52075 0 1925 0 640377 0 0 0 WILLIAM GRONEMAN CHIEF HR OFFICER (10/23-1/24) 382252 0 94141 0 70621 0 50533 0 33429 0 630976 0 0 0 KELVIN HANGAR PRESIDENT & COO-GOOD SAM 396752 0 106312 0 31944 0 32913 0 40081 0 608002 0 0 0 JEREMIAH KIRKLAND PRES & COO-MHMH/BUTLER 384968 0 94265 0 24203 0 58957 0 36912 0 599305 0 0 0 MICHAEL CROFTON INTERIM CFO (START 3/24) 336643 0 84701 0 43419 0 50761 0 26011 0 541535 0 0 0 CATHY FRENCH FORMER KEY EMPLOYEE 0 0 0 0 448510 0 0 0 0 0 448510 0 0 0 LORRAINE STEPHENS MD MED STAFF PRES (END 12/23) 0 173451 0 6710 0 112525 0 23015 0 38812 0 354513 0 0 JERRI IRBY CHIEF HR OFFICER (END 10/23) 159504 0 50000 0 73851 0 3038 0 4646 0 291039 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS UP PAYMENTS: ALL DIRECTORS IN AN EMPLOYMENT POSITION OF VICE PRESIDENT AND HIGHER WITHIN TRIHEALTH, INC. ARE ELIGIBLE TO RECEIVE TAX GROSS-UP PAYMENTS ON THE FOLLOWING BENEFITS: * SUPPLEMENTAL OR SPLIT DOLLAR LIFE INSURANCE * EXECUTIVE HEALTH PROGRAM SERVICES * LONG-TERM DISABILITY INSURANCE * LONG-TERM CARE INSURANCE * FINANCIAL COUNSELING * BUSINESS CLUB MEMBERSHIPS * HEALTH CLUB MEMBERSHIPS HEALTH OR SOCIAL CLUB OR INITIATION FEES: TRIHEALTH, INC. MAINTAINS A MEMBERSHIP IN A LOCAL SOCIAL CLUB IN THE NAME OF THE PRESIDENT & CEO AS THE SOCIAL CLUB REQUIRES THE MEMBERSHIP TO BE IN AN INDIVIDUAL'S NAME. THIS MEMBERSHIP IS A BUSINESS MEMBERSHIP FOR THE BENEFIT OF TRIHEALTH, INC. AS SUCH, THE MONTHLY DUES ARE PAID BY TRIHEALTH, INC. DURING THE CURRENT YEAR, THERE WAS NOT ANY PERSONAL USE BY THE PRESIDENT & CEO. PART I, LINES 4A-B ELIGIBLE EXECUTIVES (GENERALLY VICE PRESIDENT AND ABOVE) PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. DURING THE 2023 CALENDAR YEAR, NONE OF THE INDIVIDUALS LISTED IN SCHEDULE J, PART II, RECEIVED A PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WHICH WAS TREATED AS TAXABLE COMPENSATION BY TRIHEALTH, INC. PART I, LINE 4A: THE ORGANIZATION HAS A STANDARD EMPLOYEE SEVERANCE PACKAGE. GENERAL SEVERANCE PAY IS BASED ON LENGTH OF SERVICE. IN ADDITION, NOTICE PAY, IF APPLICABLE UNDER TRIHEALTH, INC. POLICY, MAY BE ADDED TO THE SEVERANCE PACKAGE AND THE AMOUNT OF NOTICE PAY WILL BE DETERMINED BY HUMAN RESOURCES IN ACCORDANCE WITH TRIHEALTH, INC. POLICY. PAYMENTS OF SEVERANCE ARE CONDITIONED UPON SIGNING A SEPARATION AND RELEASE AGREEMENT. DURING THE 2023 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: CATHY FRENCH - $448,510 JERRI IRBY - $16,538 MARK CLEMENT OFFICER SPLIT $ X 11143641 11143641 0 1 1 ANDREW DEVOE OFFICER SPLIT $ X 2624926 2624926 0 1 1 STEVE GRACEY OFFICER SPLIT $ X 1615213 1615213 0 1 1 TERRI BREMER KEY EE SPLIT $ X 1836738 1836738 0 1 1 STEVE MOMBACH KEY EE SPLIT $ X 6262255 6262255 0 1 1 MARLA SILLIMAN KEY EE SPLIT $ X 1764497 1764497 0 1 1 JOHN WARD KEY EE SPLIT $ X 3084676 3084676 0 1 1 DONNA PETERS KEY EE SPLIT $ X 754304 754304 0 1 1 HELEN KOSELKA MD KEY EE SPLIT $ X 1603356 1603356 0 1 1 JENNY SKINNER KEY EE SPLIT $ X 1110266 1110266 0 1 1 THOMAS SHOCKLEY JR KEY EE SPLIT $ X 484306 484306 0 1 1 WILLIAM GRONEMAN KEY EE SPLIT $ X 1200014 1200014 0 1 1 MICHAEL CROFTON KEY EE SPLIT $ X 2389573 2389573 0 1 1 35873765 HEALTHCARE SOLUTIONS GROUP LLC QUINT STUDER-BOARD MEMBER 1318643 CONSULTING ENGAGEMENT WITH 35% OWNED ENTITY 0 TERRI CROFTON FAMILY MEMBER -MICHAEL CROFTON KEY EMPLOYEE 38622 EMPLOYEE 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: THE AMOUNT SHOWN IN PART IV, COLUMN (C) IS AT FAIR MARKET VALUE. FORM 990, PART III, LINE 1 THE MISSION OF TRIHEALTH, INC. IS TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. WE PURSUE OUR MISSION BY PROVIDING A FULL RANGE OF HEALTH RELATED SERVICES INCLUDING PREVENTION, WELLNESS AND EDUCATION. CARE IS PROVIDED WITH COMPASSION CONSISTENT WITH THE VALUES OF OUR ORGANIZATION. TRIHEALTH, INC. SERVES AS THE ENTITY THAT PROVIDES JOINT MANAGEMENT OF BETHESDA HOSPITAL AND GOOD SAMARITAN HOSPITAL UNDER AN AFFILIATION AGREEMENT BETWEEN BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES. FORM 990, PART III, LINE 4A TRIHEALTH, INC. ("TRIHEALTH") COMBINES THE STRENGTHS OF TWO OF GREATER CINCINNATI'S FINEST HEALTH CARE ORGANIZATIONS, BETHESDA HOSPITAL, INC. ("BETHESDA") AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO ("GOOD SAMARITAN"). FORMED IN 1995, TRIHEALTH CREATED AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IT SERVES, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION. TRIHEALTH IS DEDICATED TO DELIVERING THE BEST CARE POSSIBLE. BETHESDA AND GOOD SAMARITAN HAVE VALUES ROOTED IN SPIRITUAL HERITAGE AND COMPASSIONATE SERVICES TO THE COMMUNITY. BETHESDA WAS FOUNDED IN 1896 BY GERMAN METHODIST DEACONESSES TO CARE FOR CINCINNATI'S SICK AND POOR. A CATHOLIC ORGANIZATION, GOOD SAMARITAN WAS ESTABLISHED IN 1852 UNDER THE SPONSORSHIP OF THE SISTERS OF CHARITY TO PROVIDE CARE FOR THE POOR AND MEDICALLY UNDERSERVED. IN KEEPING WITH THESE EARLY PURPOSES, TRIHEALTH CONTINUES TO PROVIDE UNCOMPENSATED CARE TO THOSE IN NEED. THE "TRI" IN TRIHEALTH REPRESENTS ITS HOSPITALS, PHYSICIANS AND COMMUNITY WORKING TOGETHER TO IMPROVE THE HEALTH AND WELLNESS OF THE PEOPLE IT SERVES. THE "TRI" ALSO EXPRESSES OUR COMMITMENT TO THE PHYSICAL, MENTAL AND SPIRITUAL ASPECTS OF HEALTH. IN SERVING THE COMMUNITY'S NEEDS, TRIHEALTH OFFERS COMPREHENSIVE SERVICES AT MORE THAN 130 CONVENIENT LOCATIONS IN THE GREATER CINCINNATI AND TRISTATE AREA. ITS SITES INCLUDE FIVE HOSPITAL LOCATIONS AND PHYSICIAN OFFICE BUILDINGS IN ADDITION TO FITNESS, REHABILITATION, OCCUPATIONAL HEALTH AND OUTPATIENT CENTERS. TRIHEALTH ALSO PROVIDES SERVICES IN THE HOME AND IN THE WORKPLACE AND DELIVERS CARE AND EDUCATION COOPERATIVELY THROUGH COMMUNITY-BASED ORGANIZATIONS, SUCH AS CHURCHES, SCHOOLS, CLINICS AND SOCIAL AGENCIES. TRIHEALTH HOSPITALS HAVE BEEN RECOGNIZED LOCALLY AND NATIONALLY AS TOP-RATED IN MATERNITY CARE, NEONATAL INTENSIVE CARE, CARDIAC SURGERY AND CARDIOLOGY, ORTHOPEDICS, UROLOGY, NEUROLOGY/NEUROSURGERY, AND ENDOCRINOLOGY. TRIHEALTH PROVIDES ADMINISTRATIVE SUPPORT SERVICES FOR BOTH BETHESDA AND GOOD SAMARITAN AS WELL AS VARIOUS SUBSIDIARIES AND AFFILIATES. THE ADMINISTRATIVE SUPPORT SERVICES INCLUDE GENERAL ADMINISTRATION, INFORMATION SYSTEMS, FINANCE, HUMAN RESOURCES AND OTHER GENERAL SUPPORT SERVICES. THESE COSTS ARE ALLOCATED TO THE VARIOUS TRIHEALTH ENTITIES AND THE ENTITIES REIMBURSE TRIHEALTH AT COST. IN ADDITION, BETHESDA AND GOOD SAMARITAN EQUALLY FUND THE CASH FLOWS OF TRIHEALTH AND AS SUCH THE COSTS ALLOCATED BY TRIHEALTH ARE RECORDED AS EXPENSES ON THE FINANCIAL STATEMENTS OF BETHESDA AND GOOD SAMARITAN. THEREFORE, THE ALLOCATED SERVICE COSTS ARE PRESENTED ON TRIHEALTH'S FORM 990, PARTS VIII AND IX IN THE AGGREGATE AS THE EXPENSES ARE PRESENTED AS MANAGEMENT AND GENERAL EXPENSES ON THE FORMS 990 FOR BETHESDA AND GOOD SAMARITAN. FORM 990, PART VI, SECTION A, LINE 6 TRIHEALTH, INC. HAS TWO CORPORATE MEMBERS, BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES, THE PARENT ORGANIZATION OF THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. FORM 990, PART VI, SECTION A, LINE 7A TRIHEALTH, INC. HAS TWO CORPORATE MEMBERS, BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES, THE PARENT ORGANIZATION OF THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, WHO HAVE THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF TRIHEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B TRIHEALTH, INC. HAS TWO CORPORATE MEMBERS, BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES, THE PARENT ORGANIZATION OF THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, WHO MUST APPROVE AMENDMENTS TO TRIHEALTH INC.'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B MEMBERS OF THE BOARD ARE PROVIDED AN ELECTRONIC COPY OF FORM 990 PRIOR TO FILING AFTER REVIEW BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD, ALONG WITH THE COMMITTEE'S SUMMARY OF THE FORM 990. HOWEVER, FOR THE PROTECTION OF DONOR PRIVACY, SCHEDULE B - SCHEDULE OF CONTRIBUTORS WAS REMOVED FROM THE COPY PROVIDED TO THE BOARD. SUBSEQUENT TO PRESENTATION TO THE BOARD, THE ORGANIZATION FILES THE RETURNS MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH NON-SUBSTANTIVE CHANGES ARE NOT SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE CERTAIN FINANCIAL INTERESTS AND FIDUCIARY RELATIONSHIPS. THE EXECUTIVE COMMITTEE AND CORPORATE COUNSEL REVIEW RESPONSES, CONDUCT FURTHER INVESTIGATION (IF NECESSARY), AND DETERMINE WHEN A CONFLICT EXISTS WITH RESPECT TO A CERTAIN TRANSACTION. IF A CONFLICT EXISTS, THE TRANSACTION IS NOT TO BE ENTERED INTO UNLESS ALTERNATIVES ARE FULLY INVESTIGATED, AND IN THEIR ABSENCE, THE BOARD, WITHOUT THE PARTICIPATION OF THE INTERESTED MEMBER(S), DETERMINES THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. PLANS TO MANAGE THE CONFLICT DURING THE RELATIONSHIP ARE IMPLEMENTED. ALL DISCUSSIONS ARE APPROPRIATELY DOCUMENTED. ALL DIRECTORS AND MANAGERS, WHICH INCLUDE OFFICERS AND KEY EMPLOYEES, ARE REQUIRED TO ANNUALLY DISCLOSE ANY CIRCUMSTANCES, INCLUDING FAMILY AND BUSINESS RELATIONSHIPS, THAT MAY CREATE A CONFLICT OF INTEREST FOR THE ORGANIZATION. THESE RESPONSES ARE REVIEWED AND ACTED UPON BY A CONFLICT OF INTEREST COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE ANNUAL PROCESS PERFORMED BY TRIHEALTH, INC. INCLUDED: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANT; COMPENSATION SURVEY OR STUDY; AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ADDITIONALLY, ALL DISCUSSIONS AND DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 TRIHEALTH, INC.'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, LINE 16B DURING THE YEAR, TRIHEALTH, INC. PARTICIPATED IN A JOINT VENTURE WITH ONE OR MORE TAXABLE PERSONS AND/OR ORGANIZATIONS. AS OF THE END OF THE FISCAL YEAR, TRIHEALTH, INC. HAD NOT ADOPTED A WRITTEN POLICY OR PROCEDURE THAT REQUIRES THE ORGANIZATION TO NEGOTIATE, IN ITS TRANSACTIONS AND ARRANGEMENTS WITH OTHER MEMBERS OF THE VENTURE OR ARRANGEMENT, SUCH TERMS AND SAFEGUARDS AS ARE ADEQUATE TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. HOWEVER, ALL JOINT VENTURES, WHEN ENTERED INTO, HAVE OUTSIDE LEGAL COUNSEL REVIEW OF THE OPERATING AGREEMENT OR OTHER ORGANIZATIONAL DOCUMENTS TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED PRIOR TO THE COMMENCEMENT OF THE JOINT VENTURE. ONCE THE JOINT VENTURE COMMENCES, TRIHEALTH, INC. PERSONNEL MONITORS ITS ACTIVITIES TO ENSURE THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. FORM 990, PART VII, SECTION A - AVERAGE HOURS PER WEEK DIRECTORS (AS NOTED WITH A "MED STAFF PRES" REFERENCE) FOR TRIHEALTH, INC. SERVE ON THE BOARD IN THEIR CAPACITY AS MEDICAL STAFF PRESIDENT FOR EITHER BETHESDA HOSPITAL, INC. OR THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. COMPENSATION SHOWN OF $45,000 (AND WHEN APPLICABLE $12,000) IS FOR HIS/HER DUTIES AS MEDICAL STAFF PRESIDENT (OR MEDICAL STAFF PRESIDENT ELECT) OF THE RESPECTIVE HOSPITAL AND NOT FOR SERVING AS A DIRECTOR. IN ADDITION, IF APPLICABLE, THESE INDIVIDUALS MAY ALSO BE EMPLOYEES OF THE TRIHEALTH SYSTEM AND ANY REMAINING COMPENSATION FOR THOSE INDIVIDUALS SHOWN IS FOR THOSE DUTIES AND NOT FOR SERVING AS A DIRECTOR. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,035,352. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,035,352. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 31,910,872. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,910,872. CONSULTING: PROGRAM SERVICE EXPENSES 12,691,699. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,691,699. STAFFING: PROGRAM SERVICE EXPENSES 1,532,539. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,532,539. LINGUISTIC SERVICES: PROGRAM SERVICE EXPENSES 3,259,452. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,259,452. RECRUITMENT SERVICES: PROGRAM SERVICE EXPENSES 2,208,044. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,208,044. CATERING: PROGRAM SERVICE EXPENSES 126,873. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 126,873. AMBULANCE SERVICES: PROGRAM SERVICE EXPENSES 321,074. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 321,074. NUTRITION SERVICES: PROGRAM SERVICE EXPENSES 315,591. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 315,591. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 1,265,998. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,265,998. FORM 990, PART XI, LINE 9: CAPITAL CONTRIBUTION UNDER JOINT OPERATING AGREEMENT 142,080,972. CHANGE IN PENSION PLAN/SERP FUNDED STATUS 125,463,380. NET INCOME OF GOOD SAMARITAN HOSPITAL FREE CLINIC (FILES FORM 990) -18,036. FORM 990, PART VI, LINE 1A THE BOARD OF TRUSTEES OF TRIHEALTH, INC. ("THE CORPORATION"), ESTABLISHED AN EXECUTIVE COMMITTEE WHICH MAY EXERCISE SUCH POWER AND AUTHORITY OF THE BOARD OF TRUSTEES IN INTERVALS BETWEEN MEETINGS OF THE BOARD AS AUTHORIZED BY THE BOARD. THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT & CEO, SECRETARY AND TWO OTHER BOARD MEMBERS ALL IN ACCORDANCE WITH THE NETWORK AFFILIATION AGREEMENT. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF TRIHEALTH, INC. ARE AUDITED WITH ITS SUBSIDIARIES AND AFFILIATES ("TRIHEALTH"). TRIHEALTH HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF BOTH ITS AND ITS SUBSIDIARIES AND AFFILIATES FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF THE INDEPENDENT AUDITOR. DURING THE TAX YEAR, THERE WAS NOT A CHANGE IN THE PROCESS OF AUDIT OVERSIGHT AND/OR SELECTION OF AN INDEPENDENT AUDITOR BY TRIHEALTH. 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