2021-05-13T10:06:59-05:00 2020-06-30 861065772 DELOITTE TAX LLP 250 EAST FIFTH STREET SUITE 1900 CINCINNATI OH 45202 990 2019-07-01 311438846 TRIHEALTH INC TRIH 5135696575 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 MICHAEL CROFTON VP FINANCE 5135696577 2021-05-13 1 ALICIA JANISCH P00741382 5137847100 2019 2022-09-23 18:48:47Z MARK CLEMENT 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 388162471 0 X WWW.TRIHEALTH.COM X 1994 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 13 8 1339 8 383260 0 1968366 13494530 232049087 334393026 4128971 2742761 9924379 6925332 248070803 357555649 634442 1380150 0 0 138282040 163409822 0 0 0 125478295 204162543 264394777 368952515 -16323974 -11396866 1150513364 1357132386 157865104 178037705 992648260 1179094681 X SEE SCHEDULE O 0 0 368952515 1380150 341025445 SEE SCHEDULE O 368952515 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 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 291 0 1 1339 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 13 8 1 0 1 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 CRAIG EISENTROUT MD TRUSTEE (END 6/20) 1.00 60.00 X 0 304084 51011 RALPH MICHAEL CHAIR 1.00 3.00 X X 0 0 0 MARK CLEMENT PRESIDENT/CEO 25.00 35.00 X X 1481585 0 346875 PHILLIP CASTELLINI TRUSTEE 1.00 3.00 X 0 0 0 KATHY KELLY TRUSTEE (START 7/19) 1.00 3.00 X 0 0 0 THEODORE TORBECK TREASURER 1.00 3.00 X X 0 0 0 BOB COLLINS MD TRUSTEE 1.00 3.00 X 127616 0 0 PHILIP FOSTER TRUSTEE 1.00 3.00 X 0 0 0 SCOTT FRIEDSTROM MD MED STAFF PRES (END 12/19) 1.00 60.00 X 0 628253 88603 PHILLIP OBLINGER MD MED STAFF PRES (END 12/19) 1.00 60.00 X 83751 45000 0 QUINT STUDER TRUSTEE 1.00 3.00 X 0 0 0 RANCE DUKE TRUSTEE (START 7/19) 1.00 3.00 X 0 0 0 DANNY FISCHER MD MED STAFF PRES-(START 1/20) 1.00 3.00 X 0 12000 0 KURT KNOCHEL MD MED STAFF PRES-(START 1/20) 1.00 3.00 X 56056 12000 0 ANDREW DEVOE ASST TREASURER/CFO 25.00 35.00 X 737448 0 176417 STEVE GRACEY ASST SECRETARY/SVP LEGAL 25.00 35.00 X 534649 0 141312 JENNIFER SKINNER CHIEF NURSING EXEC. 55.00 5.00 X 384395 0 126252 DAVID COOK CHIEF HR OFFICER 55.00 5.00 X 475894 0 104412 JOHN WARD SVP-BETHESDA REGION 60.00 0.00 X 530464 0 157847 STEVE MOMBACH SVP-AMBULATORY SERVICES 5.00 55.00 X 567034 0 154881 KEVIN JOSEPH MD CHIEF MEDICAL OFFICER 25.00 35.00 X 692349 0 157176 ROB CERCEK EVP POP HEALTH (END 10/19) 60.00 0.00 X 643972 0 129240 MARLA SILLIMAN SVP-GOOD SAM REGION 60.00 0.00 X 613397 0 135315 CATHY FRENCH CIO (START 9/19) 60.00 0.00 X 310763 0 88289 BRYAN STRADER MD PHYSICIAN EXECUTIVE - TPP 0.00 60.00 X 574304 0 148499 VESTA JOHNS ADMIN EXEC-TPP 0.00 60.00 X 419693 0 155152 RANDY CURNOW JR PRESIDENT-TRIHEALTH PHO 0.00 60.00 X 380608 89663 90848 STEFANIE NEWMAN CNO-BETHESDA HOSPITAL 60.00 0.00 X 527004 0 69717 MARK WITTE EXECUTIVE DIRECTOR-TCI 60.00 0.00 X 460220 0 55836 MICHAEL CROFTON FORMER OFFICER 60.00 0.00 X 366377 0 113843 WILLIAM GRONEMAN FORMER KEY EMPLOYEE 60.00 0.00 X 418772 0 141038 MARY IRVIN FORMER KEY EMPLOYEE 0.00 0.00 X 190256 0 11541 GAIL DONOVAN FORMER KEY EMPLOYEE 0.00 0.00 X 903818 0 199356 11480425 1091000 2843460 340 1 1 0 HURON CONSULTING GROUP 1166 AVENUE OF THE AMERICAS NEW YORK NY 10036 CONSULTING 18192237 CATHOLIC HEALTHCARE INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 CLINICAL ENGINEERING 14593396 MICROSOFT CORPORATION ONE MICROSOFT WAY REDMOND WA 98052 SOFTWARE LICENSING 4449121 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 SOFTWARE CONSULTING 4433991 EMPOWER MEDIA MARKETING 15 EAST 14TH STREET CINCINNATI OH 45202 MARKETING 4120523 176 13494530 13494530 SHARED SERVICES REV 900099 292533340 292533340 AFFILIATED BILLING REV 900099 22722948 22722948 AFFILIATED IT REVENUE 900099 9208562 9208562 AFFILIATED RENTAL REV 531120 6984413 6984413 AFFILIATED UTILIZATION 900099 812595 812595 2131168 1747908 383260 334393026 4805365 4805365 6186 0 6186 6186 6186 28544218 30606822 -2062604 -2062604 -2062604 VALUE BASED REVENUE 900099 5533541 5533541 PURCHASE CARD REBATES 900099 390118 390118 VENDING REVENUE 900099 286727 286727 708760 708760 6919146 357555649 333657772 383260 10020087 X 1380150 1380150 8818715 8818715 2458798 2458798 114960859 114960859 10151413 10151413 18848534 18848534 8171503 8171503 153000 153000 6530300 6530300 771985 771985 335196 335196 78075483 78075483 16576851 16576851 8761580 8761580 28277855 28277855 8906364 8906364 679131 679131 246439 246439 1454658 1454658 40479560 40479560 4510623 4510623 MEDICAL/DIETARY SUPPLY 3486631 3486631 EQUIPMENT 2379162 2379162 ALLOCATION 1359045 1359045 DUES & SUBSCRIPTIONS 658178 658178 520502 520502 368952515 368952515 0 0 1698337 39061307 4351585 1509737 9856702 9856702 6215778 8447975 313938465 165940796 173547594 147997669 86308704 79245822 22208995 19445574 0 20000000 2250000 2118750 844075669 1029448850 1150513364 1357132386 55210204 73887800 20845794 6648686 49564577 82113442 32244529 15387777 157865104 178037705 X 992648260 1179094681 992648260 1179094681 1150513364 1357132386 X -11396866 -589209 198432496 X X 0 1 X 1 0 X X 2 BETHESDA HOSPITAL INC 310537122 3 1 0 142165410 GOOD SAMARITAN HOSPITAL OF CINTI 310537486 3 1 0 135914497 2 0 278079907 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 28575 28575 0 PART II-B, LINE 1: 1I) TRIHEALTH, INC. PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. 2486186 2486186 46685082 10533215 36151867 34100994 7973271 26127723 215304368 145597954 69706414 15361835 1836356 13525479 147997669 DUE FROM RELATED ORGANIZATIONS 981995548 INVESTMENT IN UNCONSOLIDATED ORGANIZATIONS 10695356 RIGHT OF USE ASSETS - OPERATING LEASE 34319074 ESCROW DEPOSIT 557400 MALPRACTICE ASSET 1881472 1029448850 ACCRUED EIB 4001466 ACCRUED WORKERS COMPENSATION 1528049 MALPRACTICE LIABILITY 9856722 ACCRUED PENSION OBLIGATION 1540 15387777 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, 2020 OR 2019. CENTRAL AMERICA AND THE CARIBBEAN INVESTMENTS 5568605 0 0 0 0 0 0 5568605 0 5568605 1 0 1 0 0 0 PART III ACCOUNTING METHOD: 1 UPTOWN CONSORTIUM INC 619 OAK STREET SUITE 1100 CINCINNATI OH 45206 200688727 501(C)(3) 362500 GENERAL PURPOSES UNITED WAY 2400 READING ROAD CINCINNATI OH 45202 310537502 501(C)(3) 152448 GENERAL SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 125000 SPONSORSHIP LEGAL AID SOCIETY OF CINCINNATI 215 EAST NINTH STREET SUITE 200 CINCINNATI OH 45202 310536673 501(C)(3) 112500 M-HELP PROGRAM FUNDING HEALTHY MOMS & BABES INC 2270 BANNING ROAD NO 200 CINCINNATI OH 45239 311155292 501(C)(3) 105000 GENERAL SUPPORT GREATER CINCINNATI FOUNDATION 720 E PETE ROSE WAY SUITE 120 CINCINNATI OH 45202 310669700 501(C)(3) 100000 PROJECT LIFT FUNDING FREESTORE FOODBANK INC 1141 CENTRAL PARKWAY CINCINNATI OH 45202 237122205 501(C)(3) 74044 SPONSORSHIP AMERICAN CANCER SOCIETY INC 250 WILLIAMS STREET NW SUITE 400 ATLANTA GA 30303 131788491 501(C)(3) 48500 SPONSORSHIP CENTER FOR RESPITE CARE INC PO BOX 141301 CINCINNATI OH 45250 202544994 501(C)(3) 40000 GENERAL SUPPORT SWEET CHEEKS DIAPER BANK 1615 REPUBLIC STREET CINCINNATI OH 45202 475175383 501(C)(3) 40000 SPONSORSHIP JDRF INTERNATIONAL 200 VESEY STREET 28TH FLOOR NEW YORK NY 10281 231907729 501(C)(3) 30000 SPONSORSHIP KAREN WELLINGTON MEMORIAL FOUNDATION FOR LIVING W BREAST CANCER 312 WALNUT ST NO 1800 CINCINNATI OH 45202 263768567 501(C)(3) 25000 SPONSORSHIP OVARIAN CANCER ALLIANCE OF GREATER CINCINNATI 4918 COOPER ROAD CINCINNATI OH 45242 311287785 501(C)(3) 20000 SPONSORSHIP FRIARS CLUB INC 4300 VINE STREET CINCINNATI OH 45217 310537485 501(C)(3) 20000 PROGRAM SUPPORT NAMI OF SOUTHWEST OHIO 4055 EXECUTIVE PARK DRIVE SUITE 450 450 CINCINNATI OH 45241 310998076 501(C)(3) 20000 SPONSORSHIP LEUKEMIA & LYMPHOMA SOCIETY INC 3 INTERNATIONAL DRIVE RYE BROOK NY 10573 135644916 501(C)(3) 15000 SPONSORSHIP EPISCOPAL RETIREMENT HOMES INC 3870 VIRGINA AVE CINCINNATI OH 45227 310554071 501(C)(3) 10000 SPONSORSHIP MARCH OF DIMES 10806 KENWOOD ROAD CINCINNATI OH 45242 131846366 501(C)(3) 10000 SPONSORSHIP INTERFAITH HOSPITALITY NETWORK OF GREATER CINCINNATI 990 NASSAU STREET CINCINNATI OH 45206 311335474 501(C)(3) 10000 DIREST SERVICES TO HOMELESS FAMILIES OHIO CANCER RESEARCH ASSOCIATES 85 EAST GAY STREET SUITE 700 COLUMBUS OH 43215 311038309 501(C)(3) 10000 SPONSORSHIP DOWN SYNDROME ASSOCIATION OF GREATER CINCINNATI 4623 WESLEY AVENUE CINCINNATI OH 45212 311051378 501(C)(3) 10000 SPONSORSHIP TENDER MERCIES INC 27 WEST 12TH STREET CINCINNATI OH 45202 311137270 501(C)(3) 10000 GENERAL SUPPORT EASTER SEALS TRISTATE 2901 GILBERT AVE CINCINNATI OH 45206 310873433 501(C)(3) 8000 SPONSORSHIP AMERICAN LUNG ASSOCIATION 4050 EXECUTIVE PARK DRIVE SUITE 402 402 CINCINNATI OH 45241 131632524 501(C)(3) 7500 SPONSORSHIP 24 0 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 CRAIG EISENTROUT MD TRUSTEE (END 6/20) 0 299737 0 0 0 4347 0 25410 0 25601 0 355095 0 0 MARK CLEMENT PRESIDENT/CEO 1158232 0 264531 0 58822 0 329321 0 17554 0 1828460 0 0 0 SCOTT FRIEDSTROM MD MED STAFF PRES (END 12/19) 0 543036 0 31795 0 53422 0 55677 0 32926 0 716856 0 0 ANDREW DEVOE ASST TREASURER/CFO 579546 0 140404 0 17498 0 144652 0 31765 0 913865 0 0 0 STEVE GRACEY ASST SECRETARY/SVP LEGAL 429210 0 86917 0 18522 0 109962 0 31350 0 675961 0 0 0 JENNIFER SKINNER CHIEF NURSING EXEC. 309470 0 58382 0 16543 0 108609 0 17643 0 510647 0 0 0 DAVID COOK CHIEF HR OFFICER 391458 0 81103 0 3333 0 79254 0 25158 0 580306 0 0 0 JOHN WARD SVP-BETHESDA REGION 416123 0 84343 0 29998 0 131884 0 25963 0 688311 0 0 0 STEVE MOMBACH SVP-AMBULATORY SERVICES 414506 0 124288 0 28240 0 137081 0 17800 0 721915 0 0 0 KEVIN JOSEPH MD CHIEF MEDICAL OFFICER 535110 0 124151 0 33088 0 125353 0 31823 0 849525 0 0 0 ROB CERCEK EVP POP HEALTH (END 10/19) 455459 0 118061 0 70452 0 106374 0 22866 0 773212 0 0 0 MARLA SILLIMAN SVP-GOOD SAM REGION 486503 0 121711 0 5183 0 120510 0 14805 0 748712 0 0 0 CATHY FRENCH CIO (START 9/19) 253556 0 53614 0 3593 0 68118 0 20171 0 399052 0 0 0 BRYAN STRADER MD PHYSICIAN EXECUTIVE - TPP 471969 0 82555 0 19780 0 116695 0 31804 0 722803 0 0 0 VESTA JOHNS ADMIN EXEC-TPP 343233 0 57126 0 19334 0 115510 0 39642 0 574845 0 0 0 RANDY CURNOW JR PRESIDENT-TRIHEALTH PHO 300305 89207 64409 0 15894 456 76990 4380 7488 1990 465086 96033 0 0 STEFANIE NEWMAN CNO-BETHESDA HOSPITAL 153704 0 80594 0 292706 0 49037 0 20680 0 596721 0 0 0 MARK WITTE EXECUTIVE DIRECTOR-TCI 230762 0 45891 0 183567 0 38443 0 17393 0 516056 0 0 0 MICHAEL CROFTON FORMER OFFICER 312830 0 47263 0 6284 0 88322 0 25521 0 480220 0 0 0 WILLIAM GRONEMAN FORMER KEY EMPLOYEE 305676 0 39310 0 73786 0 114176 0 26862 0 559810 0 27729 0 MARY IRVIN FORMER KEY EMPLOYEE 13497 0 38113 0 138646 0 9902 0 1639 0 201797 0 0 0 GAIL DONOVAN FORMER KEY EMPLOYEE 740011 0 155885 0 7922 0 189660 0 9696 0 1103174 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 IN ADDITION, DURING THE CALENDAR YEAR 2019, WILLIAM GRONEMAN RECEIVED A TAX INDEMNIFICATION AND GROSS UP PAYMENT ON A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PAYMENT. TRIHEALTH, INC. INCLUDED THE ENTIRE TAX INDEMNIFICATION AND GROSS UP PAYMENT AS TAXABLE INCOME ON THE INDIVIDUAL'S FORM W-2 FOR 2019. 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. THE FOLLOWING 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.: WILLIAM GRONEMAN - $27,729 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 2019 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: STEFANIE NEWMAN - $254,509 TERRI CROFTON FAMILY MEMBER MICHAEL CROFTON FORMER OFFICER 35294 EMPLOYEE 0 MICHAEL CROFTON JR FAMILY MEMBER MICHAEL CROFTON FORMER OFFICER 78506 EMPLOYEE 0 SCH L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS: THE AMOUNTS SHOWN IN PART IV, COLUMN (C) ARE 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 2 THE OFFICERS, DIRECTORS AND TRUSTEES OF TRIHEALTH, INC. LISTED IN PART VII, SECTION A HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARDS OF BETHESDA HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, BOTH AFFILIATED ENTITIES OF TRIHEALTH, INC. AS WELL AS TRIHEALTH HOSPITAL, INC. A SUBSIDIARY OF TRIHEALTH, INC. KEVIN JOSEPH, MD, MARK CLEMENT, ROB CERCEK AND STEVE GRACEY HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL, AN AFFILIATED ENTITY OF TRIHEALTH, INC. KATHY KELLY, RANCE DUKE, PHILLIP OBLINGER, MD, CRAIG EISENTROUT, MD, DANNY FISCHER, MD, QUINT STUDER AND BOB COLLINS, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF BETHESDA, INC., THE SINGLE CORPORATE MEMBER OF BETHESDA HOSPITAL, INC. MARK CLEMENT, JENNY SKINNER, AND SR. SALLY DUFFY HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE, AN AFFILIATED ENTITY OF TRIHEALTH, INC. MARK CLEMENT, ANDREW DEVOE, STEVE GRACEY, DAVID COOK, KEVIN JOSEPH, MD, ROB CERCEK, CRAIG EISENTROUT, MD, SCOTT FRIEDSTROM, MD, PHILLIP OBLINGER, MD, STEVE MOMBACH, JOHN WARD, MARLA SILLIMAN AND JENNIFER SKINNER HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON RELATED ENTITY BOARDS OF TRIHEALTH, INC. AND ITS SUBSIDIARIES AND AFFILIATES AS WELL AS BEING EMPLOYED BY TRIHEALTH, INC. OR ITS AFFILIATES/SUBSIDIARIES. MARK CLEMENT AND CRAIG EISENTROUT, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE BETHESDA FOUNDATION, INC., AN AFFILIATED ENTITY. FORM 990, PART VI, SECTION A, LINE 4 DURING THE TAX YEAR, THE CODE OF REGULATIONS FOR TRIHEALTH, INC. WAS AMENDED TO PERMIT EACH SPONSOR TO HAVE A TRUSTEE SERVE AN UNLIMITED NUMBER OF TERMS. 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 IS FOR HIS/HER DUTIES AS MEDICAL STAFF PRESIDENT OF THE RESPECTIVE HOSPITAL AND NOT FOR SERVING AS A DIRECTOR. IN ADDITION, THESE INDIVIDUALS ARE ALSO EMPLOYEES OF THE TRIHEALTH SYSTEM AND ANY REMAINING COMPENSATION SHOWN IS FOR THOSE DUTIES AND NOT FOR SERVING AS A DIRECTOR. FORM 990, PART IX, LINE 11G BILLING SERVICES: PROGRAM SERVICE EXPENSES 8,472,835. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,472,835. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 25,611,505. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,611,505. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 16,711,258. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,711,258. CONSULTING: PROGRAM SERVICE EXPENSES 21,856,409. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,856,409. STAFFING: PROGRAM SERVICE EXPENSES 1,279,080. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,279,080. LINGUISTIC SERVICES: PROGRAM SERVICE EXPENSES 1,483,654. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,483,654. RECRUITMENT SERVICES: PROGRAM SERVICE EXPENSES 959,536. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 959,536. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 296,287. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 296,287. CATERING: PROGRAM SERVICE EXPENSES 451,967. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 451,967. AMBULANCE SERVICES: PROGRAM SERVICE EXPENSES 368,607. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 368,607. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 584,345. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 584,345. FORM 990, PART XI, LINE 9: CAPITAL CONTRIBUTION UNDER JOINT OPERATING AGREEMENT 177,634,196. CHANGE IN PENSION PLAN/SERP FUNDED STATUS 14,656,107. NET INCOME OF GOOD SAMARITAN HOSPITAL FREE CLINIC (FILES FORM 990) -249,689. NON-FINANCIAL INSURANCE ADJUSTMENT 12,627,642. ADJUSTMENT DUE TO LEASE REPORTING IMPLEMENTATION -503,035. REMOVAL OF PRIOR YEAR INVESTMENT LAG AMOUNT -5,732,725. 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. BETHESDA HOSPITAL INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310537122 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310537486 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN ENTERPRISE CORP 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311383365 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN INSTITUTE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311074519 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 TRIHEALTH INC 1 GOOD SAMARITAN HOSPITAL FREE CLINIC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 273893817 FREE CLINIC OH SECTION 501(C)(3) SCHEDULE A, LINE 7 TRIHEALTH INC 1 TRIHEALTH HOSPITAL INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 461393755 INPATIENT AND OUTPATIENT SERVICES OH SECTION 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