2019-05-15T10:13:48-05:00 2018-06-30 861065772 DELOITTE TAX LLP 250 EAST FIFTH STREET SUITE 1900 CINCINNATI OH 45202 990 2017-07-01 310650283 MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED MCCU 5135245310 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 MICHAEL CROFTON VP-FINANCE 5135245310 2019-05-14 1 ALICIA JANISCH P00741382 5137847100 174.226.148.89 2019-05-14 21:35:29 ED P CD71869BFC494223FABD92E93AB0669CE7B22062 5D794220C68C161820A811785299AFD302F4C684 2017 2019-02-21 02:37:17Z X MARK CLEMENT 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 55450106 0 X WWW.MHMH.ORG X 1953 OH ACUTE CARE HOSPITAL DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. 9 6 379 230 0 0 0 0 46408912 54627412 96212 28360 295262 588626 46800386 55244398 314854 12815 0 0 23091890 23245347 0 0 0 26763812 29680455 50170556 52938617 -3370170 2305781 56126707 56041994 23800093 20919848 32326614 35122146 X ACUTE CARE HOSPITAL FACILITY DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE. 0 0 45601707 12815 54514873 SURGERY - THIS SERVICE IS COMPRISED OF SURGERY AND MINOR PROCEDURES. TOTAL VOLUME WAS 1,601 CONSISTING OF IP CARE (31%) AND OUTPATIENT CARE (69%).PHARMACY - THIS SERVICE CONSISTS OF CARE PROVIDED TO INPATIENTS (16%) AND OUTPATIENTS (84%). OUTPATIENT CARE INCLUDES A MAJOR PROGRAM FOR ONCOLOGY TREATMENT.INPATIENT CARE - INPATIENT VOLUME CONSISTED OF 1,961 DISCHARGES AND 5,394 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 2.75 DAYS. BIRTHS TOTALED 393 AND A TOTAL OF 761 OBSERVATION DAYS OF SERVICE.FOR ADDITIONAL INFORMATION PLEASE SEE SCHEDULE H. 45601707 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 104 0 1 379 1 1 1 0 0 0 0 0 0 0 0 0 X 9 6 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MICHAEL CROFTON 5135696577 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 ALAN OAK CHAIR 1.00 1.00 X X 0 0 0 ROBERT COLLINS MD DIRECTOR (END 12/17) 1.00 60.00 X 0 600543 165747 HILLARY EVANS MD DIRECTOR 1.00 1.00 X 0 0 0 JOHN HARLAN MD DIRECTOR 1.00 1.00 X 0 0 0 MYRTIS POWELL DIRECTOR 1.00 1.00 X 0 0 0 MARK CLEMENT SECRETARY 1.00 60.00 X X 0 1443430 315687 GAIL DONOVAN VICE CHAIR 1.00 60.00 X X 0 924940 201973 JAMES FORMAL TREASURER 1.00 1.00 X X 0 0 0 JASON NIEHAUS DIRECTOR 1.00 60.00 X 0 503194 98789 RALPH GUTOWSKI DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL CROFTON ASSISTANT TREASURER 1.00 60.00 X 0 393249 117173 BRETT KIRKPATRICK EXECUTIVE DIRECTOR-MHMH 30.00 30.00 X 0 238260 44918 GREGORY CALKINS MD PHYSICIAN 60.00 0.00 X 191208 0 28718 SHARON HANCOCK SITE DIRECTOR - HR 60.00 0.00 X 145559 0 28505 STEVEN VORDENBERG PHYSICIAN ASSISTANT 60.00 0.00 X 127789 0 11354 TIMOTHY HOLDER DIRECTOR-PHYSICAL THERAPY 60.00 0.00 X 115792 0 23873 JAMES VANDEN EYNDEN DIRECTOR-FACILITY & SERVICES 60.00 0.00 X 112544 0 12409 JOHN PROUT FORMER OFFICER 0.00 40.00 X 0 252304 0 DWIGHT ELLINGWOOD FORMER OFFICER 0.00 0.00 X 0 188878 9422 692892 4544798 1058568 13 1 1 0 SHIFTWISE INC 1800 SW 1ST AVE SUITE 510 PORTLAND OR 97201 MEDICAL STAFFING 560989 WESTERN OHIO ANESTHESIA ASSOCIATES 110 N POPLAR STREET OXFORD OH 45056 ANESTHESIA SERVICES 340417 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 CLINICAL ENGINEERING 310841 UNITED WOMEN'S HEALTH SERVICES LLC 1700 WEST PARK DR WESTBOROUGH MA 01581 MEDICAL SERVICES 148704 SIRIUS COMPUTER SOLUTIONS INC 10100 REUNION PLACE SAN ANTONIO TX 78216 IT SOLUTIONS 143785 16 PATIENT SERVICES 900099 54168460 54168460 MANAGEMENT REVENUE 900099 254219 254219 AFFILIATED RENTAL REV. 531120 204733 204733 54627412 26161 26161 390746 205708 185038 185038 185038 2199 0 2199 2199 2199 CAFETERIA/VENDING 722210 311394 311394 WELLNESS CENTER 900099 62875 62875 MEDICAL RECORDS 900099 15155 15155 14164 14164 403588 55244398 54514873 0 729525 12815 12815 18220604 18220604 299554 299554 3458146 3458146 1267043 1267043 1435387 1435387 9065 9065 22000 22000 3537 3537 4137530 4127548 9982 332821 66553 266268 696847 691205 5642 1400512 1397506 3006 1822366 1817559 4807 26445 24415 2030 17141 16221 920 472757 472757 5282504 279589 5002915 161505 161505 MEDICAL/DIETARY SUPPLY 11393257 11338924 54333 EQUIPMENT 1407358 1405951 1407 OHIO HOSPITAL TAX 942985 942985 DUES AND SUBSCRIPTIONS 114680 71826 42854 1758 1758 52938617 45601707 7336910 0 2473 2474 1264657 2816060 5278484 7089055 312019 367080 932378 843512 585805 396157 56385339 16867691 39942807 39517648 7402266 4606546 405818 403462 56126707 56041994 3764582 3697003 9320000 9320000 7774412 6987939 2941099 914906 23800093 20919848 X 32303807 35099941 22807 22205 32326614 35122146 56126707 56041994 X 2305781 336512 153239 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 135 135 0 PART II-B, LINE 1: DURING THE TAX YEAR, MCCULLOUGH-HYDE MEMORIAL HOSPITAL PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. 7548410 7548410 20795153 3214812 17580341 2272500 1250208 1022292 18611974 12170848 6441126 7157302 231823 6925479 39517648 ESTIMATED THIRD PARTY SETTLEMENTS 100515 ACCRUED MALPRACTICE LIABILITY 124771 ACCRUED EIB 198777 SECURITY DEPOSITS 19327 DUE TO RELATED ORGANIZATION 471516 914906 X PART X, LINE 2: THE FINANCIAL STATEMENTS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL ARE AUDITED AS PART OF TRIHEALTH AND ITS SUBSIDIARIES AND AFFILIATES ("TRIHEALTH"). 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 CERTAIN TAX POSITIONS UNDER ASC 740-10-25: TRIHEALTH PERFORMED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT JUNE 30, 2018 OR 2017. 1 1 X 1 X 1 X 1 1 0 1 1 360853 1241682 0 0.00000 8801635 4005129 4796506 0.09060 9162488 5246811 4796506 0.09060 2950 0 2950 0.00010 55023 0 55023 0.00100 10000 0 10000 0.00020 67973 67973 0.00130 9230461 5246811 4864479 0.09190 0 2658618 0 9847452 11371171 -1523719 X 1 1 1 1 MCCULLOUGH-HYDE MEMORIAL HOSPITAL 110 N POPLAR STREET OXFORD OH 45056 WWW.MHMH.ORG 55577 X X X MCCULLOUGH-HYDE MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X SEE PART V, SECTION C, PAGE 7 X 1 15 1 SEE PART V, SECTION C, PAGE 7 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: PRIMARY RESEARCHCHNA COMMUNITY FOCUS GROUPS/PUBLIC MEETINGS: THE FOCUS GROUPS WERE CONDUCTED BY AN ASSIGNED FACILITATOR AND SCRIBES. THE FACILITATOR INTRODUCED THE ATTENDEES TO THE COUNTY SNAPSHOT AND THE CNI MAP. AFTER A PERIOD OF QUESTIONS AND BRAINSTORMING, EACH ATTENDEE WAS ASKED TO INDICATE WHICH ISSUES WERE MOST IMPORTANT. THE ATTENDEES INCLUDED MEMBERS OF THE COMMUNITY AND REPRESENTATIVES OF ORGANIZATIONS SERVING THE COMMUNITY, INCLUDING COMMUNITY ADVOCATES AND REPRESENTATIVES FROM FAITH-BASED ORGANIZATIONS, PUBLIC HEALTH DEPARTMENTS, AND COMMUNITY-BASED HEALTH CENTERS. THE PURPOSE OF THE MEETINGS WAS TO SOLICIT PUBLIC INPUT. THE RESULTS OF THE COMMUNITY FOCUS GROUPS WERE SUMMARIZED BY COUNTY. THIS DOCUMENT REFERS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY FOCUS GROUPS AS "COMMUNITY FOCUS GROUPS OR "FOCUS GROUPS".CHNA COMMUNITY HEALTH SURVEYS: THE SURVEY WAS CUSTOMIZED FOR THREE DIFFERENT RESPONDENTS: CONSUMERS, AGENCIES, AND HEALTH DEPARTMENTS. A SPANISH LANGUAGE SURVEY WAS ALSO CREATED WITH THE HELP OF COMMUNITY HEALTH WORKERS. THE SURVEY CONTAINED QUESTIONS ABOUT THE HEALTH ISSUES FACING THE COMMUNITY, IF HEALTH ISSUES WERE BEING ADDRESSED, AND WHAT BARRIERS THE COMMUNITY WAS EXPERIENCING. SOME PARTICIPANTS PREFERRED TO RESPOND IN-PERSON OR OVER THE PHONE, THESE RESPONSES WERE TRANSCRIBED INTO THE SURVEY TOOL. THIS DOCUMENT REFERS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMMUNITY SURVEYS AS "SURVEYS".SECONDARY RESEARCHSECONDARY RESEARCH CONSISTED OF GATHERING AVAILABLE HEALTH-RELATED DATA FOR A COLLECTION OF TWENTY-THREE COUNTIES, INCLUDING BUTLER, CLERMONT, HAMILTON, AND WARREN COUNTIES. BECAUSE THE TARGETED REGION SPANNED THREE STATES, CONSISTENT DATA WERE NOT ALWAYS AVAILABLE, AND NOT ALL DATA WERE AVAILABLE FOR THE ENTIRE REGION. WHENEVER POSSIBLE, DATA WERE COLLECTED AT THE COUNTY LEVEL. SUB-COUNTY LEVEL DATA WERE NOT A FOCUS OF THIS RESEARCH. THE COUNTY HEALTH RANKINGS (CHR) FORMED THE FOUNDATION FOR DATA COLLECTION WITH ITS COUNTY-LEVEL FOCUS ON HEALTH OUTCOMES, HEALTH FACTORS, HEALTH BEHAVIORS, QUALITY OF LIFE, CLINICAL CARE, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC FACTORS. DATA WAS VERIFIED AND FORMATTED CONSISTENTLY; SUPPLEMENTAL DATA WAS ALSO IDENTIFIED AND COLLECTED. THE INTERACTIVE TOOL ON THE CNI (COMMUNITY NEED INDEX) WAS ACCESSED TO CREATE COUNTY-LEVEL MAPS AND ZIP CODE TABLES. THE CHR AND CNI WEBSITES WERE MONITORED FOR PERIODIC DATA UPDATES AND DATA WORKSHEETS WERE REVISED UNTIL SEPTEMBER 2015.STANDARDS FOR RESEARCHING AND INCLUDING THE DATA WERE ESTABLISHED AND INCLUDED THE FOLLOWING CHARACTERISTICS: COMPARABLE, COUNTY-LEVEL, FOCUSED ON HEALTH OUTCOMES, REPRODUCIBLE, REPUTABLE, AND TRENDED. THE CHR SERVED AS A STARTING POINT BUT RESOURCES WITH MORE RECENT DATA AND ADDITIONAL MEASURES WERE ALSO IDENTIFIED.INPUT FROM A BROAD RANGE OF REPRESENTATIVESINPUT WAS RECEIVED FROM INDIVIDUALS REPRESENTING UNDERSERVED POPULATIONS USING, PRIMARILY THE TWO SURVEY APPROACHES DESCRIBED ABOVE. THE COMBINATION OF THESE METHODS PROVIDED A WIDE-RANGE OF DATA COLLECTION OPPORTUNITIES ON WHICH THE CHNA COULD BE BASED.CHNA COMMUNITY FOCUS GROUPS: A TOTAL OF 156 INDIVIDUALS ATTENDED THE 11 FOCUS GROUPS, 134 OF THE ATTENDEES REPRESENTED AN ORGANIZATION. THE ORGANIZATIONS REPRESENTED BY THESE ATTENDEES SERVE THE FOLLOWING POPULATIONS: CHILDREN, ELDERLY, HOMELESS, LOW-INCOME, MEDICALLY UNDERSERVED, MINORITY, PEOPLE WITH MENTAL ILLNESS, AND VICTIMS OF DOMESTIC VIOLENCE. FIFTEEN INDIVIDUALS, ALL REPRESENTING ORGANIZATIONS, ATTENDED THE BUTLER COUNTY FOCUS GROUP ON JULY 30, 2015. THREE INDIVIDUALS ATTENDED THE CLERMONT COUNTY FOCUS GROUP ON JULY 28, 2015. APPROXIMATELY 50 INDIVIDUALS ATTENDED MEETINGS ON BEHALF OF HAMILTON COUNTY, THE MAJORITY REPRESENTED AN ORGANIZATION. ON JULY 7, 2015, SIX INDIVIDUALS ATTENDED THE WARREN COUNTY FOCUS GROUP AND REPRESENTED PREMIER HEALTH: ATRIUM MEDICAL CENTER AND PREVENTIONFIRST OR CAME ON THEIR OWN BEHALF. CHNA SURVEY: IN AGGREGATE, 329 INDIVIDUALS, 55 AGENCY REPRESENTATIVES, 52 LATINOS, AND 24 HEALTH DEPARTMENT REPRESENTATIVES COMPLETED THE CHNA SURVEY. THE CHNA TEAM, CHNA COMMITTEE, AND PARTNERS HELPED DISTRIBUTE THE SURVEY. AT COMMUNITY MEETINGS, A HANDOUT PROVIDED THE SURVEY LINK, AND THE LINKS WERE WRITTEN ON AN EASEL PAD AT THE FRONT OF THE ROOM. THROUGHOUT THE REGION, 381 INDIVIDUAL SURVEYS AND 55 AGENCY SURVEYS WERE COMPLETED, INCLUDING RESPONSES FROM AGENCIES SUCH AS BUTLER COUNTY UNITED WAY, CLERMONT COUNTY MENTAL HEALTH & RECOVERY BOARD, AND THE YMCA OF GREATER CINCINNATI. IN BUTLER, CLERMONT, HAMILTON, AND WARREN COUNTIES, RESPONDENTS INCLUDED CONTACTS FROM LOCAL HEALTH DEPARTMENTS: THE BUTLER COUNTY HEALTH DEPARTMENT, CITY OF HAMILTON HEALTH DEPARTMENT, THE MIDDLETOWN CITY HEALTH DISTRICT, THE CLERMONT COUNTY GENERAL HEALTH DISTRICT, HAMILTON COUNTY PUBLIC HEALTH, NORWOOD CITY HEALTH DISTRICT, SPRINGDALE CITY HEALTH DISTRICT, AND WARREN COUNTY COMBINED HEALTH DISTRICT. OTHER ORGANIZATIONS THAT COMPLETED THE SURVEY INCLUDED GOOD SAMARITAN FREE HEALTH CENTER, AND THE GREATER CINCINNATI FOUNDATION, ETC. MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: ADAMS COUNTY REGIONAL MEDICAL CENTER, ATRIUM MEDICAL CENTER, DEARBORN COUNTY HOSPITAL, LINDNER CENTER OF HOPE, MARGARET MARY COMMUNITY HOSPITAL, MERCY HEALTH, UC HEALTH, BETHESDA NORTH HOSPITAL, BETHESDA BUTLER COUNTY, GOOD SAMARITAN HOSPITAL OF CINCINNATI,THE CHRIST HOSPITAL, CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: HEALTH COLLABORATIVE, CITY OF CINCINNATI HEALTH DEPARTMENT, HAMILTON COUNTY PUBLIC HEALTH, INTERACT FOR HEALTH, XAVIER UNIVERSITY DEPARTMENT OF HEALTH SERVICES ADMINISTRATION MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: AVAILABLE UPON REQUEST WITHOUT CHARGE. MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: OBESITY: TO ADDRESS THIS SIGNIFICANT HEALTH NEED IN THE COMMUNITY, MHMH/TH PLANS TO TAKE THE FOLLOWING ACTIONS AND COMMIT THE FOLLOWING RESOURCES: * COALITION FOR A HEALTHY COMMUNITY: CONTINUE TO SUPPORT THEIR OBESITY REDUCTION/PREVENTION WORKGROUP EFFORTS, AS FOLLOWS: **THRIVING COMMUNITY OXFORD (ACTIVE LIVING): THEIR WORK INCLUDES COMMUNITY WALKING CHALLENGES, SOCIAL MARKETING PROGRAM WITH SCHOOLS AND COMMUNITY MEMBERS, "ROX" FOR HEALTHY CHOICES. ** HEALTHY CHOICES IN FOOD, BOTH IN SCHOOLS, KIDS BACKPACK PROGRAMMING, MEALS ON WHEELS. SUPPORT HEALTHY CHOICES WITH SOCIAL MARKETING CAMPAIGN AT LOCAL GROCERY STORES AND RESTAURANTS. ** SUPPORT COMMUNITY GARDENS AND FOOD PANTRIES. ** SAFE ROUTES TO SCHOOL INITIATIVE ** COMMUNITY WALKING CHALLENGES, RESOURCES TO SCHOOLS, ETC. * OXFORD AREA TRAILS: COMMITMENT TO EXTEND THE TRAIL FROM THE CITY TO THE TRAIL HEAD. THIS STARTS ONE BLOCK FROM MHMH/TH AND GOES PAST MANY MEDICAL OFFICE BUILDINGS. * SAFE ACTIVE PLAY IN RURAL AREAS: MHMH/TH WILL BUILD PLAYGROUNDS IN 3 COMMUNITIES, DARRTOWN, OHIO; BROOKVILLE, INDIANA AND CAMDEN, OHIO (ONE EACH YEAR) TO ENCOURAGE PLAY AND INTERACTION WITH ADULTS. * SUPPORT OTHER HEALTH AND WELLNESS INITIATIVES IN OUR SERVICE AREA THAT PROMOTE HEALTHY LIFESTYLES * ASSESS REVIVING MHMH/TH HEALTHY YOU PROGRAM: THIS PROGRAM ALLOWED 2 ONE ON ONE VISITS WITH AN EXERCISE PHYSIOLOGIST AND DIETITIAN. AN INDIVIDUAL PLAN WAS DEVELOPED AND TELEPHONE FOLLOW-UP OCCURRED 6 MONTHS AND 12 MONTHS POST VISIT.MENTAL HEALTH: TO ADDRESS THIS SIGNIFICANT HEALTH NEED IN THE COMMUNITY, MHMH/TH PLANS TO TAKE THE FOLLOWING ACTIONS AND COMMIT THE FOLLOWING RESOURCES: * COALITION FOR A HEALTHY COMMUNITY: CONTINUE TO SUPPORT THEIR MENTAL WORKGROUP EFFORTS, AS FOLLOWS: ** LOCAL RESOURCE LIST WHICH IS UPDATED EVERY 6 MONTHS AND SENT OUT TO PHYSICIANS, POLICE, CHURCHES, SOCIAL SERVICE AGENCIES AND SCHOOLS. ** DEVELOP A SOCIAL NORM CAMPAIGN AND COMMUNITY EDUCATION ON MENTAL HEALTH ** WORK WITH BUTLER COUNTY MENTAL HEALTH BOARD TO BRING OUTPATIENT MENTAL HEALTH SERVICES TO OXFORD. * SUPPORT OTHER IDENTIFIED WORK OF THE COALITION AND OTHER MENTAL HEALTH AND WELLNESS INITIATIVES IN OUR SERVICE AREA. * OFFER MENTAL HEALTH FIRST AID THROUGHOUT OUR SERVICE AREA (BOTH THE YOUTH AND ADULT COURSES): THIS EVIDENCE BASED PROGRAM THAT IS NATIONALLY RECOGNIZED. PROGRAM TEACHES HOW TO IDENTIFY WHEN A PERSON IS HAVING MENTAL HEALTH PROBLEMS, HOW TO TALK TO THEM AND HOW TO MAKE REFERRALS. * CONTINUE TO WORK WITH TRIHEALTH 'S BEHAVIORAL HEALTH ON INPATIENT PLACEMENT.ALCOHOL AND OTHER DRUGS (AOD): TO ADDRESS THIS SIGNIFICANT HEALTH NEED IN THE COMMUNITY, MHMH/TH PLANS TO TAKE THE FOLLOWING ACTIONS AND COMMIT THE FOLLOWING RESOURCES: * COALITION FOR A HEALTHY COMMUNITY: CONTINUE TO SUPPORT THEIR AOD WORKGROUP EFFORTS: * LOCK BOX PROGRAM: PROVIDE LOCK BOXES TO LOCAL PHYSICIANS TO GIVE TO THEIR PATIENTS TO LOCK UP MEDS. ** COMMUNITY PROGRAMING ON OPIATES AND OTHER DRUGS. ** MEDICATION TAKE BACK DAYS ** SUPPORT OTHER IDENTIFIED WORK OF THE COALITION AND OTHER AOD HEALTH AND WELLNESS INITIATIVES IN OUR SERVICE AREA. * YOUTH LED PREVENTION RETREAT: TALAWANDA'S YOUTH INITIATIVE TEAM (YIT) IS AN ACTIVE/ EXPERIENCED YOUTH PREVENTION TEAM. THE PLAN IS FOR OTHER SCHOOL DISTRICTS TO LEARN FROM THEIR EXPERIENCE. MHMH/TH WOULD INVITE 20 STUDENT LEADERS FROM BROOKVILLE HIGH SCHOOL, PREBLE SHAWNEE HIGH SCHOOL (CAMDEN), ROSS HIGH SCHOOL, COLLEGE CORNER/UNION COUNTY JOINT SCHOOL DISTRICT HIGH SCHOOL, EATON HIGH SCHOOL AND TALAWANDA TO COME TOGETHER TO LEARN ABOUT EVIDENCE BASED PREVENTION STRATEGIES AND TO EMPOWER THE STUDENTS TO TAKE THESE IDEAS BACK TO THEIR SCHOOLS AND COMMUNITIES FOR IMPLEMENTATION. MHMH/TH WOULD ASK EACH SCHOOL DISTRICT TO IDENTIFY A STAFF MEMBER TO PROVIDE ADULT SUPERVISION, ADVISE THE STUDENT LEADERS AND HELP THEM IMPLEMENT THEIR PREVENTION STRATEGY PROJECT. MHMH/TH WOULD PROVIDE A STIPEND TO THESE STAFF LEADERS. EACH SCHOOL DISTRICT WOULD BE ASKED TO DEVELOP A WRITTEN PLAN FOR THEIR PREVENTION STRATEGY AND MAKE PREVENTION TO A PANEL AT MHMH/TH. EACH SCHOOL DISTRICT THAT DOES THIS WOULD BE GIVEN $1000 TO HELP THEM IMPLEMENT THEIR PLAN. MHMH/TH WOULD ASK EACH SCHOOL TO REPORT ON THE SUCCESS OF THEIR PROJECT OR IF NOT SUCCESSFUL, WHAT THEY WOULD CHANGE FOR NEXT TIME. THIS WOULD BE HELD ONCE A YEAR. * MCCULLOUGH-HYDE/TRIHEALTH TASKFORCE: THIS GROUP WILL BE FORMED TO ASSESS PRESCRIBING PRACTICES OF LOCAL PHYSICIANS AND HOW TO CARE FOR PATIENTS WHO ARE ADDICTED BUT NEED CONTROL IN THE HOSPITAL SETTING.ACCESS TO CARE: MHMH/TH IS ASSISTING WITH ACCESS TO CARE AND THE COMMUNITY'S TRANSPORTATION NEEDS, BUT IS NOT TAKING A SUPPORTIVE ROLE IN THIS INITIATIVE. MHMH/TH IS SUPPORTING THE OXFORD FREE CLINIC, WHICH PROVIDES FREE HEALTHCARE TO THE COMMUNITY, AND SUPPORTS COMMUNITY LIFE SQUADS. ADDITIONALLY, MHMH/TH'S AFFILIATION HAS INCREASED THE NUMBER OF SPECIALISTS AVAILABLE TO SERVE THE COMMUNITY, INCLUDING THE INTRODUCTION OF A MAMMOGRAPHY VAN INTO THE AREA. FINALLY, PRIMARY HEALTH SOLUTIONS, A FEDERALLY QUALIFIED HEALTH CENTER, HAS RECENTLY OPENED OFFICES IN MHMH/TH'S COMMUNITY, WHICH WILL FURTHER ACCESS TO CARE. MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 13B: SEE PART VI RESPONSE RELATED TO PART I, LINE 3C. MCCULLOUGH-HYDE MEMORIAL HOSPITAL PART V, SECTION B, LINE 13H: SEE PART VI RESPONSE RELATED TO PART I, LINE 3C. PART V, SECTION B, LINES 7A AND 10A CHNA & IMPLEMENTATION PLAN WEBSITE HTTPS://WWW.TRIHEALTH.COM/HOSPITALS-AND-PRACTICES/UNFORTUNATELY, THE URL IS TOO LONG FOR THE SOFTWARE. SO ONCE YOU HAVE USED THE ABOVE URL, PLEASE PERFORM THE NEXT STEPS:UNDER "HOSPITALS (& EMERGENCY)", CLICK ON "MCCULLOUGH-HYDE MEMORIAL HOSPITAL"IN THE GREY BOX ON THE LEFT HAND SIDE OF THE PAGE, CLICK "SERVICES".IN THE GREY BOX ON THE LEFT HAND SIDE OF THE PAGE, CLICK "COMMUNITY SERVICES AND THEN "HEALTH NEEDS ASSESSMENT". 5 1 - MCCULLOUGH-HYDE MEDICAL BUILDING 5151 MORNING SUN ROAD OXFORD OH 45056 PHYSICAL THERAPY 2 - MCCULLOUGH-HYDE MEDICAL BUILDING 10058 COOLEY ROAD BROOKVILLE IN 47012 OUTPATIENT 3 - MCCULLOUGH-HYDE PT & REHAB 1390 EATON ROAD HAMILTON OH 45013 PHYSICAL THERAPY 4 - MCCULLOUGH-HYDE OUTPATIENT SERVICES 2449 ROSS-MILLVILLE ROAD HAMILTON OH 45013 OUTPATIENT, URGENT CARE, PT 5 - MCCULLOUGH-HYDE OUTPATIENT SERVICES 79 W CENTRAL AVENUE CAMDEN OH 45311 OUTPATIENT PART I, LINE 3C: MCCULLOUGH-HYDE MEMORIAL HOSPITAL UTILIZES THE FEDERAL POVERTY GUIDELINES ("FPG") IN DETERMINING CHARITY CARE ELIGIBILITY. SEE THE RESPONSES TO PART I, LINES 3A AND 3B.AN INDIVIDUAL'S INCOME UNDER THE FPG IS A SIGNIFICANT FACTOR IN DETERMINING ELIGIBILITY FOR CHARITY CARE. ADDITIONALLY, AN INDIVIDUAL'S INCOME IN RELATION TO HIS/HER MEDICAL EXPENSES IS ALSO TAKEN INTO ACCOUNT AND SUCH A PATIENT MAY BE EXTENDED DISCOUNTED OR FREE CARE BASED UPON THE FACTS AND CIRCUMSTANCES. FINALLY, MCCULLOUGH-HYDE MEMORIAL HOSPITAL PROVIDES DISCOUNTED CARE AT SELECT CLINICS. PART I, LINE 6A: IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH, INC TO CREATE AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION. IN 2015, TRIHEALTH PURCHASED A 60% INTEREST IN MCCULLOUGH-HYDE MEMORIAL HOSPITAL TO SUPPORT ITS MISSION.THE COMMUNITY BENEFIT PROVIDED BY MCCULLOUGH-HYDE MEMORIAL HOSPITAL IS TRACKED ON A STANDALONE BASIS; HOWEVER, ITS COMMUNITY BENEFIT IS REPORTED IN A REPORT PREPARED BY TRIHEALTH IN COMBINATION WITH ITS RELATED HOSPITALS - BETHESDA HOSPITAL, INC., THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND TRIHEALTH HOSPITAL, INC. PART I, LINE 7: MCCULLOUGH-HYDE MEMORIAL HOSPITAL UTILIZED WORKSHEET 2 - RATIO OF PATIENT CARE COST-TO-CHARGES, WHICH WAS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H, TO CALCULATE THE COST-TO-CHARGE RATIO. PART I, LN 7 COL(F): BAD DEBT EXPENSE IS NOT INCLUDED ON FORM 990, PART IX, LINE 25. IT IS PRESENTED ON FORM 990, PART VIII, LINE 2 AS A DEDUCTION FROM PATIENT SERVICE REVENUE WHICH CORRESPONDS TO ITS FINANCIAL STATEMENT PRESENTATION. SEE RESPONSE TO PART III, LINE 4. THEREFORE, NO ADJUSTMENT TO TOTAL EXPENSES SHOWN ON FORM 990, PART IX, LINE 25 IS NECESSARY. PART II, COMMUNITY BUILDING ACTIVITIES: MHMH PROMOTES HEALTH AND WELL-BEING IN OUR COMMUNITY IN NUMEROUS WAYS NOT LISTED IN THE COMMUNITY EVENTS AND PROGRAMS SECTION OF THE FORM 990. EXAMPLES INCLUDE:1) MHMH HELPED PROMOTE WELLNESS BY PROVIDING MEETING SPACE TO THE INFANT/CHILD LOSS BEREAVEMENT SUPPORT GROUP AND FIBROMYALGIA SUPPORT GROUP.2) MHMH ASSISTED OUR LOCAL SCHOOL DISTRICT WITH IDENTIFIED HEALTH/WELLNESS NEEDS. EXAMPLES INCLUDE:A) DEVELOPED AND PROVIDED CRISIS CARDS FOR ALL 8TH GRADE STUDENTS AND ALL COUNSELORS IN THE SCHOOL DISTRICT.B) DEVELOPED CURRICULUM THAT COMBINED TRADITIONAL LEARNING WITH EXERCISE TO HELP FIGHT OBESITY IN OUR ELEMENTARY STUDENTS.C) DEVELOPED AND HELD MINI-HEALTH SEMINARS FOR 6TH GRADE STUDENTS ON SLEEP, NUTRITION, EXERCISE AND MENTAL HEALTH.3) MHMH PROVIDED OFFICE SPACE AND MEETING SPACE FOR THE OXFORD COLLEGE CORNER CLINIC, WHICH IS A CLINIC THAT PROVIDES FREE HEALTH CARE TO THE UNINSURED AND UNDERINSURED ADULTS IN OUR COMMUNITY.4) MHMH IMPROVED THEIR EMPLOYEE WELLNESS PROGRAM BY:A) IMPLEMENTING A HEALTH RISK ASSESSMENT FOR THEIR EMPLOYEES TO IDENTIFY HEALTH NEEDS/CONCERNS IN OUR EMPLOYEE POPULATION.B) OFFERING MAMMOGRAMS AND PROSTATE SCREENING TO APPROPRIATE EMPLOYEES FREE OF CHARGE.C) INCENTIVIZING EMPLOYEES TO ADOPT HEALTHIER BEHAVIOR. PART III, LINE 2: SEE PART VI RESPONSE TO PART III, LINE 4. PART III, LINE 3: SEE PART VI RESPONSE TO PART III, LINE 4. PART III, LINE 4: MCCULLOUGH-HYDE MEMORIAL HOSPITAL'S FINANCIAL STATEMENTS ARE AUDITED AS PART OF THE TRIHEALTH AUDIT REPORT AND AS SUCH FOLLOWING IS THAT REPORT'S FOOTNOTE.NET PATIENT ACCOUNTS RECEIVABLE (PART OF FOOTNOTE B)NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUE HAVE BEEN ADJUSTED TO THE ESTIMATED AMOUNTS EXPECTED TO BE COLLECTED. THESE ESTIMATED AMOUNTS ARE SUBJECT TO FURTHER ADJUSTMENTS UPON REVIEW BY THIRD-PARTY PAYORS. THE PROVISION FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY AS NECESSARY THE PROVISIONS FOR BAD DEBT AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS RECEIVABLE IN THE PERIOD OF SERVICE BASED UPON HISTORICAL WRITE-OFF EXPERIENCE.AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, TRIHEALTH FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY TRIHEALTH.THERE HAVE BEEN NO SIGNIFICANT CHANGES IN TEH CURRENT YEAR TO THE UNDERLYING ASSUMPTIONS USED BY TRIHEALTH TO ESTIMATE THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.FINANCIAL INSTRUMENTS THAT POTENTIALLY SUBJECT TRIHEALTH TO CONCENTRATIONS OF CREDIT RISK CONSIST PRIMARILY OF NONGOVERNMENTAL PATIENT ACCOUNTS RECEIVABLE. TRIHEALTH GRANTS CREDIT WITHOUT COLLATERAL TO ITS PATIENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS.THE PERCENTAGES OF GROSS PATIENT ACCOUNTS RECEIVABLE FROM PATIENTS AND THIRD-PARTY PAYORS AT JUNE 30 APPROXIMATED THE FOLLOWING:2017 - MEDICARE 14%, MEDICAID 2%, MANAGED CARE 28%, SELF PAY 20%, COMMERCIAL AND OTHER 36%2016 - MEDICARE 17%, MEDICAID 3%, MANAGED CARE 32%, SELF PAY 16%, COMMERCIAL AND OTHER 32%TRIHEALTH HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. THE BASIS FOR PAYMENT UNDER THESE AGREEMENTS INCLUDES PROSPECTIVELY DETERMINED RATES, COST REIMBURSEMENT, NEGOTIATED DISCOUNTS FROM ESTABLISHED RATES, AND PER DIEMPAYMENTS. PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEW AND INVESTIGATIONS. THE DIFFERENCES BETWEEN THE ESTIMATED AND ACTUAL ADJUSTMENTS ARE RECORDED AS PART OF NET PATIENT SERVICE REVENUE IN FUTURE PERIODS, AS THE AMOUNTS BECOME KNOWN, OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS. TRIHEALTH RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBT IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS.AS FOR THE AMOUNT OF BAD DEBT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, MCCULLOUGH-HYDE MEMORIAL HOSPITAL DOES NOT REPORT ACTUAL BAD DEBT EXPENSE AS COMMUNITY BENEFIT. IF UPON FURTHER RESEARCH, IT IS ULTIMATELY DETERMINED THAT A PORTION OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER TRIHEALTH'S CHARITY CARE POLICY, THOSE COSTS WOULD BE RECLASSIFIED, AS APPROPRIATE, TO COMMUNITY BENEFIT AT THAT TIME.PLEASE NOTE THAT BAD DEBT EXPENSE IS NOT DETERMINED UNTIL AFTER ALL DISCOUNTS AND ANY ASSOCIATED PAYMENTS ARE TAKEN INTO ACCOUNT. IF ANY PAYMENTS ARE RECEIVED AFTER A PATIENT ACCOUNT IS DETERMINED TO BE BAD DEBT, THE ACCOUNT WILL BE ADJUSTED ACCORDINGLY AT THAT TIME. PART III, LINE 9B: AS OF THE FILING OF THIS RETURN, MCCULLOUGH-HYDE MEMORIAL HOSPITAL, AS PART OF TRIHEALTH, INC., MAINTAINS A WRITTEN DEBT COLLECTION POLICY. TRIHEALTH, INC., WHO PERFORMS THE BILLING SERVICES FOR ALL AFFILIATED HOSPITALS, WILL NOT INITIATE COLLECTION PRACTICES ON PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. BEFORE COLLECTION ACTIONS ARE TAKEN, TRIHEALTH, INC. WILL MAKE REASONABLE EFFORTS, GENERALLY AS EARLY IN THE BILLING PROCESS AS POSSIBLE, TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. AFTER SUCH EFFORTS HAVE BEEN MADE AND A BALANCE REMAINS THAT IS THE RESPONSIBILITY OF THE PATIENT OR GUARANTOR, TRIHEALTH, INC. MAY PURSUE, IN ITS SOLE DISCRETION, WHATEVER ACTIONS IT MAY BE ENTITLED TO TAKE UNDER LAW. PART VI, LINE 2: MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") PARTICIPATED IN A PROCESS OF COMMUNITY HEALTH NEEDS ASSESSMENT DURING TAX YEAR 2013 AND TAX YEAR 2015. THE PROCESS INCLUDED THE FOLLOWING ELEMENTS:1) A NEEDS ASSESSMENT THAT SERVES AS A FOUNDATION FOR DEVELOPING AN IMPLEMENTATION STRATEGY TO ADDRESS THOSE NEEDS. THE QUESTION OF HOW MHMH CAN BEST USE ITS LIMITED RESOURCES TO ASSIST COMMUNITIES IN NEED WILL BE ADDRESSED IN THE IMPLEMENTATION PHASE.2) THE NEEDS ASSESSMENT SEEKS TO IDENTIFY PRIORITY HEALTH STATUS AND ACCESS ISSUES FOR OUR SERVICE AREA. MHMH IS COMMITTED TO TAKING A LEADERSHIP ROLE IN THE ASSESSMENT AND IMPLEMENTATION PHASES. THE ASSESSMENT FOCUSED ON THE FOLLOWING QUESTIONS:* WHO IN THE COMMUNITY IS MOST VULNERABLE IN TERMS OF HEALTH STATUS OR ACCESS TO CARE?* WHAT ARE THE UNIQUE HEALTH STATUS AND/OR ACCESS NEEDS FOR OUR POPULATION?* WHERE DO THESE PEOPLE LIVE IN OUR COMMUNITY?* WHY ARE THESE PROBLEMS PRESENT?3) MHMH HAS IDENTIFIED ITS COMMUNITY AS THE RESIDENTS OF FIVE (5) COUNTIES. IN OHIO: BUTLER AND PREBLE AND IN INDIANA: FAYETTE, FRANKLIN AND UNION. OHIO COUNTIES REPRESENT 63% OF THE SERVICE AREA WHILE INDIANA COUNTIES COMPRISE 37%.4) BASED ON THE DATA GATHERED, THE MAJOR NEEDS OF THE COMMUNITY SERVED BY MHMH ARE ACCESS TO CARE AND OBESITY (INCLUDING RELATED ISSUES SUCH AS DIABETES AND HEART DISEASE).THE FULL TEXT OF THIS NEEDS ASSESSMENT IS AVAILABLE ON MHMH'S WEBSITE. SEE SCHEDULE H, PART V, LINE 7A FOR THE URL. PART VI, LINE 3: TRIHEALTH, INC. PERFORMS THE BILLING SERVICES FOR ALL AFFILIATED HOSPITALS INCLUDING TRIHEALTH HOSPITAL, INC. BROCHURES/APPLICATIONS, PROVIDED IN MULTIPLE LANGUAGES, ARE VISIBLE AND AVAILABLE IN THE REGISTRATION AND ADMITTING AREAS OF ALL TRIHEALTH AFFILIATED HOSPITALS. IN ADDITION, THE APPLICATION IS PRINTED ON THE REVERSE SIDE OF A PATIENT'S BILL WITH INSTRUCTIONS ON HOW TO COMPLETE THE APPLICATION AS WELL AS HOW TO RETURN IT. FINANCIAL COUNSELORS ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. FINALLY, TRIHEALTH, INC.'S WEBSITE CONTAINS INFORMATION REGARDING ITS CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS WITH DIRECTIONS ON HOW TO CONTACT THE APPROPRIATE PERSONNEL TO INITIATE AN APPLICATION OR ASK QUESTIONS ABOUT THE PROCESS. PART VI, LINE 4: MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") SERVES A DIVERSE DEMOGRAPHIC INCLUDING THE NORTHWESTERN CORNER OF BUTLER COUNTY, OHIO, THE SOUTHWESTERN CORNER OF PREBLE COUNTY, OHIO AND THE COUNTIES OF FRANKLIN, UNION AND FAYETTE IN INDIANA. THE MAIN CAMPUS IS LOCATED IN OXFORD, OHIO, THE HOME OF MIAMI UNIVERSITY. OXFORD HAS A POPULATION RANGING FROM 30,000 DURING THE SCHOOL YEAR TO HALF THAT NUMBER DURING THE SUMMER.MHMH COUNTS ITS PRIMARY SERVICE AREA AS THE FOLLOWING:*OXFORD, OH (ZIP CODE 45056) - POPULATION 29,739*BROOKVILLE, IN (ZIP CODE 47012) - POPULATION 10,455*COLLEGE CORNER, OH (ZIP CODE 45003) - POPULATION 971*EATON, OH (ZIP CODE 45320) - POPULATION 15,354*SOMERSVILLE, OH (ZIP CODE 45064) - POPULATION 2,963*CAMDEN, OH (ZIP CODE 45311) - POPULATION 7,215*LIBERTY, IN (ZIP CODE 47353) - POPULATION 5,698*WEST COLLEGE CORNER, IN (ZIP CODE 47003) - 834TOTAL PRIMARY SERVICE AREA POPULATION - 73,229AND ITS SECONDARY SERVICE AREAS ARE THE FOLLOWING:*HAMILTON, OH (ZIP CODE 45013) - POPULATION 54,814*CONNERSVILLE, IN (ZIP CODE 47331) - POPULATION 23,438*METAMORA, IN (ZIP CODE 47030) - POPULATION 1,631*OKEANA, OH (ZIP CODE 45053) - POPULATION 3,712TOTAL SECONDARY SERVICE AREA POPULATION - 83,595IN TERMS OF SOCIO-ECONOMIC DEMOGRAPHICS, THE EDUCATIONAL ATTAINMENT IS LOWER THAN COUNTY, STATE AND NATIONAL AVERAGES AND THE UNEMPLOYMENT RATE IS HIGHER THAN COUNTY, STATE AND NATIONAL AVERAGES IN ALL OF THE UNINCORPORATED RURAL AREAS SERVED BY MHMH. ALL OF THE AREAS IN INDIANA AND THE RURAL AREAS IN PREBLE AND BUTLER COUNTIES (CAMDEN, SOMERVILLE) ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS BY THE NATIONAL HEALTH SERVICE CORPS. MHMH HAS RECRUITED, SUPPORTED AND WILL CONTINUE TO RECRUIT AND SUPPORT BOTH PRIMARY CARE PHYSICIANS AND SPECIALISTS TO MEET THE NEEDS OF RESIDENTS OF THESE COMMUNITIES. PART VI, LINE 5: MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") IS BASED ON A PATIENT-CENTERED, CARING PHILOSOPHY. ITS STAFF IS DEDICATED TO PROVIDING SAFE AND HIGH-QUALITY SERVICES, WITH THE UTMOST KINDNESS AND COMPASSION. MHMH HAS AN OPEN MEDICAL STAFF WHO HAVE IMPECCABLE TRAINING, EXPERIENCE AND SKILLS. THE VAST MAJORITY ARE BOARD-CERTIFIED IN THEIR CHOSEN PROFESSIONAL FIELD. MHMH PROVIDES A 24-HOUR EMERGENCY ROOM AT ITS MAIN CAMPUS IN OXFORD, OHIO. IT ALSO PROVIDES PREVENTATIVE, DIAGNOSTIC/THERAPEUTIC REHABILITATIVE SERVICES AT MULTIPLE LOCATIONS: OXFORD, CAMDEN, HAMILTON, ROSS. PART VI, LINE 6: IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH IN ORDER TO CREATE AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION.THROUGH FIVE (5) HOSPITALS, THREE (3) AMBULATORY LOCATIONS AND OVER 125 SITES OF CARE (EMPLOYING OVER 600 PHYSICIANS INCLUDING RESIDENTS), TRIHEALTH PROVIDES A WIDE RANGE OF CLINICAL, EDUCATIONAL, PREVENTIVE AND SOCIAL PROGRAMS. TRIHEALTH'S NON-HOSPITAL SERVICES INCLUDE PHYSICIAN PRACTICE MANAGEMENT, FITNESS CENTERS AND FITNESS CENTER MANAGEMENT, OCCUPATIONAL HEALTH CENTERS, HOME HEALTH AND HOSPICE CARE. 1 OXFORD COLLEGE CORNER CLINIC PO BOX 390 OXFORD OH 45056 204253386 501(C)(3) 6665 ANNUAL FUNDING 1 PART I, LINE 2: MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") PROVIDES FUNDS TO ONLY LOCAL ORGANIZATIONS FOR SPECIFIC ACTIVITIES AND NOT ONGOING ACTIVITIES. THE LOCAL ORGANIZATION PROVIDES A RECEIPT OF SUCH FUNDS WHICH SERVES AS MHMH'S SUBSTANTIATION. THUS, THE NEED TO MONITOR THE USE OF THE FUNDS IS NOT NEEDED BY MHMH. 1 1 0 0 0 0 0 0 0 ROBERT COLLINS MD DIRECTOR (END 12/17) 0 442689 0 132072 0 25782 0 148839 0 16908 0 766290 0 0 MARK CLEMENT SECRETARY 0 1064319 0 361237 0 17874 0 297460 0 18227 0 1759117 0 0 GAIL DONOVAN VICE CHAIR 0 692100 0 215255 0 17585 0 192834 0 9139 0 1126913 0 0 JASON NIEHAUS DIRECTOR 0 397240 0 94600 0 11354 0 74904 0 23885 0 601983 0 0 MICHAEL CROFTON ASSISTANT TREASURER 0 302565 0 64965 0 25719 0 88719 0 28454 0 510422 0 0 BRETT KIRKPATRICK EXECUTIVE DIRECTOR-MHMH 0 195585 0 42081 0 594 0 19128 0 25790 0 283178 0 0 GREGORY CALKINS MD PHYSICIAN 191208 0 0 0 0 0 188 0 28530 0 219926 0 0 0 SHARON HANCOCK SITE DIRECTOR - HR 135493 0 7633 0 2433 0 188 0 28317 0 174064 0 0 0 JOHN PROUT FORMER OFFICER 0 0 0 0 0 252304 0 0 0 0 0 252304 0 12304 DWIGHT ELLINGWOOD FORMER OFFICER 0 0 0 0 0 188878 0 0 0 9422 0 198300 0 0 PART I, LINES 4A-B ELIGIBLE EXECUTIVES (GENERALLY VICE PRESIDENTS 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 INDIVIDUAL LISTED IN SCHEDULE J, PART II, RECEIVED A PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WHICH WAS TREATED AS TAXABLE COMPENSATION BY TRIHEALTH, INC.: JOHN PROUT - $12,304 PART I, LINES 3 TRIHEALTH, INC., A RELATED ORGANIZATION OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE. PART I, LINE 4A THE REPORTABLE INDIVIDUALS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL, INCORPORATED ARE PAID BY TRIHEALTH, INC., A RELATED ORGANIZATION, RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3). TRIHEALTH, INC. 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 2017 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: DWIGHT ELLINGWOOD - $183,894 A BUTLER COUNTY-SERIES 2015 316000061 000000000 2015-09-29 9320000 REFUNDING OF 2009 SERIES 0 0 0 A 9320000 146198 33454 9140348 2015 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 1 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 1 DURING THE INTERVALS BETWEEN BOARD OF DIRECTORS MEETINGS, THE EXECUTIVE COMMITTEE SHALL, SUBJECT TO SECTIONS 5.07, 7.04 AND 7.05 OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL'S CODE OF REGULATIONS, POSSESS AND MAY EXERCISE ALL THE POWERS AND FUNCTIONS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT AND DIRECTION OF THE AFFAIRS OF THE CORPORATION IN MATTERS OF URGENCY WHICH REQUIRE ACTION BETWEEN REGULARLY SCHEDULED OR SPECIAL MEETINGS OF THE BOARD OF DIRECTORS. ALL ACTIONS OF THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD OF DIRECTORS AT ITS NEXT MEETING SUCCEEDING SUCH ACTION. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR AND FOUR (4) ADDITIONAL BOARD MEMBERS ELECTED TO THE COMMITTEE BY THE BOARD OF DIRECTORS SUCH THAT THE EXECUTIVE COMMITTEE SHALL CONSIST OF A PERCENTAGE OF TRIHEALTH-APPOINTED DIRECTORS AND TRUST-APPOINTED DIRECTORS CONSISTENT WITH COMPOSITION OF THE BOARD OF DIRECTORS (I.E. TRIHEALTH, INC.-60% AND MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST-40%). THE CEO OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL SHALL BE A MEMBER, EX OFFICIO, WITHOUT A VOTE. THE BOARD CHAIR SHALL CHAIR THE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 2 JAMES FORMAL, ALAN OAK, HILLARY EVANS, MD, RALPH GUTOWSKI AND JOHN HARLAN, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF DIRECTORS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST, ONE OF THE CLASS OF MEMBERS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL. MARK CLEMENT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF DIRECTORS OF TRIHEALTH, INC., ONE OF THE CLASS OF MEMBERS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL. AS WELL AS, SITTING ON THE BOARDS OF DIRECTORS OF BETHESDA HOSPITAL, INC., THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE AND TRIHEALTH HOSPITAL, INC., ALL AFFILIATED ENTITIES OF TRIHEALTH, INC. MARK CLEMENT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF DIRECTORS OF BETHESDA FOUNDATION, INC., AN AFFILIATED ENTITY. MARK CLEMENT, GAIL DONOVAN, ROBERT COLLINS, MD, BRETT KIRKPATRICK, MICHAEL CROFTON AND JASON NIEHAUS HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF BEING EMPLOYEES OF TRIHEALTH, INC., ONE OF THE CLASS OF MEMBERS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 MCCULLOUGH-HYDE MEMORIAL HOSPITAL HAD TWO (2) CLASSES OF MEMBERS. THE FIRST CLASS CONSISTS SOLELY OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST OR ITS PERMITTED SUCCESSOR (40%). THE SECOND CLASS CONSISTS SOLELY OF TRIHEALTH, INC. OR ITS PERMITTED SUCCESSOR (60%). FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF MHMH SHALL CONSIST OF TEN (10) INDIVIDUALS APPOINTED BY THE MEMBERS IN ACCORDANCE WITH THEIR RESPECTIVE MEMBERSHIP INTERESTS IN MHMH. FOUR (4) DIRECTORS SHALL BE APPOINTED EXCLUSIVELY BY THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST (THE "TRUST APPOINTED DIRECTORS"). THE TRUST APPOINTED DIRECTORS SHALL BE SELECTED SOLELY BY THE MCCULLOUGH-HYDE MEMORIAL TRUST AND MAY INCLUDE PERSONS WHO ARE TRUSTEES OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST, PHYSICIANS, MEMBERS OF THE COMMUNITY AND SUCH OTHER PERSONS AS THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST DETERMINES APPROPRIATE, BUT WITH NO MINIMUM REPRESENTATION OF ANY STAKEHOLDERS. IN MAKING SUCH DETERMINATION, THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST SHALL CONSIDER (TOGETHER WITH SUCH OTHER FACTORS, AS DEEMED APPROPRIATE) THE VALUE OF A PHYSICIAN ON THE MEDICAL STAFF OF MHMH BEING ON THE BOARD OF DIRECTORS. SIX (6) DIRECTORS SHALL BE APPOINTED EXCLUSIVELY BY TRIHEALTH, INC. (THE "TRIHEALTH APPOINTED DIRECTORS"). THE TRIHEALTH APPOINTED DIRECTORS SHALL BE SELECTED SOLELY BY TRIHEALTH, INC. AND MAY INCLUDE ITS SENIOR MANAGEMENT, PHYSICIANS, MEMBERS OF THE COMMUNITY AND SUCH OTHER PERSONS AS TRIHEALTH, INC. DETERMINES APPROPRIATE, WITH NO MINIMUM REPRESENTATION OF ANY STAKEHOLDER. THE MEMBERS SHALL RECEIVE RECOMMENDATIONS FROM THE GOVERNANCE AND NOMINATING COMMITTEE FOR FILLING ANY VACANCIES ON THE BOARD OF DIRECTORS DUE TO EXPIRATION OF TERMS OR FOR ANY OTHER REASON; HOWEVER, THE COMMITTEE SHALL NOT EXERCISE ANY POWER OR AUTHORITY OVER THE BOARD OF DIRECTORS OR THE MEMBERS AND THE MEMBERS RETAIN THE EXCLUSIVE RIGHT TO APPOINT THE BOARD OF DIRECTORS. EACH DIRECTOR SHALL SERVE FOR A TERM OF FOUR (4) YEARS AND SERVE NO MORE THAN TWO CONSECUTIVE TERMS, HOWEVER, THE TRIHEALTH CHIEF EXECUTIVE OFFICER AND OTHER OFFICERS AND MANAGEMENT PERSONNEL OF TRIHEALTH WHO SERVE AS TRIHEALTH APPOINTED DIRECTORS MAY SERVE AN UNLIMITED NUMBER OF TERMS AS A DIRECTOR. ANY DIRECTOR MAY RESIGN AT ANY TIME BY GIVING WRITTEN NOTICE TO THE BOARD OF DIRECTORS AND THE MEMBER WHICH APPOINTED THE DIRECTOR. ANY DIRECTOR MAY BE REMOVED FROM OFFICE, WITH OR WITHOUT CAUSE, BY THE MEMBER WHICH APPOINTED THE DIRECTOR AT ANY TIME. THE RESIGNATION OR REMOVAL OF A DIRECTOR SHALL BE DEEMED TO CREATE A VACANCY ON THE BOARD, WHICH WILL BE FILLED BY THE MEMBER APPOINTING A SUCCESSOR TO SERVE THE BALANCE OF THAT DIRECTOR'S TERM. FORM 990, PART VI, SECTION A, LINE 7B EACH MEMBER OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") SHALL HAVE ALL RIGHTS AFFORDED TO MEMBERS OF NONPROFIT CORPORATIONS UNDER SECTION 1702 OF THE OHIO REVISED CODE, AS AMENDED. NOTWITHSTANDING ANY OTHER PROVISION OF THIS CODE OR OF OHIO LAW, MHMH SHALL HAVE NO POWER OR AUTHORITY TO TAKE ANY ACTION DESCRIBED IN SECTION 3.02 OF ITS CODE OF REGULATIONS WITHOUT PRIOR CONSENT, EXPRESSED IN WRITING AND FILED WITH THE SECRETARY OF MHMH AS PART OF THE ITS MINUTES, OF BOTH MEMBERS. THE FOLLOWING MATTERS SHALL BE SUBJECT TO UNANIMOUS APPROVAL OF THE MEMBERS: A) ANY ACTION WHICH INTENTIONALLY AFFECTS THE STATUS OF MHMH AS AN ORGANIZATION EXEMPT FROM FEDERAL TAXATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE IRC; B) ANY CHANGES TO THE EXISTING MISSION, VISION AND VALUES STATEMENT OF MHMH, AS REVISED; C) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION; D) ANY AMENDMENT TO THIS CODE OF REGULATIONS THAT AFFECTS THE RIGHTS OF EITHER MEMBER INDIVIDUALLY, OR THE MEMBERS COLLECTIVELY, THE SPECIAL VOTING MATTERS, AS DEFINED IN ARTICLE V HEREOF, OR THE RIGHTS, RESPONSIBILITIES, POWER AND AUTHORITY OF THE BOARD OF DIRECTORS, THE TRIHEALTH APPOINTED DIRECTORS OR THE TRUST APPOINTED DIRECTORS; E) ANY SALE, TRANSFER, OR OTHER DISPOSITION OF ASSETS OF THE CORPORATION WITH A NET BOOK VALUE WHICH IS IN EXCESS OF 40% OF THE NET VALUE OF THE CORPORATION'S ASSETS, WITHIN ANY PERIOD OF THREE (3) CONSECUTIVE FISCAL YEARS. FOR THE PURPOSE OF CALCULATING THE 40% THRESHOLD, THE ASSETS TRANSFERRED SHALL BE VALUED AT THEIR NET BOOK VALUE AND THE PERCENTAGE SHALL BE MEASURED BY REFERENCE TO MHMH'S TOTAL NET ASSETS AS OF THE END OF FISCAL QUARTER PRIOR TO THE FIRST TRANSFER OF ANY THREE-YEAR MEASUREMENT PERIOD; F) ANY TRANSFER, SALE, OR OTHER DISPOSITION OF EITHER MEMBER'S MEMBERSHIP INTEREST IN MHMH OTHER THAN TO A CONTROLLED AFFILIATE OF THE MEMBER THAT IS AN ENTITY DESCRIBED IN SECTION 501(C)(3) OF THE IRC. G) EXCEPT AS SET FORTH IN SECTION 11.3 OF THE AFFILIATION AGREEMENT, ANY ACTION THAT (I) WOULD CAUSE MHMH TO BE SUBJECT TO THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (THE "ERDS"), (II) THE EFFECT OF WHICH IS TO CONVERT MHMH FROM ITS NONSECTARIAN STATUS INTO A FAITH-BASED OR RELIGIOUSLY-AFFILIATED HOSPITAL, OR (III) WHICH WOULD RESTRICT THE SERVICES PROVIDED BY MHMH IN A MANNER WHICH WOULD BE REQUIRED IF MHMH WERE SUBJECT TO THE ERDS; H) ANY CONTRIBUTION TO CAPITAL BY EITHER MEMBER (OTHER THAN AS CONTEMPLATED BY SECTIONS 4.2 AND 4.3 OF THE AFFILIATION AGREEMENT), OR THE LOAN OF $1.0 MILLION OR MORE TO MHMH MADE OR GUARANTEED BY ANY MEMBER OR ANY AFFILIATE OF ANY MEMBER; AND I) THE STANDARD AS TO WHAT CONSTITUTES A "MATERIAL AMENDMENT OR VARIATION" FROM AN APPROVED ANNUAL BUDGET (AS CONTEMPLATED IN SECTION 3.04(E) OF MHMH'S CODE OF REGULATIONS). IN ADDITION, THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST SOLELY SHALL HAVE THE POWER TO APPROVE ANY ACTION OF MHMH THAT WOULD NOT BE CONSISTENT WITH THE 1966 ORDER OF THE BUTLER COUNTY COMMON PLEAS COURT OR THE 1989 ORDER OF THE BUTLER COUNTY PROBATE COURT RELATING TO THE IT. TRIHEALTH, INC. SHALL HAVE SOLE AUTHORITY TO APPROVE THE FOLLOWING MATTERS, AFTER RECEIVING A RECOMMENDATION FROM THE BOARD OF DIRECTORS (OR, IN THE CASE OF THE APPOINTMENT OF THE CEO, THE CEO SELECTION COMMITTEE): A) APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER ("CEO"); B) TERMINATION OF THE CEO; C) AN INITIAL FIVE-YEAR FINANCIAL PLAN ("THE "FINANCIAL PLAN") FOR MAINTAINING AND IMPROVING THE KEY FINANCIAL INDICATORS OF MHMH(ON A STAND-ALONE BASIS) IN A MANNER DETERMINED TO BE IN MHMH'S BEST INTERESTS CONSISTENT WITH PRUDENT HOSPITAL OPERATIONS. THE KEY FINANCIAL INDICATORS INCLUDED IN THE FINANCIAL PLAN WILL BE SELECTED BASED ON INDICATORS REPORTED BY RATING AGENCIES IN THEIR HOSPITAL METRIC REPORTS; D) ANNUAL CAPITAL AND OPERATING BUDGETS FOR MHMH; E) ANY MATERIAL AMENDMENT OR DEVIATION FROM AN APPROVED CAPITAL OR OPERATING BUDGET; AND F) ANY AMENDMENT OF THE FINANCIAL PLAN OR ACTION THAT WOULD CAUSE A DEVIATION FROM THE FINANCIAL PLAN SUCH THAT THE KEY FINANCIAL INDICATORS SPECIFIED IN THE FINANCIAL PLAN ARE NOT PROJECTED TO BE ATTAINED. EXCEPT AS SPECIFIED IN SECTION 7.02(E) OF MHMH'S CODE OF REGULATIONS, TRIHEALTH, INC. MAY APPROVE SUCH ACTION AS IT SEES FIT AFTER RECEIVING THE RECOMMENDATION OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY RECEIVES AN ELECTRONIC COPY OF THE FORM 990 INCLUDING REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE, FOR REVIEW AND APPROVAL PRIOR TO FILING. 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 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 CAUSE 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 C, LINE 19 MCCULLOUGH-HYDE MEMORIAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION, THE FINANCIAL STATEMENTS ARE PRESENTED TO THE CITY COUNCIL OF OXFORD ANNUALLY AT A MEETING THAT IS OPEN TO THE PUBLIC. FORM 990, PART XI, LINE 9: CAPITAL CONTRIBUTION 153,239. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL ARE AUDITED AS PART OF TRIHEALTH, INC. AND ITS SUBSIDARIES 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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