2018-05-10T12:03:41-05:00 2017-06-30 861065772 DELOITTE TAX LLP 250 EAST FIFTH STREET CINCINNATI OH 45202 990 2016-07-01 311438846 TRIHEALTH INC TRIH 5135696575 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 BRIAN KRAUSE VP FINANCE 5135695126 2018-05-10 1 ALICIA JANISCH P00741382 5137847100 2016 2022-09-23 18:48:47Z MARK CLEMENT 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 247539178 0 X WWW.TRIHEALTH.COM X 1994 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 13 9 1580 9 -689462 -689462 4404388 10790412 211437766 232240000 349083 2029381 1158606 1731291 217349843 246791084 1254878 1470023 0 0 117077310 129248022 0 0 0 104628119 127364651 222960307 258082696 -5610464 -11291612 555095062 637772992 62557932 66509989 492537130 571263003 X SEE SCHEDULE O 0 0 258082696 1470023 233691429 SEE SCHEDULE O 258082696 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 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 1 331 0 1 1580 1 1 1 0 0 0 0 0 0 0 0 0 X 13 9 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X BRIAN KRAUSE 5135695126 619 OAK STREET - 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("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 19183 19183 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. 9779903 4340875 5439028 5677397 4336431 1340966 153904528 112520216 41384312 19228252 1877396 17350856 65515162 DUE FROM RELATED ORGANIZATIONS 520115703 INVESTMENT IN UNCONSOLIDATED ORGANIZATIONS 2773817 ESCROW DEPOSIT 310000 MALPRACTICE ASSET 2132629 525332149 PENSION LIABILITY 10744734 ACCRUED EIB 5000000 ACCRUED WORKERS COMPENSATION 891249 MALPRACTICE LIABILITY 16748296 33384279 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 PERFORMED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT EITHER DATE. 1 UPTOWN CONSORTIUM INC 629 OAK STREET SUITE 306 CINCINNATI OH 45206 200688727 501(C)(3) 295527 GENERAL PURPOSES THE CENTER FOR CLOSING THE HEALTH GAP IN GREATER CINCINNATI 3120 BURNET AVE ROOM 201 CINCINNATI OH 45229 200902286 501(C)(3) 200000 GENERAL PURPOSES FREESTORE FOODBANK INC 1141 CENTRAL PARKWAY CINCINNATI OH 45202 237122205 501(C)(3) 155250 SPONSORSHIP AMERICAN HEART ASSOCIATION 5211 MADISON ROAD CINCINNATI OH 45227 135613797 501(C)(3) 140000 SPONSORSHIP HEALTHY MOMS & BABES INC 2270 BANNING ROAD NO 200 CINCINNATI OH 45239 311155292 501(C)(3) 92270 GENERAL PURPOSES BETHESDA FOUNDATION INC 10500 MONTGOMERY ROAD CINCINNATI OH 45242 237374129 501(C)(3) 80200 SPONSORSHIP HEALTHY BEGINNINGS INC 47 E HOLLISTER CINCINNATI OH 45219 311380939 501(C)(3) 60000 GENERAL SUPPORT CENTER FOR RESPITE CARE INC PO BOX 141301 CINCINNATI OH 45250 202544994 501(C)(3) 50000 GENERAL PURPOSES FRIARS CLUB INC 2316 HARRYWOOD COURT CINCINNATI OH 45239 310537485 501(C)(3) 32000 SPONSORSHIP OVARIAN CANCER ALLIANCE OF GREATER CINCINNATI 4918 COOPER ROAD CINCINNATI OH 45242 311287785 501(C)(3) 26250 SPONSORSHIP MARCH OF DIMES 10806 KENWOOD ROAD CINCINNATI OH 45242 131846366 501(C)(3) 23000 SPONSORSHIP THE MATT HAVERKAMP FOUNDATION 5870 DAY RD CINCINNATI OH 45252 204155820 501(C)(3) 20025 GENERAL SUPPORT ARTHRITIS FOUNDATION 7124 MIAMI AVE CINCINNATI OH 45243 274014550 501(C)(3) 20000 SPONSORSHIP CRAYONS TO COMPUTERS 1350 TENNESSEE AVE CINCINNATI OH 45229 311507076 501(C)(3) 20000 GENERAL SUPPORT AMERICAN CANCER SOCIETY INC 250 WILLIAMS STREET NW SUITE 400 ATLANTA GA 30303 131788491 501(C)(3) 15000 SPONSORSHIP JDRF SOUTHWEST OHIO CHAPTER 8050 HOSBROOK RD SUITE 314 CINCINNATI OH 45236 231907729 501(C)(3) 15000 SPONSORSHIP OHIO CANCER RESEARCH 50 W BROAD STREET STE 1132 COLUMBUS OH 43215 311038309 501(C)(3) 15000 SPONSORSHIP MONTESSORI CENTER ROOM INC 2505 RIVERSIDE DRIVE CINCINNATI OH 45202 310731908 501(C)(3) 15000 OUTDOOR CLASSROOM: SHADE STRUCTURE AND FALL SURFACE MAYFIELD EDUCATION & RESEARCH FOUNDATION 506 OAK STREET CINCINNATI OH 45219 310921099 501(C)(3) 10000 SPONSORSHIP EPISCOPAL RETIREMENT HOMES INC 3870 VIRGINA AVE CINCINNATI OH 45227 310554071 501(C)(3) 10000 SPONSORSHIP INTERFAITH HOSPITALITY NETWORK OF GREATER CINCINNATI 990 NASSAU STREET CINCINNATI OH 45206 311335474 501(C)(3) 10000 GENERAL SUPPORT LIFE LEARNING CENTER INC 20 W 18TH STREET COVINGTON KY 41011 203454261 501(C)(3) 10000 SPONSORSHIP REDI CINCINNATI LLC 3 E FOURTH STREET SUITE 301 CINCINNATI OH 45202 472090230 10000 REGIONAL ECONOMIC DEVELOPMENT INITIATIVE COMMITMENT NAMI SOUTHWEST OHIO 4055 EXECUTIVE PARK DRIVE SUITE 450 450 CINCINNATI OH 45241 310998076 501(C)(3) 7500 SPONSORSHIP AMERICAN LUNG ASSOCIATION OF THE MIDLAND STATES INC 5900 WILCOX PLACE DUBLIN OH 43016 314379531 501(C)(3) 7500 SPONSORSHIP KENZIE'S CLOSET PO BOX 43285 CINCINNATI OH 45243 205533270 501(C)(3) 7500 GENERAL SUPPORT 25 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 X 1 1 X X X X 1 1 0 0 0 0 0 0 0 CRAIG EISENTROUT MD TRUSTEE 0 652461 0 0 0 6190 0 9912 0 28000 0 696563 0 0 MARK CLEMENT PRESIDENT/CEO 955818 0 296481 0 36985 0 254562 0 21511 0 1565357 0 0 0 DONNA NIENABER ESQ ASST SECRETARY (END 7/16) 376676 0 91104 0 37884 0 108889 0 10775 0 625328 0 0 0 MICHAEL CROFTON ASST TREASURER 379000 0 123542 0 30713 0 102850 0 27912 0 664017 0 0 0 WILLIAM GRONEMAN EXEC VP SYSTEM DEVELOPMENT 513167 0 152266 0 93725 0 173074 0 28957 0 961189 0 28092 0 ROBERT COLLINS MD CHIEF MEDICAL OFFICER 427064 0 119473 0 22379 0 124996 0 16269 0 710181 0 0 0 MARY IRVIN SVP-CHIEF NURSING EXEC. 302726 0 74778 0 22609 0 91326 0 18198 0 509637 0 0 0 GAIL DONOVAN EXEC VP & COO 644732 0 193447 0 57378 0 126278 0 7376 0 1029211 0 0 0 DAVID COOK CHIEF HUMAN RESOURCES OFFICER 224097 0 44247 0 22268 0 32287 0 9282 0 332181 0 0 0 JOHN WARD CHIEF INFORMATION OFFICER 265332 0 60184 0 17253 0 51103 0 23649 0 417521 0 0 0 STEVE MOMBACH SVP-AMBULATORY SERVICES 370198 0 74610 0 27320 0 88692 0 14937 0 575757 0 0 0 ANDREW DEVOE CHIEF FINANCIAL OFFICER 0 0 0 0 570000 0 0 0 0 0 570000 0 0 0 JOHN PROUT ENVOY 541905 0 308973 0 539030 0 18967 0 5142 0 1414017 0 200215 0 WALTER MCLARTY CHIEF HR OFFICER-FORMER 177847 0 70834 0 181469 0 55719 0 8622 0 494491 0 0 0 DWIGHT ELLINGWOOD SVP-STRATEGY/COMMUNICATION 175051 0 89942 0 167498 0 48026 0 22886 0 503403 0 0 0 JOHN SUNDE VP-MANAGE CARE 223746 0 74083 0 124500 0 28356 0 22979 0 473664 0 0 0 THOMAS TAMI MD TPP PHYSICIAN EXECUTIVE 395973 133337 82493 0 11127 1424 68571 0 8900 3271 567064 138032 0 0 GERALD OLIPHANT FORMER KEY EMPLOYEE 0 0 0 0 558601 0 7250 0 9665 0 575516 0 0 0 GEORGES FEGHALI MD FORMER KEY EMPLOYEE 1674 0 0 0 828637 0 0 0 0 0 830311 0 828637 0 CRAIG RUCKER FORMER OFFICER 0 0 0 0 405856 0 0 0 0 0 405856 0 405856 0 STEVE SCHWALBE FORMER HIGHEST COMPENSATED EMPLOYEE 0 0 0 0 451652 0 0 0 0 0 451652 0 451652 0 RICHARD MOORE FORMER HIGHEST COMPENSATED EMPLOYEE 0 0 0 0 659060 0 0 0 0 0 659060 0 659060 0 SHER MCCLANAHAN FORMER HIGHEST COMPENSATED EMPLOYEE 0 0 0 0 631769 0 0 0 0 0 631769 0 631769 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 2016, 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 2016. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: DURING THE CALENDAR YEAR 2016, MARK CLEMENT, GAIL DONOVAN AND DAVID COOK RECEIVED PAYMENT FOR A HOUSING ALLOWANCE AFTER EACH ONE RELOCATED FROM OUT-OF-STATE AND UNTIL A PERMANENT RESIDENCE COULD BE ESTABLISHED. TRIHEALTH, INC. INCLUDED THE ENTIRE ALLOWANCE AS TAXABLE INCOME ON THE INDIVIDUAL'S FORM W-2 FOR 2016. 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.: JOHN PROUT - $200,215 WILLIAM GRONEMAN - $28,092 GEORGES FEGHALI, MD - $828,637 STEVE SCHWALBE - $451,652 RICK MOORE - $659,060 SHER MCCLANAHAN - $631,769 CRAIG RUCKER - $405,856 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 2016 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: GERALD OLIPHANT - $485,193 DWIGHT ELLINGWOOD - $136,338 JOHN SUNDE - $76,627 KATHLEEN OLIPHANT FAMILY MEMBER GERALD OLIPHANT FORMER KEY EMPLOYEE 158590 EMPLOYEE 0 TERRI CROFTON FAMILY MEMBER MICHAEL CROFTON CURRENT OFFICER 24057 EMPLOYEE 0 MICHAEL CROFTON JR FAMILY MEMBER MICHAEL CROFTON CURRENT OFFICER 48912 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. MICHAEL CROFTON, ROBERT COLLINS, MD, MARK CLEMENT, GAIL DONOVAN AND MYRTIS POWELL 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. WAYNE SHIRCLIFF, MARK DELWORTH, MD, CRAIG EISENTROUT, MD, LISA KNUTSON, MICHAEL HAVERKAMP, AND MYRTIS POWELL 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 AND MYRTIS POWELL 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, DONNA NIENABER, ESQ., WILLIAM GRONEMAN, GAIL DONOVAN, MICHAEL CROFTON, ROBERT COLLINS, MD, CRAIG EISENTROUT, MD AND MARY IRVIN 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, CRAIG EISENTROUT, MD AND MYRTIS POWELL 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 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 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 MEDICARE COMPLIANCE: PROGRAM SERVICE EXPENSES 704,829. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 704,829. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 20,462,963. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,462,963. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 2,162,876. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,162,876. RECRUITMENT/RELOCATION SERVICES: PROGRAM SERVICE EXPENSES 529,735. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 529,735. CONSULTING: PROGRAM SERVICE EXPENSES 29,260,444. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,260,444. STAFFING: PROGRAM SERVICE EXPENSES 1,663,459. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,663,459. LINGUISTIC SERVICES: PROGRAM SERVICE EXPENSES 1,051,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,051,750. CATERING: PROGRAM SERVICE EXPENSES 249,708. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 249,708. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 43,786. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 43,786. FORM 990, PART XI, LINE 9: CAPITAL CONTRIBUTION UNDER JOINT OPERATING AGREEMENT 95,517,334. CHANGE IN PENSION PLAN/SERP FUNDED STATUS 2,812,643. TRANSFER OF FUNDS FOR BUYOUT OF JOINT VENTURE -18,000,000. NET LOSS OF GOOD SAMARITAN HOSPITAL FREE CLINIC (FILES FORM 990) -59,963. 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 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 310537122 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 310537486 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN ENTERPRISE CORP 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 311383365 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN INSTITUTE 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 311074519 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 TRIHEALTH INC 1 GOOD SAMARITAN HOSPITAL FREE CLINIC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 273893817 FREE CLINIC OH SECTION 501(C)(3) SCHEDULE A, LINE 7 TRIHEALTH INC 1 TRIHEALTH HOSPITAL INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 461393755 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 BETHESDA HEALTHCARE INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311027660 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 12B BETHESDA INC 1 BETHESDA FAMILY PRACTICE CENTER 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311242442 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 12A BETHESDA HOSPITAL INC 1 BETHESDA PROPERTIES INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311352694 PROPERTY MANAGEMENT OH SECTION 501(C)(2) BETHESDA HOSPITAL INC 1 HOSPICE OF CINCINNATI INCORPORATED 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 310917155 HOSPICE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 BETHESDA HOSPITAL INC 1 FERNSIDE INC A CENTER FOR GRIEVING CHILDREN 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311179234 COUNSELING TO GRIEVING CHILDREN OH SECTION 501(C)(3) SCHEDULE A, LINE 7 HOSPICE OF CINCINNATI INCORPORATED 1 GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311778403 EDUCATION OH SECTION 501(C)(3) SCHEDULE A, LINE 2 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 237419853 DIALYSIS OH SECTION 501(C)(2) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 MCCULLOUGH HYDE MEMORIAL HOSPITAL INC 110 N POPLAR STREET OXFORD OH 45056 310650283 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 HEALTHCARE SOLUTIONS NETWORK LLC 619 OAK STREET CINCINNATI OH 45206 472103334 PHYSICIAN HOSPITAL ORGANIZATION OH N/A UNRELATED -679522 -49302 0 1 0.50000 TRIHEALTH PHYSICIAN SOLUTIONS INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 311444353 CLAIMS ADMINISTRATION OH N/A C 4265505 3292568 1.00000 1 TRIHEALTH PHYSICIANS OF INDIANA INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 461125130 PHYSICIAN PRACTICES OH N/A C 3915364 1.00000 1 TRIHEALTH CIPHO INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 463294306 PHYSICIAN HEALTH ORGANIZATION OH N/A C 1.00000 1 1 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 1 1 1 TRIHEALTH PHYSICIAN ENTERPRISE CORP A 234632 FMV BETHESDA HOSPITAL INC A 6212 FMV TRIHEALTH PHYSICIAN ENTERPRISE CORP B 116971666 CASH BETHESDA HOSPITAL INC C 47758667 CASH THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO C 47758667 CASH BETHESDA PROPERTIES INC K 547488 FMV THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO K 2896 FMV BETHESDA HOSPITAL INC L 102961068 COST THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO L 102301738 COST TRIHEALTH HOSPITAL INC L 3480872 COST BETHESDA HEALTHCARE INC L 479198 COST BETHESDA PROPERTIES INC L 56700 COST TRIHEALTH PHYSICIAN SOLUTIONS L 110541 COST HOSPICE OF CINCINNATI INCORPORATED L 278235 COST TRIHEALTH PHYSICIAN ENTERPRISE CORP L 3456437 COST BETHESDA HEALTHCARE INC M 1620673 FMV TRIHEALTH PHYSICIAN SOLUTIONS M 87500 FMV TRIHEALTH PHYSICIAN SOLUTIONS O 3119512 FMV GOOD SAMARITAN HOSPITAL FREE CLINIC O 517132 FMV THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO Q 204742103 COST BETHESDA HOSPITAL INC Q 215481730 COST TRIHEALTH PHYSICIAN ENTERPRISE CORP Q 128738952 COST TRIHEALTH PHYSICIAN SOLUTIONS Q 2151900 COST TRIHEALTH HOSPITAL INC Q 33316756 COST TRIHEALTH PHYSICIANS OF INDIANA INC Q 780351 COST TRIHEALTH CIPHO INC Q 704493 COST GOOD SAMARITAN HOSPITAL FREE CLINIC Q 124270 COST BETHESDA PROPERTIES INC Q 3685564 COST BETHESDA HEALTHCARE INC Q 7829422 COST HOSPICE OF CINCINNATI INCORPORATED Q 13297302 COST FERNSIDE INC A CENTER FOR GREIVING CHILDREN Q 187903 COST GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE Q 1349413 COST MCCULLOUGH HYDE MEMORIAL HOSPITAL INC Q 26076253 COST TRIHEALTH PHYSICIAN SOLUTIONS R 1880856 CASH