MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED (EIN 31-0650283)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-09
IRS object ID: 201711299349300816
Schema version: 2015v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-09T08:21:53-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	440160260	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BKD LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	312 WALNUT STREET SUITE 3000	AddressLine1Txt
City	CINCINNATI	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45202	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	310650283	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MCCULLOUGH-HYDE MEMORIAL HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	MCCU	BusinessNameControlTxt
Phone	5135245310	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	110 NORTH POPLAR STREET	AddressLine1Txt
City	OXFORD	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45056	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	BRIAN KRAUSE	PersonNm
Person Title	VP-FINANCE	PersonTitleTxt
Phone	5135245310	PhoneNum
Signature	2017-05-09	SignatureDt

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
PTIN	P00961884	PTIN
Phone	5136218300	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JOHN S PROUT	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	619 OAK STREET	AddressLine1Txt
City	CINCINNATI	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45206	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$49,233,623	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.MHMH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1953	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	ACUTE CARE HOSPITAL DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE.	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	444	TotalEmployeeCnt
Total Volunteers	5	TotalVolunteersCnt
Total Gross UBI	-$8,928	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$8,928	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$124,266	PYContributionsGrantsAmt
CY Contributions Grants	$410,513	CYContributionsGrantsAmt
PY Program Service Revenue	$23,381,559	PYProgramServiceRevenueAmt
CY Program Service Revenue	$47,354,760	CYProgramServiceRevenueAmt
PY Investment Income	$75,517	PYInvestmentIncomeAmt
CY Investment Income	$29,549	CYInvestmentIncomeAmt
PY Other Revenue	-$300,196	PYOtherRevenueAmt
CY Other Revenue	$1,128,287	CYOtherRevenueAmt
PY Total Revenue	$23,281,146	PYTotalRevenueAmt
CY Total Revenue	$48,923,109	CYTotalRevenueAmt
PY Grants And Similar Paid	$24,118	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$26,552	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$12,931,806	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$24,637,255	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$12,991,626	PYOtherExpensesAmt
CY Other Expenses	$27,196,402	CYOtherExpensesAmt
PY Total Expenses	$25,947,550	PYTotalExpensesAmt
CY Total Expenses	$51,860,209	CYTotalExpensesAmt
PY Revenues Less Expenses	-$2,666,404	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$2,937,100	CYRevenuesLessExpensesAmt
Total Assets BOY	$48,233,146	TotalAssetsBOYAmt
Total Assets EOY	$58,205,117	TotalAssetsEOYAmt
Total Liabilities BOY	$17,101,874	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$23,086,025	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$31,131,272	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$35,119,092	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	ACUTE CARE HOSPITAL FACILITY DELIVERING QUALITY SERVICES TO OUR PATIENTS AND THE COMMUNITIES WE SERVE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$49,996,220	ExpenseAmt
Grant	$26,552	GrantAmt
Revenue	$48,170,247	RevenueAmt
Desc	FOLLOWING ARE THE THREE LARGEST PROGRAM SERVICE ACCOMPLISHMENTS FOR MCCULLOUGH-HYDE MEMORIAL HOSPITAL DURING THE TAX YEAR:INPATIENT CARE - INPATIENT VOLUME CONSISTED OF 1,769 DISCHARGES AND 5,213 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 2.95 DAYS. BIRTHS TOTALED 351 WITH A TOTAL OF 607 OBSERVATION DAYS OF SERVICE.SURGERY - THIS SERVICE IS COMPRISED OF SURGERY, AND MINOR PROCEURES. TOTAL VOLUME IS 2,542 CONSISTING OF IP CARE (20%) AND OUTPATIENT CARE (80%).PHARMACY - THIS SERVICE CONSISTS OF CARE PROVIDED TO INPATIENTS (21%) AND OUTPATIENTS (79%). OUTPATIENT CARE INCLUDES A MAJOR PROGRAM FOR ONCOLOGY TREATMENT.FOR ADDITIONAL INFORMATION PLEASE SEE SCHEDULE H.	Desc
Total Program Service Expenses	$49,996,220	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	118	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	444	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	10	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BRIAN KRAUSE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5135695126	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	619 OAK STREET-ACCOUNTING 3 WEST	AddressLine1Txt
City	CINCINNATI	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45206	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
RICHARD NORMAN
CHAIR	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
DEE ELLINGWOOD
VICE CHAIR	1.00	60.00	Yes (X)	Yes (X)	$0	$385,156	$83,407
ALAN OAK
TREASURER	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOHN PROUT
SECRETARY (END 1/16)	1.00	60.00	Yes (X)	Yes (X)	$0	$2,429,327	$43,760
ROBERT COLLINS MD
DIRECTOR	1.00	60.00	Yes (X)		$0	$539,152	$130,898
MICHAEL CROFTON
DIRECTOR	1.00	60.00	Yes (X)		$0	$579,691	$145,213
HILLARY EVANS MD
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
JOHN HARLAN MD
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
MYRTIS POWELL
DIRECTOR	1.00	1.00	Yes (X)		$0	$0	$0
JERRY OLIPHANT
DIRECTOR (END 10/15)	1.00	60.00	Yes (X)		$0	$704,803	$132,198
MARK CLEMENT
DIRECTOR (START 10/15)	1.00	60.00	Yes (X)		$0	$516,747	$61,675
GAIL DONOVAN
DIRECTOR (START 1/16)	1.00	60.00	Yes (X)		$0	$94,642	$18,000
BRYAN HEHEMANN
CEO	60.00	0.00		Yes (X)	$10,111	$242,420	$56,728
BRETT KIRKPATRICK
EXECUTIVE DIRECTOR-MHMH	60.00	0.00			$0	$202,767	$31,962	Yes (X)
MATTHEW DAGGY MD
PHYSICIAN	30.00	30.00			$135,499	$131,175	$24,105		Yes (X)
PAUL CANGEMI MD
PHYSICIAN	30.00	30.00			$144,596	$243,658	$7,013		Yes (X)
BRYAN MCCULLOUGH MD
PHYSICIAN	30.00	30.00			$257,102	$291,016	$35,400		Yes (X)
GREGORY CALKINS MD
PHYSICIAN	60.00	0.00			$181,281	$0	$28,283		Yes (X)
DONALD WATSON
DIRECTOR-PHARMACY	60.00	0.00			$131,532	$0	$25,551		Yes (X)
JOHN CLEMENTS
FORMER	0.00	0.00			$14,787	$140,250	$14,907			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$874,908	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$6,500,804	TotReportableCompRltdOrgAmt
Total Other Compensation	$839,100	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	16	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ARAMARK
25271 NETWORK PLACE	CHICAGO	IL	60673	FOOD SERVICES	$1,457,088
SHIFTWISE INC
1800 SW 1ST AVE SUITE 510	PORTLAND	OR	97201	MEDICAL STAFFING	$812,591
WESTERN OHIO ANESTHESIA ASSOCIATES
110 N POPLAR STREET	OXFORD	OH	45056	ANESTHESIA SERVICES	$340,417
OXFORD INTERNAL MEDICINE
12 WEST CHURCH STREET	OXFORD	OH	45056	MEDICAL SERVICES	$234,577
OUTSOURCE BILLING SERVICES
1039 SHELBY STREET	INDIANAPOLIS	IN	46203	BILLING SERVICES	$212,481

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	15	CntrctRcvdGreaterThan100KCnt
Related Organizations	$410,513	RelatedOrganizationsAmt
Total Contributions	$410,513	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
PATIENT SERVICES	900099	$47,293,654	$47,293,654
AFFILIATED RENTAL REV.	531120	$61,106		$61,106

Field	Value	IRS element (for citing)
Total Program Service Revenue	$47,354,760	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$80,177	TotalRevenueColumnAmt
Exclusion	$80,177	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$257,347	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$254,801	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,546	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,546	TotalRevenueColumnAmt
Unrelated Business Revenue	-$8,928	UnrelatedBusinessRevenueAmt
Exclusion	$11,474	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$5,085	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$55,713	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$55,713	SecuritiesAmt
Other	$5,085	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$50,628	TotalRevenueColumnAmt
Exclusion	-$50,628	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
EHR INCENTIVES	900099	$732,192	$732,192
CAFETERIA/VENDING	722210	$249,148		$249,148
WELLNESS CENTER	900099	$57,418	$57,418

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$86,983	TotalRevenueColumnAmt
Related Or Exempt Func Income	$86,983	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,125,741	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$48,923,109	TotalRevenueColumnAmt
Related Or Exempt Func Income	$48,170,247	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	-$8,928	UnrelatedBusinessRevenueAmt
Exclusion	$351,277	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$26,552	TotalAmt
Program Services	$26,552	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$19,200,813	TotalAmt
Program Services	$19,149,063	ProgramServicesAmt
Management And General	$51,750	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$234,856	TotalAmt
Program Services	$234,551	ProgramServicesAmt
Management And General	$305	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,058,557	TotalAmt
Program Services	$4,049,812	ProgramServicesAmt
Management And General	$8,745	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,143,029	TotalAmt
Program Services	$1,139,430	ProgramServicesAmt
Management And General	$3,599	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$1,013,589	TotalAmt
Program Services	$93,593	ProgramServicesAmt
Management And General	$919,996	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$174,877	TotalAmt
Management And General	$174,877	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$16,257	TotalAmt
Management And General	$16,257	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$6,089,725	TotalAmt
Program Services	$6,070,242	ProgramServicesAmt
Management And General	$19,483	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$608,024	TotalAmt
Program Services	$35,927	ProgramServicesAmt
Management And General	$572,097	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$701,789	TotalAmt
Program Services	$692,492	ProgramServicesAmt
Management And General	$9,297	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,403,257	TotalAmt
Program Services	$1,403,257	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,932,895	TotalAmt
Program Services	$1,932,895	ProgramServicesAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$37,031	TotalAmt
Program Services	$35,444	ProgramServicesAmt
Management And General	$1,587	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$23,184	TotalAmt
Program Services	$23,158	ProgramServicesAmt
Management And General	$26	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$418,942	TotalAmt
Program Services	$418,942	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,908,992	TotalAmt
Program Services	$4,905,496	ProgramServicesAmt
Management And General	$3,496	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$286,417	TotalAmt
Program Services	$286,417	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL/DIETARY SUPPLIE	$8,127,268	$8,117,789	$9,479
OHIO HOSPITAL TAX	$797,925	$797,925
EQUIPMENT	$456,156	$454,728	$1,428
DUES AND SUBSCRIPTIONS	$98,686	$27,119	$71,567

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$101,388	TotalAmt
Program Services	$101,388	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$51,860,209	TotalAmt
Program Services	$49,996,220	ProgramServicesAmt
Management And General	$1,863,989	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,700	BOYAmt
EOY	$2,479	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,836,566	BOYAmt
EOY	$810,803	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,271,435	BOYAmt
EOY	$5,957,871	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$3,878,131	BOYAmt
EOY	$413,830	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,146,800	BOYAmt
EOY	$910,947	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$737,567	BOYAmt
EOY	$655,886	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$42,217,519	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$6,372,680	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$29,277,422	BOYAmt
EOY	$35,844,839	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$4,551,877	BOYAmt
EOY	$8,912,617	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$530,648	BOYAmt
EOY	$4,695,845	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$48,233,146	BOYAmt
EOY	$58,205,117	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$5,020,197	BOYAmt
EOY	$3,584,934	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$9,631,045	BOYAmt
EOY	$9,320,000	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$8,528,122	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$651,027	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,799,605	BOYAmt
EOY	$1,652,969	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$17,101,874	BOYAmt
EOY	$23,086,025	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$31,103,964	BOYAmt
EOY	$35,091,628	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$27,308	BOYAmt
EOY	$27,464	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$31,131,272	BOYAmt
EOY	$35,119,092	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$48,233,146	BOYAmt
EOY	$58,205,117	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$2,937,100	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$698,993	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$7,623,913	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$1,101	OtherActivitiesAmt
Total Lobbying Expenditures	$1,101	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,030,000	OtherCostOrOtherBasisAmt
Book Value	$7,030,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,418,653	OtherCostOrOtherBasisAmt
Depreciation	$936,618	DepreciationAmt
Book Value	$11,482,035	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,272,500	OtherCostOrOtherBasisAmt
Depreciation	$564,375	DepreciationAmt
Book Value	$1,708,125	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,682,361	OtherCostOrOtherBasisAmt
Depreciation	$4,871,687	DepreciationAmt
Book Value	$11,810,674	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,814,005	OtherCostOrOtherBasisAmt
Book Value	$3,814,005	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$35,844,839	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
UNAMORTIZED FINANCE COSTS	$130,595
BWC REBATE	$265,576
CASH SURRENDER VALUE	$54,377
DUE FROM RELATED ORGANIZATION	$4,245,297

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$4,695,845	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
ESTIMATED THIRD PARTY SETTLEMENTS	$728,571
ACCRUED MALPRACTICE LIABILITY	$126,877
ACCRUED EIB	$198,777
ACCRUED SWAP LIABILITY	$598,744

Field	Value	IRS element (for citing)
Total Liability	$1,652,969	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	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 EITHER DATE.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$653,462	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$653,462	DirectOffsettingRevenueAmt

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,931,228	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,398,827	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,532,401	NetCommunityBenefitExpnsAmt
Total Expense	0.08740	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,584,690	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,052,289	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,532,401	NetCommunityBenefitExpnsAmt
Total Expense	0.08740	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,500	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$17,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,602,190	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,052,289	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,549,901	NetCommunityBenefitExpnsAmt
Total Expense	0.08770	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,508,805	BadDebtExpenseAmt
Reimbursed By Medicare	$4,076,312	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$5,364,386	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,288,074	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MCCULLOUGH-HYDE MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	110 N POPLAR STREET	AddressLine1Txt
City	OXFORD	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45056	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.MHMH.ORG	WebsiteAddressTxt
State License	55577	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MCCULLOUGH-HYDE MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.MHMH.ORG\COMMUNITY_SERVICES\NEEDS_ASSESSMENT	OwnWebsiteURLTxt
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.MHMH.ORG\COMMUNITY_SERVICES\NEEDS_ASSESSMENT	StrategyWebsiteURLTxt
Strategy Attached	Yes (1)	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/	FAPAppAvailableOnWebsiteURLTxt
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 THEPHONE, 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 ACOLLECTION 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 FS 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.
MCCULLOUGH-HYDE MEMORIAL HOSPITAL	PART V, SECTION B, LINE 16I: MCCULLOUGH-HYDE MEMORIAL HOSPITAL DOES NOT PROVIDE A DETAILED COPY OF ITS FINANCIAL ASSISTANCE POLICY TO PATIENTS; HOWEVER, IT DOES PROVIDE A SUMMARY OF THE POLICY.IN ADDITION, SUCH INFORMATION SHALL BE PROVIDED IN LANGUAGES CONSIDERED TO BE COMMONLY SPOKEN BY THE POPULATION MCCULLOUGH-HYDE MEMORIAL HOSPITAL SERVES. IF TRANSLATION OR OTHER ASSISTANCE IS NEEDED TO FACILITATE COMPLETION AND/OR UNDERSTANDING OF THE FINANCIAL ASSISTANCE POLICY AND/OR APPLICATION, TRANSLATION AND OTHER REASONABLE REQUESTS FOR ASSISTANCE WILL BE PROVIDED.
MCCULLOUGH-HYDE MEMORIAL HOSPITAL	PART V, SECTION B, LINE 22D: MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("MHMH") ISSUES A BILLING STATEMENT TO ALL FAP-ELIGIBLE INDIVIDUALS THAT STATES GROSS CHARGES FOR THE CARE RECEIVED AS THE STARTING POINT FOR APPLYING THE DISCOUNTS AND DEDUCTIONS THE FAP-ELIGIBLE INDIVIDUAL IS ENTITLED TO UNDER ITS FAP, SUCH THAT THE AMOUNT THAT A FAP-ELIGIBLE IS REQUIRED TO PAY IS (I) LESS THAN THE GROSS CHARGES FOR SUCH CARE AND (II) TYPICALLY LESS THAN THE AMOUNTS GENERALLY BILLED TO PERSONS WITH INSURANCE. CURRENTLY, AS PART OF THE TRIHEALTH SYSTEM, MHMH PROVIDES FREE CARE TO PATIENTS WHOSE INCOME FALLS BELOW 100% OF THE FEDERAL POVERTY GUIDELINES. IN ADDITION, IT PROVIDES DISCOUNTED CARE ON A SLIDING SCALE TO PATIENTS WITH INCOMES ALL THE WAY UP TO 400% OF THE FEDERAL POVERTY GUIDELINES. ANY UNINSURED PATIENT THAT FILLS OUT A FINANCIAL ASSISTANCE FORM AUTOMATICALLY RECEIVES A 40% DISCOUNT REGARDLESS OF INCOME WHILE OTHER PATIENTS RECEIVE A 45% DISCOUNT (INCOME BETWEEN 300% AND 400% OF POVERTY GUIDELINES), 60% DISCOUNT (INCOME BETWEEN 200% AND 300% OF POVERTY GUIDELINES), OR AN 80% DISCOUNT (INCOME BETWEEN 100% AND 200% OF POVERTY GUIDELINES). THE CURRENT AVERAGE DISCOUNT WITH COMMERCIAL INSURANCE COMPANIES IS 65% SO VIRTUALLY ALL PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE WITH INCOME UP TO 300% OF THE POVERTY GUIDELINES ARE RECEIVING DISCOUNTS EQUAL TO OR GREATER THAN THE AVERAGE COMMERCIAL INSURANCE DISCOUNT. IN ADDITION, MHMH BELIEVES THE TRIHEALTH FINANCIAL ASSISTANCE POLICY IS GENEROUS AS MANY HOSPITALS DO NOT OFFER ANY FINANCIAL ASSISTANCE TO PATIENTS WITH INCOME OVER 300% OF THE POVERTY GUIDELINE. HOWEVER, IT PREFERS TO EXTEND DISCOUNTS TO SUCH INDIVIDUALS RATHER THAN DENY THEM ELIGIBILITY UNDER THE POLICY SO THAT SUCH INDIVIDUALS RECEIVE SOME FINANCIAL ASSISTANCE RATHER THAN NONE.

Field	Value	IRS element (for citing)
Facility	5	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
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

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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:	MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("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 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 HISTORICALWRITE-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.DUE TO THE ONGOING EXPANSION OF MEDICAID IN OHIO, TRIHEALTH HAS EXPERIENCED DECLINES IN CHARITY CARE WRITE-OFFS, ALTHOUGH IT HAS NOT CHANGED ITS CHARITY CARE POLICY SINCE JUNE 30, 2015. THE COMPANY HAS NOT EXPERIENCED SIGNIFICANT CHANGES IN THE SELF-PAY ACCOUNTS RECEIVABLE OR WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS SINCE JUNE 30, 2015. THE OVERALL ALLOWANCE PERCENTAGE FOR UNCOLLECTIBLE ACCOUNTS DECREASED FROM 36% AT JUNE 30, 2015, TO 30% AT JUNE 30, 2016, AS A RESULT OF CHANGES IN PAYOR MIX PRIMARILY DUE TO THE AFFORDABLE CARE ACT.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:2016 - MEDICARE 17%, MEDICAID 3%, MANAGED CARE 32%, SELF PAY 16%, COMMERCIAL AND OTHER 32%2015 - MEDICARE 17%, MEDICAID 2%, MANAGED CARE 34%, SELF PAY 16%, COMMERCIAL AND OTHER 31%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, BETHESDA HOSPITAL, INC. 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 29,739BROOKVILLE, IN (ZIP CODE 47012) - POPULATION 10,455COLLEGE CORNER, OH (ZIP CODE 45003) - POPULATION 971EATON, OH (ZIP CODE 45320) - POPULATION 15,354SOMERSVILLE, OH (ZIP CODE 45064) - POPULATION 2,963CAMDEN, OH (ZIP CODE 45311) - POPULATION 7,215LIBERTY, IN (ZIP CODE 47353) - POPULATION 5,698WEST 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 54,814CONNERSVILLE, IN (ZIP CODE 47331) - POPULATION 23,438METAMORA, IN (ZIP CODE 47030) - POPULATION 1,631OKEANA, 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 ANDD 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.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
OXFORD COLLEGE CORNER CLINIC
PO BOX 390	OXFORD	OH	45056	204253386	501(C)(3)	$10,000	SCHOOL PROGRAMS
SANE OF BUTLER COUNTY
PO BOX 18818	FAIRFIELD	OH	45018	311604036	501(C)(3)	$7,500	FORENSIC CARE

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DEE ELLINGWOOD
VICE CHAIR	$0	$300,290	$0	$64,605	$0	$20,261	$0	$60,419	$0	$22,988	$0	$468,563	$0	$0
JOHN PROUT
SECRETARY (END 1/16)	$0	$965,035	$0	$369,675	$0	$1,094,617	$0	$34,500	$0	$9,260	$0	$2,473,087	$0	$1,038,567
ROBERT COLLINS MD
DIRECTOR	$0	$394,037	$0	$127,465	$0	$17,650	$0	$115,738	$0	$15,160	$0	$670,050	$0	$0
MICHAEL CROFTON
DIRECTOR	$0	$410,902	$0	$134,295	$0	$34,494	$0	$119,077	$0	$26,136	$0	$724,904	$0	$0
JERRY OLIPHANT
DIRECTOR (END 10/15)	$0	$455,494	$0	$171,732	$0	$77,577	$0	$106,022	$0	$26,176	$0	$837,001	$0	$0
MARK CLEMENT
DIRECTOR (START 10/15)	$0	$469,331	$0	$40,486	$0	$6,930	$0	$50,953	$0	$10,722	$0	$578,422	$0	$0
BRYAN HEHEMANN
CEO	$6,572	$205,977	$0	$25,780	$3,539	$10,663	$253	$38,460	$83	$17,932	$10,447	$298,812	$0	$0
BRETT KIRKPATRICK
EXECUTIVE DIRECTOR-MHMH	$0	$157,091	$0	$39,168	$0	$6,508	$0	$9,243	$0	$22,719	$0	$234,729	$0	$0
MATTHEW DAGGY MD
PHYSICIAN	$115,882	$121,025	$0	$10,000	$19,617	$150	$945	$831	$12,256	$10,073	$148,700	$142,079	$0	$0
PAUL CANGEMI MD
PHYSICIAN	$142,500	$233,658	$0	$10,000	$2,096	$0	$750	$4,167	$2,096	$0	$147,442	$247,825	$0	$0
BRYAN MCCULLOUGH MD
PHYSICIAN	$242,342	$249,016	$0	$10,000	$14,760	$32,000	$938	$5,896	$12,907	$15,659	$270,947	$312,571	$0	$0
GREGORY CALKINS MD
PHYSICIAN	$181,281	$0	$0	$0	$0	$0	$963	$0	$27,320	$0	$209,564	$0	$0	$0
DONALD WATSON
DIRECTOR-PHARMACY	$130,178	$0	$0	$0	$1,354	$0	$964	$0	$24,587	$0	$157,083	$0	$0	$0
JOHN CLEMENTS
FORMER	$4,483	$67,052	$0	$0	$10,304	$73,198	$371	$2,502	$51	$11,983	$15,209	$154,735	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 RELATED ORGANIZATION THAT PAID THE SALARIES OF THE INDIVIDUALS LISTED IN SCHEDULE J, PART II, CONTRIBUTED, ON BEHALF OF THE FOLLOWING INDIVIDUALS, TO A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE AMOUNTS AS NOTED: MARK CLEMENT - $23,678 DEE ELLINGWOOD - $33,144 ROBERT COLLINS, MD - $80,496 MICHAEL CROFTON - $82,575 GERALD OLIPHANT - $91,626 BRYAN HEHEMANN - $12,174 IN ADDITION, 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 - $1,038,567
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, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE.
PART I, LINE 4A	THE REPORTABLE INDIVIDUALS OF BETHESDA HEALTHCARE, INC. 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 2015 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: GERALD OLIPHANT - $56,179 JOHN CLEMENTS - $71,323

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	BUTLER COUNTY-SERIES 2015	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	316000061	BondIssuerEIN
CUSIP	NONEAVAIL	CUSIPNum
Bond Issued	2015-09-29	BondIssuedDt
Issue Price	$9,320,000	IssuePriceAmt
Purpose	REFUNDING OF 2009 SERIES	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$9,320,000	TotalProceedsAmt
Issuance Costs From Proceeds	$146,198	IssuanceCostsFromProceedsAmt
Working Capital Expenditures	$33,454	WorkingCapitalExpendituresAmt
Other Spent Proceeds	$9,140,348	OtherSpentProceedsAmt
Substantial Completion	2015	SubstantialCompletionYr
Current Refunding	Yes (1)	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	0	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	Yes (1)	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	Yes (1)	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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	RICHARD NORMAN, ALAN OAK, HILLARY EVANS, MD 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. JOHN PROUT, 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 BOARD OF DIRECTORS OF THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE, AN AFFILIATED ENTITY OF TRIHEALTH, INC. RICHARD NORMAN, ALAN OAK, HILLARY EVANS, MD 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. JOHN PROUT, 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. DEE ELLINGWOOD, MARK CLEMENT, JOHN PROUT, GERALD OLIPHANT, GAIL DONOVAN, ROBERT COLLINS, MD, AND MICHAEL CROFTON 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 11	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 B, LINE 15	IN DETERMINING COMPENSATION OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL'S OFFICERS AND DIRECTORS, THE ANNUAL PROCESS PERFORMED BY TRIHEALTH, INC. (A RELATED ORGANIZATION WHO PAID THE INDIVIDUALS) INCLUDED: * COMPENSATION COMMITTEE; * INDEPENDENT COMPENSATION CONSULTANT; * COMPENSATION SURVEY OR STUDY; * APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE ADDITIONALLY, ALL DISCUSSIONS AND DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED.
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 IX, LINE 11G	MISCELLANEOUS: PROGRAM SERVICE EXPENSES 12,465. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,465. CONTRACT STAFFING: PROGRAM SERVICE EXPENSES 2,447,402. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,447,402. MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,113,969. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,113,969. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 135,474. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 135,474. BILLING SERVICES: PROGRAM SERVICE EXPENSES 291,438. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 291,438. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 246,449. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 246,449. TRANSCRIPTION SERVICES: PROGRAM SERVICE EXPENSES 23,847. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 23,847. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 76,750. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,750. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 164,133. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,133. HIPAA COMPLIANCE SERVICES: PROGRAM SERVICE EXPENSES 75,333. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 75,333. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,482,982. MANAGEMENT AND GENERAL EXPENSES 19,483. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,502,465.
FORM 990, PART XI, LINE 9:	CAPITAL CONTRIBUTION 7,623,913.
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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
TRIHEALTH INC
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	311438846	SUPPORT TO AFFILIATED HOSPITALS	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 11B	N/A	0
MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT
110 NORTH POPLAR	OXFORD	OH	45056	237374256	OBTAIN CHARITABLE CONTRIBUTIONS, MANAGE THEM AND DISBURSE BY BOARD	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 11A	N/A	0
GOOD SAMARITAN HOSPITAL FREE CLINIC
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	273893817	HEALTHCARE SERVICES	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 7		Yes (1)	TRIHEALTH INC
TRIHEALTH PHYSICIAN ENTERPRISE CORP
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	311383365	PHYSICIAN PRACTICES	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 9		Yes (1)	TRIHEALTH INC
TRIHEALTH PHYSICIAN INSTITUTE
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	311074519	PHYSICIAN PRACTICES	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 9		Yes (1)	TRIHEALTH INC
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		0	TRIHEALTH INC
BETHESDA HEALTHCARE INC
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	311027660	HEALTHCARE SERVICES	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 11B		Yes (1)	BETHESDA INC
BETHESDA FAMILY PRACTICE CENTER
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	311242442	HEALTHCARE SERVICES	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 11A		Yes (1)	BETHESDA HOSPITAL INC
BETHESDA PROPERTIES INC
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	311352694	PROPERTY MANAGEMENT	OH	SECTION 501(C)(2)			Yes (1)	BETHESDA HOSPITAL INC
HOSPICE OF CINCINNATI INCORPORATED
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	310917155	HOSPICE SERVICES	OH	SECTION 501(C)(3)	SCHEDULE A, LINE 9		Yes (1)	BETHESDA HOSPITAL INC
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		Yes (1)	HOSPICE OF CINCINNATI INCORPORATED
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		0	TRIHEALTH INC
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		Yes (1)	THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO
COMMUNITY LIMITED CARE DIALYSIS CENTER
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	237419853	DIALYSIS	OH	SECTION 501(C)(2)			Yes (1)	THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
TRIHEALTH PHYSICIANS OF INDIANA INC
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	461125130	PHYSICIAN PRACTICES	OH	N/A	C	0
TRIHEALTH PHYSICIAN SOLUTIONS INC
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	311444353	CLAIMS ADMINISTRATION	OH	N/A	C	0
TRIHEALTH CIPHO INC
619 OAK STREET-ACCOUNTING 3 WEST	CINCINNATI	OH	45206	463294306	PHYSICIAN HEALTH ORGANIZATION	OH	N/A	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
TRIHEALTH PHYSICIAN ENTERPRISE CORP
A	$42,872	FMV
MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT
C	$410,513	CASH
TRIHEALTH INC
C	$7,623,913	CASH
TRIHEALTH INC
M	$919,996	COST
TRIHEALTH INC
P	$26,302,957	COST