2015-05-11T15:05:59-05:00 2014-06-30 440160260 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2013-07-01 461393755 TRIHEALTH HOSPITAL INC TRIH 5135696575 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 BRIAN KRAUSE VP-FINANCE 5135695126 2015-05-11 1 P00961884 5136218300 2013 2016-03-07 17:11:31Z JOHN S PROUT 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 45263541 0 X WWW.TRIHEALTH.COM X 2012 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 11 7 237 7 0 0 0 0 12305800 45209117 0 -5952 232764 54424 12538564 45257589 0 7500 0 0 5392228 13860838 0 0 0 8568167 23495111 13960395 37363449 -1421831 7894140 136331975 160116910 33753747 47185384 102578228 112931526 X TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED BY PROVIDING A FULL RANGE OF HEALTH RELATED SERVICES INCLUDING PREVENTION, WELLNESS AND EDUCATION. 1 0 26377774 7500 45254632 SEE SCHEDULE H 26377774 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 44 0 1 237 1 0 0 0 0 0 0 0 0 0 0 X 11 7 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X BRIAN KRAUSE - VP FINANCE 5135695126 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 X MICHAEL HAVERKAMP TRUSTEE 1.00 3.00 X 0 0 0 ROBERT WALKER SECRETARY 1.00 3.00 X X 0 0 0 JOHN PROUT PRESIDENT/CEO 5.00 55.00 X X 0 1455153 328652 PAUL EDGETT III TRUSTEE 1.00 3.00 X 0 0 0 MYRTIS POWELL TRUSTEE 1.00 3.00 X 0 0 0 SR SALLY DUFFY TRUSTEE 1.00 3.00 X 0 0 0 MICHAEL MCGRAW CHAIRMAN 1.00 3.00 X X 0 0 0 STEPHEN BLATT MD MED STAFF PRES-GOOD SAM (END 12/13) 1.00 10.00 X 0 439556 59073 STUART DONOVAN MD MED STAFF PRES-BETHESDA (END 12/13) 1.00 10.00 X 0 598218 11255 JOANN LOHR MD MED STAFF PRES-GOOD SAM (START 1/14) 1.00 10.00 X 0 84621 25845 ALAN ALTMAN MD MED STAFF PRES-BETHESDA (START 1/14) 1.00 10.00 X 0 284591 91628 CRAIG EISENTROUT MD TRUSTEE 1.00 3.00 X 0 111149 8503 WAYNE SHIRCLIFF VICE CHAIRMAN/TREASURER 1.00 3.00 X X 0 0 0 DONNA NIENABER ESQ SVP CORP COUNSEL/ASST SECRETARY 5.00 55.00 X 0 503646 159585 CRAIG RUCKER SVP CFO/ASST TREASURER 5.00 55.00 X 0 590695 138806 WILLIAM GRONEMAN EXEC VP SYSTEM DEVELOPMENT 5.00 55.00 X 0 587950 184458 GERALD OLIPHANT EXEC VP & COO 5.00 55.00 X 0 657505 152110 GEORGES FEGHALI MD CHIEF MEDICAL OFFICER 5.00 55.00 X 0 580831 174618 JOHN ROBINSON MD SVP-HOSPITAL OPERATIONS 10.00 50.00 X 0 386049 94986 KELVIN HANGAR EXECUTIVE DIR-TRIHEALTH EVENDALE 60.00 0.00 X 283786 0 42286 SUELLEN JONES NURSING ADMIN-TRIHEALTH EVENDALE 60.00 0.00 X 146107 0 18904 429893 6279964 1490709 2 0 1 0 CLINICAL CO-MANAGEMENT LLC 8099 CORNELL ROAD CINCINNATI OH 45249 CLINICAL MANAGEMENT 1331877 GE HEALTHCARE PO BOX 96483 CHICAGO IL 60693 EQUIPMENT/SERVICE CONTRACTS 263479 BETHESDA HOSPITAL INC 619 OAK STREET CINCINNATI OH 45206 LABORATORY 211840 RECONSTRUCTIVE ORTHOPEDICS AND SPORTS ME 8099 CORNELL ROAD CINCINNATI OH 45206 PHYSICAL THERAPY 181618 ARAMARK 4936 MONTGOMERY ROAD CINCINNATI OH 45212 UNIFORM SERVICES 175518 8 PATIENT SERVICES 621400 45209117 45209117 45209117 8909 0 8909 8909 8909 5952 -5952 -5952 -5952 A/R MANAGEMENT FEE 900099 44549 44549 MEDICAL RECORDS 900099 966 966 45515 45257589 45254632 0 2957 7500 7500 326072 326072 11081484 10124778 956706 130058 130058 1522133 1269207 252926 801091 721628 79463 1516877 1516877 1392441 674250 718191 353817 199197 154620 61107 32009 29098 1740928 551602 1189326 6077 6077 2367943 2367943 3225084 156291 3068793 107322 107322 MEDICAL/DIETARY SUPPLY 11452952 11389475 63477 EQUIPMENT 655699 514672 141027 OHIO HOSPITAL FEE 589552 589552 DUES AND SUBSCRIPTIONS 22612 8778 13834 2700 2700 37363449 26377774 10985675 0 5651744 8343442 14868 39774066 3510150 33013731 36263916 97666500 115494684 136331975 160116910 1476809 2415841 28461777 27681595 3815161 17087948 33753747 47185384 X 102578228 112931526 102578228 112931526 136331975 160116910 X 7894140 2459158 X X 0 1 X 1 0 X 29462632 2014910 27447722 10299604 1495240 8804364 11830 11830 36263916 ACCRUED WORKERS COMPENSATION 115385 ACCRUED MALPRACTICE LIABILITY 143109 DUE TO RELATED ORGANIZATION 16829454 17087948 X PART X, LINE 2: THE FINANCIAL STATEMENTS OF TRIHEALTH HOSPITAL, INC. 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 COMPLETED AN ANALYSIS OF UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT JUNE 30, 2014 AND 2013, AND DETERMINED NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT JUNE 30, 2014 AND 2013. 1 1 X 1 X 1 X 1 1 0 1 1 275123 275123 0.00740 1605897 423408 1182489 0.03160 1881020 423408 1457612 0.03900 1881020 423408 1457612 0.03900 0 1067680 0 7738852 7048669 690183 X 1 1 1 1 TRIHEALTH EVENDALE HOSPITAL 3155 GLENDALE-MILFORD RD EVENDALE OH 45241 WWW.TRIHEALTH.COM 1482 X X TRIHEALTH EVENDALE HOSPITAL 1 0 1 1 100.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X 1 0 X X X 1 X 0 0 TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 12I: SELECT CLINIC DISCOUNT - ELIGIBLE SERVICES RENDERED IN OR ORDERED BY PHYSICIANS AT SELECT CLINICS MAY BE DISCOUNTED IN AN AMOUNT NOT TO EXCEED 85%.O/B CLINIC DISCOUNT - O/B CLINIC PATIENTS RECEIVING ELIGIBLE SERVICES WHO DO NOT QUALIFY FOR FREE CARE AND FOR WHOM THE CHARITY CARE DISCOUNT IS NOT SUFFICIENT MAY RECEIVE A DISCOUNTED FLAT FEE PRICE FOR SUCH SERVICES.UNIQUE CIRCUMSTANCES ALLOWANCE - ALLOWANCES MAY BE GRANTED TO PATIENTS WITH UNIQUE CIRCUMSTANCES WHO DO NOT QUALIFY FOR ANY OTHER FINANCIAL ASSISTANCE. TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 14G: TRIHEALTH EVENDALE HOSPITAL DOES NOT PROVIDE A DETAILED COPY OF ITS FINANCIAL ASSISTANCE POLICY TO PATIENTS; HOWEVER, IT DOES PROVIDE A SUMMARY OF THE POLICY IN A MANNER LISTED IN LINES 14A-14E.IN ADDITION, SUCH INFORMATION SHALL BE PROVIDED IN LANGUAGES CONSIDERED TO BE COMMONLY SPOKEN BY THE POPULATION TRIHEALTH EVENDALE 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. TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 20D: TRIHEALTH EVENDALE HOSPITAL ("TEH") 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, TEH 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 63% 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, TEH 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. PART V, SECTION B, LINE 1 PROPOSED TREASURY REGULATION SECTION 1.503(R)-3(D), AS PUBLISHED ON APRIL 5, 2013 IN THE FEDERAL REGISTER, STATES THAT "A HOSPITAL FACILITY THAT IS NEWLY ACQUIRED ..., MUST MEET THE REQUIREMENTS OF SECTION 501(R)(3) BY THE LAST DAY OF THE SECOND TAXABLE YEAR BEGINNING AFTER THE DATE, RESPECTIVELY, THE HOSPITAL FACILITY IS ACQUIRED; ...TRIHEALTH EVENDALE HOSPITAL WAS ACQUIRED BY TRIHEALTH HOSPITAL, INC. ON JANUARY 1, 2013. THEREFORE, IT IS NOT REQUIRED TO MEET THE COMMUNITY HEALTH NEEDS ASSESSMENT REQUIREMENT UNTIL JUNE 30, 2015. AS SUCH, THE RESPONSE TO QUESTION 1 OF SECTION B IS ANSWERED "NO" FOR THE CURRENT TAX YEAR. 3 TRIHEALTH SURGERY CENTER WEST 3660 EDGEWOOD DRIVE CINCINNATI OH 45211 OUTPATIENT SURGERY CENTER TRIHEALTH HAND SURGERY CENTER 538 OAK STREET SUITE 200 CINCINNATI OH 45219 OUTPATIENT SURGERY CENTER TRIHEALTH ENDOSCOPY CENTER NORTH 10600 MONTGOMERY ROAD CINCINNATI OH 45242 OUTPATIENT ENDOSCOPY CENTER PART I, LINE 3C: TRIHEALTH HOSPITAL INC. UTILIZES THE FEDERAL POVERTY GUIDELINES ("FPG") IN DETERMINING CHARITY CARE ELIGIBILITY. SEE THE RESPONSES TO PART I, LINE 3A AND 3B.AN INDIVIDUAL'S INCOME UNDER 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. PART I, LINE 6A: IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH, INC. ("TRIHEALTH") 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 2013, TRIHEALTH ORGANIZED TRIHEALTH HOSPITAL, INC. TO SUPPORT ITS MISSION.THE COMMUNITY BENEFIT PROVIDED BY TRIHEALTH HOSPITAL, INC. IS TRACKED ON A STANDALONE BASIS; HOWEVER, ITS COMMUNITY BENEFIT IS REPORTED IN COMBINATION WITH BOTH BETHESDA HOSPITAL, INC.'S AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO'S COMMUNITY BENEFIT IN A REPORT PREPARED BY TRIHEALTH. PART I, LINE 7: FOR THE AMOUNTS REPORTED AT COST IN PART I, LINE 7, TRIHEALTH HOSPITAL, INC. 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: TRIHEALTH HOSPITAL, INC. DID NOT ENGAGE IN ANY COMMUNITY BUILDING ACTIVITIES DURING THE TAX YEAR. PART III, LINE 2: SEE SCHEDULE H, PART III, LINE 4. PART III, LINE 3: SEE SCHEDULE H, PART III, LINE 4. PART III, LINE 4: TRIHEALTH HOSPITAL, INC.'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 DEBTS 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 DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS RECEIVABLE IN THE PERIOD OF SERVICE BASED UPON HISTORICAL WRITE-OFF EXPERIENCE.AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, TRIHEALTH FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY TRIHEALTH. OVERALL, THE TOTAL WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS AND ALLOWANCES ON SELF-PAY PATIENT ACCOUNTS RECEIVABLE HAS NOT SIGNIFICANTLY CHANGED SINCE JUNE 30, 2013. TRIHEALTH HAS NOT EXPERIENCED SIGNIFICANT CHANGES IN WRITE-OFF TRENDS AND HAS NOT CHANGED ITS CHARITY CARE POLICY SINCE JUNE 30, 2013. THE OVERALL ALLOWANCE PERCENTAGE FOR UNCOLLECTIBLE ACCOUNTS WENT FROM 52% AT JUNE 30, 2013 TO 37% AT JUNE 30, 2014 AS A RESULT OF CHANGES IN PAYOR MIX DUE TO THE AFFORDABLE CARE ACT.FINANCIAL INSTRUMENTS THAT POTENTIALLY SUBJECT TRIHEALTH TO CONCENTRATIONS OF CREDIT RISK CONSIST PRIMARILY OF NON-GOVERNMENTAL 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: 2014 - MEDICARE 18%, MEDICAID 4%, MANAGED CARE 26%, SELF PAY 20%, COMMERCIAL AND OTHER 32%2013 - MEDICARE 19%, MEDICAID 3%, MANAGED CARE 22%, SELF PAY 23%, COMMERCIAL AND OTHER 33%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, TRIHEALTH 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, TRIHEALTH HOSPITAL, INC., 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: IN 1995, BETHESDA HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO FORMED A PARTNERSHIP TO CREATE A LOCAL HEALTH SYSTEM: TRIHEALTH, INC. ("TRIHEALTH"). THE MISSION OF TRIHEALTH IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION.IN JANUARY 2013, TRIHEALTH ACQUIRED EVENDALE MEDICAL CENTER AND FORMED TRIHEALTH HOSPITAL, INC. THE HOSPITAL CAMPUS CONSISTS OF TEN OPERATING ROOMS, 29 INPATIENT ROOMS AND A COMPLETE IMAGING AND DIAGNOSTIC FACILITY. SERVICES RANGE FROM INPATIENT SURGERY TO ORTHOPEDICS, GYNECOLOGY AND OUTPATIENT IMAGING.TRIHEALTH PARTICIPATED IN AND WAS A FUNDER OF THE WORK OF A COLLABORATIVE, REGIONAL EFFORT, THE A.I.M. FOR BETTER HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT ("A.I.M."). IN THE AREAS ASSESSED, THOSE SURVEYED WERE MORE OFTEN UNDERSERVED, INCLUDING THE UNINSURED, THE UNDERINSURED, THOSE IN LOW SOCIOECONOMIC STATUS, MINORITIES, THOSE OVER THE AGE OF SIXTY-FIVE, OR THOSE WITH A DIAGNOSIS OF MENTAL ILLNESS. THE A.I.M., PUBLISHED IN THE SPRING OF 2012, WILL BE USED TO DEVELOP A SPECIFIC COMMUNITY HEALTH NEEDS ASSESSMENT FOR TRIHEALTH HOSPITAL, INC. 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 INTRUCTIONS 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: LOCATED IN CINCINNATI, OHIO, TRIHEALTH HOSPITAL, INC. AND THE TRIHEALTH, INC. SYSTEM SERVE HAMILTON, BUTLER, WARREN, CLINTON AND CLERMONT COUNTIES IN OHIO AS WELL AS PERSONS FROM INDIANA AND KENTUCKY. IN METROPOLITAN STATISTICAL AREAS, THE CINCINNATI-MIDDLETOWN REGION IS THE LARGEST IN OHIO. THE ESTIMATED POPULATION FOR THIS AREA IS 2,150,000. THE POPULATION WITHIN THE FIVE OHIO COUNTIES SERVED BY TRIHEALTH HOSPITAL, INC. AND TRIHEALTH, INC. IS ESTIMATED TO BE 1,663,000 AND 12.0 PERCENT OF THIS POPULATION IS UNINSURED. PART VI, LINE 5: TRIHEALTH HOSPITAL, INC. IS COMPRISED OF VARIOUS MEDICAL SERVICES INCLUDING TRIHEALTH EVENDALE HOSPITAL AND TRIHEALTH SURGERY CENTER WEST. ITS BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY REPRESENTATIVES.TRIHEALTH EVENDALE HOSPITAL CONSISTS OF TEN OPERATING ROOMS, 29 INPATIENT ROOMS AND A COMPLETE IMAGING AND DIAGNOSTIC FACILITY. SERVICES RANGE FROM INPATIENT SURGERY TO ORTHOPEDICS, GYNECOLOGY AND OUTPATIENT IMAGING.TRIHEALTH SURGERY CENTER WEST CONSISTS OF FOUR OPERATING ROOMS AND TWO PROCEDURE ROOMS. PART VI, LINE 6: IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH, INC. ("TRIHEALTH") 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 2013, TRIHEALTH ORGANIZED TRIHEALTH HOSPITAL, INC. TO SUPPORT ITS MISSION.TRIHEALTH'S SITES INCLUDE FOUR (4) HOSPITAL LOCATIONS AND VARIOUS PHYSICIAN OFFICE BUILDINGS THROUGHOUT THE GREATER CINCINNATI AREA IN ADDITION TO FITNESS, REHABILITATION, OCCUPATIONAL HEALTH, PALLIATIVE CARE SERVICES AND OUTPATIENT CENTERS. IT ALSO PROVIDES SERVICES IN HOMES AND WORKPLACES AND DELIVERS CARE AND EDUCATION COOPERATIVELY THROUGH COMMUNITY-BASED ORGANIZATIONS SUCH AS CHURCHES, SCHOOLS, CLINICS AND SOCIAL AGENCIES. 0 1 0 0 0 0 0 0 0 JOHN PROUT PRESIDENT/CEO 0 933901 0 370000 0 151252 0 319627 0 9025 0 1783805 0 119269 STEPHEN BLATT MD MED STAFF PRES-GOOD SAM (END 12/13) 0 371110 0 22109 0 46337 0 41395 0 17678 0 498629 0 0 STUART DONOVAN MD MED STAFF PRES-BETHESDA (END 12/13) 0 457880 0 93000 0 47338 0 10783 0 472 0 609473 0 0 ALAN ALTMAN MD MED STAFF PRES-BETHESDA (START 1/14) 0 241019 0 25000 0 18572 0 67361 0 24267 0 376219 0 0 DONNA NIENABER ESQ SVP CORP COUNSEL/ASST SECRETARY 0 335667 0 142672 0 25307 0 142672 0 16913 0 663231 0 0 CRAIG RUCKER SVP CFO/ASST TREASURER 0 438712 0 128945 0 23038 0 127978 0 10828 0 729501 0 0 WILLIAM GRONEMAN EXEC VP SYSTEM DEVELOPMENT 0 398252 0 117323 0 72375 0 157712 0 26746 0 772408 0 20369 GERALD OLIPHANT EXEC VP & COO 0 490075 0 148339 0 19091 0 127101 0 25009 0 809615 0 0 GEORGES FEGHALI MD CHIEF MEDICAL OFFICER 0 395530 0 159828 0 25473 0 152458 0 22160 0 755449 0 0 JOHN ROBINSON MD SVP-HOSPITAL OPERATIONS 0 296746 0 75179 0 14124 0 71624 0 23362 0 481035 0 0 KELVIN HANGAR EXECUTIVE DIR-TRIHEALTH EVENDALE 210359 0 72954 0 473 0 20331 0 21955 0 326072 0 0 0 SUELLEN JONES NURSING ADMIN-TRIHEALTH EVENDALE 133891 0 11426 0 790 0 11119 0 7785 0 165011 0 0 0 PART I, LINE 3 TRIHEALTH, INC., A RELATED ORGANIZATION OF TRIHEALTH HOSPITAL, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD/COMPENSATION COMMITTEE. PART I, LINE 4B 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. TRIHEALTH, INC., THE RELATED ORGANIZATION THAT PAID THE SALARIES OF THE FOLLOWING 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: JOHN PROUT - $261,496 DONNA NIENABER, ESQ. - $72,455 CRAIG RUCKER - $84,556 WILLIAM GRONEMAN - $89,099 GERALD OLIPHANT - $99,709 GEORGES FEGHALI, MD - $92,355 JOHN ROBINSON, MD - $45,737 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 - $119,269 WILLIAM GRONEMAN - $20,369 PART I, LINE 4A: THE REPORTABLE INDIVIDUALS OF BETHESDA HOSPITAL, 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). THESE INDIVIDUALS DO NOT HAVE EMPLOYMENT AGREEMENTS SO NO SPECIAL ARRANGEMENTS EXIST BEYOND TRIHEALTH, INC.'S 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. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC. DURING THE 2013 CALENDAR YEAR. FORM 990, PART III, LINE 2 BEGINNING NOVEMBER 1, 2013, TRIHEALTH HOSPITAL, INC. BEGAN PROVIDING ENDOSCOPY SERVICES TO THE COMMUNITY AT TRIHEALTH ENDOSCOPY CENTER NORTH. THE CENTER PROVIDES COMPETENT, SAFE, HIGH QUALITY, COST EFFECTIVE AND ACCESSIBLE CARE ON AN OUTPATIENT BASIS TO ITS PATIENTS WHICH MAY RANGE FROM ADOLESCENCE THROUGH THE ELDERLY ADULT. IN ADDITION, ON JANUARY 1, 2014, TRIHEALTH HOSPITAL, INC. BEGAN OPERATION OF TRIHEALTH HAND SURGERY CENTER. THIS CENTER IS A SPACIOUS, STATE-OF-THE-ART, OUTPATIENT SURGICAL FACILITY, EQUIPPED TO PERFORM SOPHISTICATED HAND SURGERY PROCEDURES. IT HAS BEEN AWARDED THE MAXIMUM AMERICAN ASSOCIATION OF AMBULATORY HEALTH CARE ACCREDITATION. BOTH OF THESE NEW FACILITIES EXPAND THE CURRENT RANGE OF HEALTH SERVICES PROVIDED BY TRIHEALTH HOSPITAL, INC. AND FURTHER ITS TAX EXEMPT MISSION OF IMPROVING THE HEALTH STATUS OF THE PEOPLE IT SERVES FROM THE SURROUNDING AREA. FORM 990, PART VI, SECTION A, LINE 2 THE OFFICERS, DIRECTORS AND TRUSTEES OF TRIHEALTH HOSPITAL, INC. LISTED IN PART VII, SECTION A HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARDS OF BETHESDA HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, BOTH AFFILIATED ENTITIES OF TRIHEALTH HOSPITAL, INC. AS WELL AS TRIHEALTH, INC., THE SINGLE CORPORATE MEMBER OF TRIHEALTH HOSPITAL, INC. WAYNE SHIRCLIFF, STUART DONOVAN, MD, CRAIG EISENTROUT, MD, ALAN ALTMAN, MD, ROBERT L. WALKER, MICHAEL HAVERKAMP, AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF BETHESDA, INC., THE SINGLE CORPORATE MEMBER OF BETHESDA HOSPITAL, INC., AN AFFILIATED ENTITY OF TRIHEALTH HOSPITAL, INC. JOHN PROUT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE, AN AFFILIATED ENTITY OF TRIHEALTH HOSPITAL, INC. JOHN PROUT AND CRAIG EISENTROUT, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF BETHESDA FOUNDATION, INC., A RELATED ENTITY OF BETHESDA HOSPITAL, INC., AN AFFILIATED ENTITY OF TRIHEALTH HOSPITAL, INC. JOHN PROUT, DONNA NIENABER, ESQ., CRAIG RUCKER, WILLIAM GRONEMAN, GERALD OLIPHANT, GEORGES FEGHALI, MD, STUART DONOVAN, MD, ALAN ALTMAN, MD, JOANN LOHR, MD AND STEPHEN BLATT, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON RELATED ENTITY BOARDS OF TRIHEALTH, INC. AND ITS SUBSIDIARIES AND AFFILIATES AS WELL AS BEING EMPLOYED BY TRIHEALTH, INC. OR ITS AFFILIATES/SUBSIDIARIES. TRIHEALTH, INC. IS THE SINGLE CORPORATE MEMBER OF TRIHEALTH HOSPITAL, INC. SR. SALLY DUFFY AND MICHAEL MCGRAW HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER VIA AN UNRELATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF TRIHEALTH HOSPITAL, INC. SHALL BE TRIHEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO ARTICLE II, SECTION 2.2 OF THE CODE OF REGULATIONS OF TRIHEALTH HOSPITAL, INC. ("HOSPITAL") THE SOLE MEMBER OF THE CORPORATION SHALL ELECT THE TRUSTEES OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF TRIHEALTH HOSPITAL, INC. ("HOSPITAL") HAS THE ABILITY TO APPROVE THE DECISIONS OF THE HOSPITAL'S GOVERNING BODY THAT ARE RESERVED TO IT BY OHIO LAW. FORM 990, PART VI, SECTION B, LINE 11 MEMBERS OF THE BOARD ARE PROVIDED AN ELECTRONIC COPY OF THIS FORM 990 PRIOR TO FILING. SUBSEQUENT TO PRESENTATION TO THE BOARD, THE ORGANIZATION FILES THE RETURN MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH NON-SUBSTANTIVE CHANGES ARE NOT SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE CERTAIN FINANCIAL INTERESTS AND FIDUCIARY RELATIONSHIPS. THE EXECUTIVE COMMITTEE AND CORPORATE COUNSEL REVIEW RESPONSES, CONDUCT FURTHER INVESTIGATION, IF NECESSARY, AND DETERMINE WHEN A CONFLICT EXISTS WITH RESPECT TO A CERTAIN TRANSACTION. IF A CONFLICT EXISTS, THE TRANSACTION IS NOT TO BE ENTERED INTO UNLESS ALTERNATIVES ARE FULLY INVESTIGATED AND, IN THEIR ABSENCE, THE BOARD, WITHOUT 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 TRIHEALTH HOSPITAL, INC.'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; AND * APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ADDITIONALLY, ALL DISCUSSIONS AND DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 TRIHEALTH HOSPITAL, INC.'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A - AVERAGE HOURS PER WEEK THE OFFICERS AND DIRECTORS FOR TRIHEALTH HOSPITAL, INC. THAT SHOW AT LEAST 60 HOURS PER WEEK PROVIDE SERVICES TO TRIHEALTH, INC. (A RELATED ORGANIZATION WHO PAID THE INDIVIDUALS) AND ITS SUBSIDIARIES/AFFILIATES ("TRIHEALTH") AS AN ENTIRE SYSTEM. HOURS WORKED, INCLUDING THEIR DUTIES AS OFFICERS AND DIRECTORS OF THE FILING ORGANIZATION, ARE NOT TRACKED ON AN ENTITY BY ENTITY BASIS, THUS THE AVERAGE HOURS PER WEEK DISCLOSED ARE ESTIMATES TO SHOW THAT THE TIME SPENT BY THESE INDIVIDUALS RELATE TO THEM FULFILLING THEIR DUTIES AS FULL-TIME, 60 HOURS-PER-WEEK EMPLOYEES OF TRIHEALTH VERSUS THEIR DUTIES AS OFFICERS AND DIRECTORS OF THE FILING ORGANIZATION. IN ADDITION, THE COMPENSATION REPORTED ON FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS IN FULFILLMENT OF THEIR DUTIES AS EMPLOYEES OF TRIHEALTH. DIRECTORS (AS NOTED WITH A "MED STAFF PRES" REFERENCE) FOR BETHESDA HOSPITAL, INC. SERVE ON THE BOARD IN THEIR CAPACITY AS MEDICAL STAFF PRESIDENT FOR EITHER BETHESDA HOSPITAL, INC. OR THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. IN ADDITION, THESE INDIVIDUALS PROVIDE SERVICES AS EMPLOYEES OF VARIOUS RELATED ENTITIES FOR WHICH THEY RECEIVE COMPENSATION. NONE OF THE COMPENSATION SHOWN IS FOR SERVING AS A DIRECTOR. FORM 990, PART XI, LINE 9: GAIN ON UNCONSOLIDATED ORGANIZATION 1,940,843. CONTRIBUTED CAPITAL BY PARENT 518,315. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF TRIHEALTH HOSPITAL, INC. ARE AUDITED AS PART OF TRIHEALTH, INC. AND ITS SUBSIDIARIES AND AFFILIATES ("TRIHEALTH"). TRIHEALTH HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF BOTH ITS AND ITS SUBSIDIARIES AND AFFILIATES FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF THE INDEPENDENT AUDITOR. DURING THE TAX YEAR, THERE WAS NOT A CHANGE IN THE PROCESS OF AUDIT OVERSIGHT AND/OR SELECTION OF AN INDEPENDENT AUDITOR BY TRIHEALTH. 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 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 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN ENTERPRISE CORP 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311383365 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 9 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN INSTITUTE 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311074519 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 9 TRIHEALTH INC 1 BETHESDA HOSPITAL INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 310537122 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 0 BETHESDA HEALTHCARE INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311027660 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 11B BETHESDA INC 1 BETHESDA FAMILY PRACTICE CENTER 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311242442 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 11C BETHESDA HOSPITAL INC 1 BETHESDA PROPERTIES INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311352694 PROPERTY MANAGEMENT OH SECTION 501(C)(2) BETHESDA HOSPITAL INC 1 HOSPICE OF CINCINNATI INCORPORATED 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 310917155 HOSPICE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 9 BETHESDA HOSPITAL INC 1 FERNSIDE INC A CENTER FOR GRIEVING CHILDREN 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311179234 COUNSELING TO GRIEVING CHILDREN OH SECTION 501(C)(3) SCHEDULE A, LINE 7 HOSPICE OF CINCINNATI INCORPORATED 1 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 310537486 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 0 GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311778403 EDUCATION OH SECTION 501(C)(3) SCHEDULE A, LINE 2 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 237419853 DIALYSIS OH SECTION 501(C)(2) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 TRIHEALTH PHYSICIANS OF INDIANA INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 461125130 PHYSICIAN PRACTICES OH N/A C 1 TRIHEALTH PHYSICIAN SOLUTIONS INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311444353 CLAIMS ADMINISTRATION OH N/A C 1 TRIHEALTH CIPHO INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 463294306 PHYSICIAN HEALTH ORGANIZATION OH N/A C 1 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 TRIHEALTH INC C 518314 CASH BETHESDA PROPERTIES INC K 98532 FMV BETHESDA HOSPITAL INC M 211840 FMV TRIHEALTH INC P 23712611 COST