2020-05-15T07:58:18-05:00 2019-06-30 861065772 DELOITTE TAX LLP 250 EAST FIFTH STREET SUITE 1900 CINCINNATI OH 45202 990 2018-07-01 461393755 TRIHEALTH HOSPITAL INC TRIH 5135696575 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 MICHAEL CROFTON VP-FINANCE 5135696577 2020-05-15 1 ALICIA JANISCH P00741382 5137847100 216.68.236.9 2020-05-15 07:48:27 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7C4C65F4048F11F90FA55EE4E3CFA51667930AD2 2018 2020-11-06 18:47:13Z MARK CLEMENT 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 69125973 0 X WWW.TRIHEALTH.COM X 2012 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 13 8 276 8 0 0 0 0 64518130 69125691 0 0 511859 282 65029989 69125973 0 0 0 0 18248895 19436858 0 0 0 32288340 37636202 50537235 57073060 14492754 12052913 187632255 199892904 28344858 28552594 159287397 171340310 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. 0 0 43317596 0 69125973 SEE SCHEDULE H 43317596 1 0 0 0 0 0 0 0 0 0 1 0 0 1 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 1 1 0 1 58 0 1 276 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X MICHAEL CROFTON - VP FINANCE 5135696577 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 X SR SALLY DUFFY SECRETARY 1.00 3.00 X X 0 0 0 CRAIG EISENTROUT MD TRUSTEE 1.00 3.00 X 0 570038 48305 WAYNE SHIRCLIFF CHAIRPERSON (END 6/19) 1.00 3.00 X X 0 0 0 RALPH MICHAEL VICE CHAIR/TREASURER 1.00 3.00 X X 0 0 0 ROBERT COLLINS MD TRUSTEE (START 7/18) 1.00 3.00 X 0 202461 27381 MARK CLEMENT PRESIDENT/CEO 5.00 55.00 X X 0 1463838 316037 PHILLIP CASTELLINI TRUSTEE 1.00 3.00 X 0 0 0 LISA KNUTSON TRUSTEE (END 6/19) 1.00 3.00 X 0 0 0 THEODORE TORBECK TRUSTEE 1.00 3.00 X 0 0 0 PHILIP FOSTER TRUSTEE 1.00 3.00 X 0 0 0 SCOTT FRIEDSTROM MD MED STAFF PRES-GOOD SAM 1.00 3.00 X 0 542743 84672 PHILLIP OBLINGER MD MED STAFF PRES-BETHESDA 1.00 3.00 X 0 129851 0 QUINT STUDER TRUSTEE (START 7/18) 1.00 3.00 X 0 0 0 ANDREW DEVOE ASST TREASURER/CFO 5.00 55.00 X 0 772272 170726 STEVE GRACEY ASST SECRETARY/SVP LEGAL 5.00 55.00 X 0 450171 125258 KELVIN HANGER EXEC DIR-PERIOP OPERATIONS 60.00 0.00 X 0 370743 46935 SUELLEN JONES NURSING ADMIN-TRIHEALTH EVENDALE 60.00 0.00 X 197148 0 27237 GAIL DONOVAN EXEC VP & COO (END 6/19) 5.00 55.00 X 0 928244 200684 DAVID COOK CHIEF HR OFFICER 5.00 55.00 X 0 460282 122582 KEVIN JOSEPH MD CHIEF MEDICAL OFFICER 5.00 55.00 X 0 643316 145667 MARY IRVIN CNE-TRIHEALTH (END 10/18) 15.00 45.00 X 0 398718 130448 JENNY SKINNER CNE-TRIHEALTH (START 11/18) 15.00 45.00 X 0 303281 62227 MARLA SILLIMAN VP-GOOD SAM REGION 15.00 45.00 X 0 433044 64724 JOANNE RISLEY NURSE MGR-TRIHEALTH EVENDALE 60.00 0.00 X 124216 0 13423 DEBORAH MONTGOMERY MGR-TRIHEALTH HAND SURGERY 60.00 0.00 X 108814 0 30893 MELISSA PAYNE PHARMACIST 60.00 0.00 X 143202 0 35746 SALLY VEATCH NURSE MGR-TRIHEALTH EVENDALE 60.00 0.00 X 122893 0 17351 VALENTINA DEDMAN NURSE MGR-TRIHEALTH EVENDALE 60.00 0.00 X 108928 0 23493 JOHN PROUT FORMER OFFICER 0.00 40.00 X 0 1853100 0 DONNA NIENABER ESQ FORMER OFFICER 0.00 0.00 X 0 361585 31808 MICHAEL CROFTON FORMER OFFICER 0.00 60.00 X 0 394919 118485 WILLIAM GRONEMAN FORMER KEY EMPLOYEE 5.00 55.00 X 0 462416 142930 JOHN ROBINSON MD FORMER KEY EMPLOYEE 0.00 0.00 X 0 250188 0 ROB CERCEK FORMER KEY EMPLOYEE 5.00 55.00 X 0 624765 152151 GERALD OLIPHANT FORMER KEY EMPLOYEE 0.00 0.00 X 0 1192978 0 805201 12808953 2139163 8 1 1 0 CLINICAL CO-MANAGEMENT LLC 8099 CORNELL ROAD CINCINNATI OH 45249 CLINICAL MANAGEMENT 1022804 SCIOTO SERVICES 3478 HAUCK RD STE D CINCINNATI OH 45241 JANITORIAL 236755 ORTHOCINCY 8099 CORNELL ROAD CINCINNATI OH 45249 PHYSICAL THERAPY STAFFING 202175 APPLIED MECHANICAL SYSTEMS INC 5598 WOLF CREEK PIKE DAYTON OH 45426 EQUIPMENT MAINTENANCE 135344 ARAMARK UNIFORM SERVICES 4936 MONTGOMERY RD CINCINNATI OH 45212 UNIFORMS 115693 6 PATIENT SERVICES 621400 69125691 69125691 69125691 MISCELLANEOUS 900099 282 282 282 69125973 69125973 0 0 224385 224385 15158498 14330596 827902 952942 440577 512365 2011216 1861910 149306 1089817 1020380 69437 1233403 1233403 802220 712226 89994 475165 475165 10410 10410 2370411 1804489 565922 10928 8143 2785 1988484 1988484 6169133 2882149 3286984 MEDICAL/DIETARY SUPPLY 17373624 17373624 OVERHEAD ALLOCATION 4972826 228234 4744592 EQUIPMENT 1193239 1192089 1150 OHIO HOSPITAL FEE 973179 973179 63180 4425 58755 57073060 43317596 13755464 0 600 601 7233384 7719345 148596 1044155 63161658 23875271 42736222 39286387 112274685 111469685 25238768 40372731 187632255 199892904 3825897 4988746 24163264 23174398 355697 389450 28344858 28552594 X 159287397 171340310 159287397 171340310 187632255 199892904 12052913 0 X X 0 1 X 1 0 X 39292605 9800537 29492068 14018 7009 7009 22666888 13930103 8736785 1188147 137622 1050525 39286387 DUE FROM RELATED ORGANIZATION 40295342 MISCELLANEOUS 77389 40372731 ACCRUED MALPRACTICE LIABILITY 288143 THIRD PARTY SETTLEMENTS 101307 389450 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 PERFORMED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT JUNE 30, 2019 OR 2018. 1 1 X 1 X 1 X 1 1 0 1 1 641480 0 641480 0.01120 4758227 3021284 1736943 0.03040 5399707 3021284 2378423 0.04160 0 0 0 0 0 0 0 0 0 0 5399707 3021284 2378423 0.04160 0 2973474 0 11755564 10715448 1040116 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 0 1 X X X X X X X X X 18 1 1 1 1 X HTTPS://WWW.TRIHEALTH.COM/ABOUT-TRIHEALTH/COMMUNITY/ X 1 18 1 HTTPS://WWW.TRIHEALTH.COM/ABOUT-TRIHEALTH/COMMUNITY/ 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 5: PRIMARY DATA SOURCES ALMOST 1,300 PEOPLE HAD AN OPPORTUNITY TO IDENTIFY AND PRIORITIZE HEALTH AND HEALTH-RELATED ISSUES AT A MEETING OR BY SURVEY. TWENTY-THREE (23) COUNTY- OR DISTRICT-LEVEL PUBLIC HEALTH DEPARTMENTS RESPONDED BY SURVEY, AND THE CHNA TEAM ALSO RECEIVED SURVEY RESPONSES FROM 5 CITY-LEVEL HEALTH DEPARTMENTS. NINETY-SIX NONPROFIT ORGANIZATIONS COMPLETED SURVEYS, AND THEY SERVED RESIDENTS IN EVERY COUNTY. TOTAL RESPONSE FAR EXCEEDED THE LEVEL OF RESPONSE EXPERIENCED THREE YEARS EARLIER FOR THE 2016 CHNAS IN CINCINNATI AND DAYTON. PRIMARY DATA WAS OBTAINED, WITH A UNIFORM SET OF QUESTIONS, VIA THE FOLLOWING: * THERE WERE 42 MEETINGS, HELD IN 23 COUNTIES DURING MAY THROUGH JULY 2018, WHICH ATTRACTED 463 REPRESENTATIVES OF COMMUNITY ORGANIZATIONS, THE GENERAL PUBLIC, AND/OR MEMBERS OF MEDICALLY UNDERSERVED AND VULNERABLE POPULATIONS TO IDENTIFY BARRIERS TO CARE, GIVE INPUT FOR CURRENT NEEDS ASSESSMENT, PRIORITIZE ISSUES, AND IDENTIFY RESOURCES TO ADDRESS HEALTH AND HEALTH-RELATED ISSUES. * ONLINE SURVEYS OF INDIVIDUALS (828), AGENCIES (96), AND PUBLIC HEALTH DEPARTMENTS (28) THROUGHOUT THE REGION FROM JUNE THROUGH AUGUST 2018. * THE REPORTING HOSPITAL DID NOT RECEIVE WRITTEN COMMENTS FROM THE PUBLIC REGARDING THE 2016 CHNA OR ITS RELATED IMPLEMENTATION STRATEGY. COMMUNITY MEETINGSOUTREACH ANY INDIVIDUAL OR AGENCY REPRESENTATIVE WHO GAVE THEIR ADDRESS DURING THE 2013 OR 2016 CHNA PROCESS WAS ADDED TO AN INVITE LIST, AND THE HEALTH COLLABORATIVE (THC) MAILED THEM AN INVITATION TO THE MEETING SCHEDULED IN THEIR COUNTY. THE CONSULTANTS ADDED NONPROFIT ORGANIZATIONS IN EACH COUNTY THAT HAD EITHER A PHONE NUMBER, STREET ADDRESS, OR EMAIL. THC SENT 544 EMAILS AND 376 LETTERS BY FIRST-CLASS MAIL. THE CONSULTANTS MADE PHONE CALLS TO AGENCIES THAT HAD NOT PREVIOUSLY ATTENDED A CHNA MEETING AS WELL AS TO STRATEGIC ORGANIZATIONS THAT SERVE VULNERABLE POPULATIONS AND/OR HAVE A BROAD REACH, E.G., UNITED WAY. THEY FOLLOWED UP WITH EMAILS. THC SENT FLYERS TO HOSPITALS AND TO MEETING HOST SITES FOR POSTING AND DISTRIBUTION. THE CONSULTANTS ALSO POSTED UPCOMING MEETINGS EVERY TWO WEEKS IN THE INTERACT FOR HEALTH E-NEWSLETTER: HEALTH WATCH, WHICH IS EMAILED ACROSS 20 COUNTIES. THE CONSULTANTS SENT FLYERS TO PUBLIC HEALTH DEPARTMENTS TO POST AND DISTRIBUTE. SOME HEALTH DEPARTMENTS PUBLICIZED MEETINGS ON THEIR SOCIAL MEDIA PAGES AND HELD ADDITIONAL MEETINGS. THERE WAS A 229% INCREASE IN MEETING ATTENDANCE, FROM 202 FOR THE 2016 CYCLE TO 463 FOR THE 2019 CYCLE. APPENDIX 1 OF THE CHNA, WHICH IS POSTED TO TRIHEALTH'S WEBSITE, INCLUDES A LIST OF MEETING ATTENDEES AND THE ORGANIZATIONS EACH REPRESENTS.PURPOSE OF MEETINGS THE PURPOSE OF THE MEETINGS WAS TO SOLICIT PUBLIC INPUT. THE DESIRE WAS TO ATTRACT INDIVIDUALS OR NONPROFIT ORGANIZATIONS WITH EXPERIENCE OR KNOWLEDGE TO SHARE, ESPECIALLY ON EMERGING ISSUES NOT CAPTURED BY THE SECONDARY DATA AND FROM THE PERSPECTIVES OF MEDICALLY UNDERSERVED, MINORITY, AND/OR LOW-INCOME POPULATIONS. THE OBJECTIVES WERE TO: * SHARE COUNTY-LEVEL HIGHLIGHTS FROM THE SECONDARY DATA (AND CITY-LEVEL FOR CINCINNATI HEALTH DEPARTMENT MEETINGS) * GATHER DIVERSE PEOPLE TO SHARE THEIR IDEAS -- GENERAL PUBLIC AND COMMUNITY LEADERS * RECEIVE INPUT FROM AGENCIES THAT REPRESENT VULNERABLE POPULATIONS * HEAR CONCERNS AND QUESTIONS ABOUT EXISTING HEALTH/HEALTH-RELATED ISSUES * OBTAIN INFORMATION ABOUT FINANCIAL AND NON-FINANCIAL BARRIERS TO HEALTH CARE * IDENTIFY RESOURCES AVAILABLE LOCALLY TO ADDRESS ISSUES * OBTAIN INSIGHT INTO LOCAL CONDITIONS FROM LOCAL PEOPLE * DISCOVER HEALTH AND HEALTH-RELATED PRIORITIES OF ATTENDEES MEETING FACILITATION A GROUP OF 2-3 CONSULTANTS WENT TO EACH MEETING, DEPENDING ON THE NUMBER OF RSVPS. EACH MEETING FOLLOWED THE SAME FORMAT AND AGENDA. REFRESHMENTS WERE SERVED, AND NAMETAGS WERE USED TO GENERATE A WELCOMING ATMOSPHERE. LOCATIONS WERE SELECTED FOR CONVENIENCE, ACCESS, AND TRUSTED REPUTATION IN THE COMMUNITY. THE FACILITATOR FIRST SHARED GENERAL TRISTATE AND STATE-SPECIFIC HEALTH AND HEALTH-RELATED DATA TO PROVIDE CONTEXT. THE SURVEY QUESTIONS WERE USED, BUT THE FIRST QUESTION ABOUT MOST SERIOUS HEALTH ISSUES WAS ASKED SEPARATELY. THIS TECHNIQUE WAS INTENDED TO CAPTURE FIRST THOUGHTS WITHOUT AN OPPORTUNITY TO BE INFLUENCED BY THE MORE SPECIFIC COUNTY-LEVEL DATA OR BY OTHER ATTENDEES. AFTER THE FIRST QUESTION, THE CONSULTANTS (A MEETING FACILITATOR AND AT LEAST ONE SCRIBE) SHARED A PROFILE OF THE COUNTY, INCLUDING A SUMMARY OF SECONDARY DATA. THE MEETINGS LASTED 90 MINUTES, OF WHICH 60 MINUTES WAS DEVOTED TO THE GROUP'S BRAINSTORMING. AT THE END, EACH PERSON WAS GIVEN 3 COLORED DOTS. THEY PLACED THE DOTS NEXT TO ISSUES THEY PRIORITIZED AS MOST IMPORTANT HEALTH CONDITIONS OR NEEDS OF THE COMMUNITY. THE AGENDA HANDOUT CONTAINED LINKS TO THE SURVEYS. SURVEYS THE CONSULTANTS DEVELOPED THREE TYPES OF SURVEYS: INDIVIDUAL CONSUMER; AGENCY; AND HEALTH DEPARTMENT. THE QUESTIONS REMAINED THE SAME FOR EACH SURVEY. THE AGENCY SURVEYS WERE PUSHED OUT VIA EMAIL AS WELL AS THE LINK WAS SHARED AT THE COMMUNITY MEETINGS. THE HEALTH DEPARTMENT VERSION ALSO REQUESTED THE QUALIFICATIONS OF THE RESPONDENTS. AS REQUIRED BY THE IRS, THE INDIVIDUAL CONSUMER SURVEY WAS ALSO TRANSLATED INTO SPANISH AND ADAPTED FOR MOBILE APPLICATION AT COMMUNITY EVENTS. THE CONSULTANTS USED SURVEYMONKEY TO COLLECT RESPONSES, TABULATE DATA, INTERPRET AND ANALYZE RESULTS, AND CREATE CATEGORIES TO TRACK KEY WORDS AND PHRASES. PAPER COPIES (TRANSLATED) WERE USED WITH SPANISH-SPEAKING FAMILIES, REFUGEES FROM RWANDA, AND AT TREATMENT FACILITIES. BOTH TRIHEALTH OUTREACH MINISTRIES AND SANTA MARIA COMMUNITY SERVICES PROVIDED THE ANSWERS ALREADY TRANSLATED INTO ENGLISH FOR THE CONSULTANTS. A TOTAL OF 113 IMMIGRANT SURVEYS WERE COMPLETED AND RETURNED. SEE APPENDIX 2 FOR THE SURVEY RESPONDENTS WHO IDENTIFIED THEMSELVES. APPENDIX 3 OF THE CHNA, WHICH IS POSTED TO TRIHEALTH'S WEBSITE, HAS A LIST OF HEALTH DEPARTMENT RESPONDENTS WITH THEIR QUALIFICATIONS.SECONDARY DATA SOURCES DATA COLLECTION 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. ADDITIONAL SOURCES SUPPLEMENTED THE CHR DATA. PUBLICLY AVAILABLE HEALTH STATISTICS AND DEMOGRAPHICS WERE OBTAINED AT THE STATE AND COUNTY LEVEL. THE EPIDEMIOLOGISTS FOR PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY (PHDMC) VOLUNTEERED TO COLLECT DATA FOR THE STATE OF OHIO AND ITS COUNTIES. THEY INCLUDED DATA THROUGH 2016. OHIO'S 2017 DATA WAS NOT AVAILABLE IN TIME FOR THIS REPORT. THE NUMBER OF DATA MEASURES INCREASED BY 33%, FROM 106 IN 2016 TO 142 IN 2019. DATA SOURCES THE STANDARDS FOR RESEARCHING AND INCLUDING DATA WERE: * COMPARABLE (MEASURES WITH BENCHMARKS SUCH AS HEALTHY PEOPLE 2020 OR STATE/NATIONAL RATES) * COUNTY-LEVEL DATA (ZIP CODE LEVEL PREFERRED BUT RARE) * FOCUS ON HEALTH OUTCOME DATA (PREFERRED OVER SUBJECTIVE SURVEY DATA WHEN BOTH WERE AVAILABLE) * REPRODUCIBLE (NEW UPDATE AVAILABLE WITHIN THREE YEARS OR AT 3-YEAR INTERVALS VS. ONE-TIME) * REPUTABLE SOURCE * TREND DATA AVAILABLE (MORE THAN ONE DATA POINT; 3-5 YEARS PREFERRED) THE CHR WAS AN EXCELLENT STARTING POINT, BUT THE CONSULTANTS DISCOVERED ADDITIONAL SOURCES WITH MORE RECENT DATA AS WELL AS INDICATORS FOR MEASURES NOT COLLECTED BY CHR. THE PREVALENCE OF CERTAIN CANCERS, THE RAPID INCREASE OF HEROIN OVERDOSE DEATHS IN THE REGION, AND ADDITIONAL MORTALITY DATA ARE EXAMPLES OF SUPPLEMENTAL DATA. MANY EXCELLENT SOURCES OF INFORMATION DID NOT HAVE A BREAKDOWN BELOW THE STATE LEVEL OR DID NOT INCLUDE THE ENTIRE REGION. THE CONSULTANTS CONTACTED STATE HEALTH DEPARTMENTS, LOCAL HEALTH DEPARTMENTS, AND LOCAL EXPERTS. THE BIGGEST CHANGE FROM THE PRIOR CYCLE IS THAT THE DEPARTMENT OF HEALTH AND HUMAN SERVICES NO LONGER MAINTAINS THE HEALTH INDICATORS WAREHOUSE AS AN ONLINE SOURCE, AND IT HAD PROVIDED DATA FOR EIGHT KEY MEASURES. PHDMC EPIDEMIOLOGISTS CONSULTED THE OHIO DATA FOR DATA RANGES ENDING WITH 2016 AND ONE PERIOD PRIOR. DUE TO CHARACTER LIMITATION IN THE SOFTWARE, THESE DATA SOURCES COULD NOT BE INCLUDED IN THIS EXPLANATION. HOWEVER, THE DATA SOURCES AND DATES CAN BE FOUND ON PAGES 12 AND 13 OF THE CHNA POSTED ON TRIHEALTH'S WEBSITE. TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 6A: * THE CHRIST HOSPITAL HEALTH NETWORK, * CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER, * CLINTON MEMORIAL HOSPITAL,* HIGHPOINT HEALTH, * KETTERING HEALTH NETWORK (FORT HAMILTON HOSPITAL, GRANDVIEW MEDICAL CENTER, GREENE MEMORIAL HOSPITAL, KETTERING BEHAVIORAL MEDICINE CENTER, KETTERING MEDICAL CENTER, SOIN MEDICAL CENTER, SOUTHVIEW MEDICAL CENTER, SYCAMORE MEDICAL CENTER)* LINDNER CENTER OF HOPE* MERCY HEALTH-CINCINNATI REGION (MERCY HEALTH-ANDERSON HOSPITAL, MERCY HEALTH-CLERMONT HOSPITAL, MERCY HEALTH-FAIRFIELD HOSPITAL, MERCY HEALTH-WEST HOSPITAL, THE JEWISH HOSPITAL)* MERCY HEALTH-SPRINGFIELD REGION (MERCY HEALTH-URBANA HOSPITAL, SPRINGFIELD REGIONAL MEDICAL CENTER)* PREMIER HEALTH (ATRIUM MEDICAL CENTER, MIAMI VALLEY HOSPITAL NORTH, MIAMI VALLEY HOSPITAL SOUTH, UPPER VALLEY MEDICAL CENTER)* TRIHEALTH (BETHESDA BUTLER HOSPITAL, BETHESDA NORTH HOSPITAL, GOOD SAMARITAN HOSPITAL, MCCULLOUGH-HYDE MEMORIAL HOSPITAL, TRIHEALTH EVENDALE HOSPITAL)* UC HEALTH (DANIEL DRAKE CENTER FOR POST-ACUTE CARE, UNIVERSITY OF CINCINNATI MEDICAL CENTER, WEST CHESTER HOSPITAL)* WILSON HEALTH* WAYNE HEALTHCARE TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 6B: * THE HEALTH COLLABORATIVE* GREATER DAYTON AREA HOSPITAL ASSOCIATION* ADAMS COUNTY HEALTH DEPARTMENT* BROWN COUNTY HEALTH DEPARTMENT* BUTLER COUNTY HEALTH DEPARTMENT* CHAMPAIGN-URBANA COUNTY HEALTH DEPARTMENT* CINCINNATI HEALTH DEPARTMENT* CITY OF HAMILTON HEALTH DEPARTMENT* CLARK COUNTY COMBINED HEALTH DEPARTMENT* CLERMONT COUNTY PUBLIC HEALTH* CLINTON COUNTY HEALTH DEPARTMENT* DARKE COUNTY GENERAL HEALTH DISTRICT* FAYETTE COUNTY PUBLIC HEALTH* GREENE COUNTY PUBLIC HEALTH* HAMILTON COUNTY PUBLIC HEALTH* HIGHLAND COUNTY HEALTH DEPARTMENT* MIAMI COUNTY PUBLIC HEALTH* MIDDLETOWN CITY HEALTH DISTRICT* NORWOOD HEALTH DEPARTMENT* PIQUA CITY HEALTH DEPARTMENT* PREBLE COUNTY PUBLIC HEALTH* PUBLIC HEALTH DAYTON & MONTGOMERY COUNTY* SIDNEY SHELBY COUNTY HEALTH DEPARTMENT* SPRINGFIELD HEALTH DEPARTMENT* WARREN COUNTY COMBINED HEALTH DISTRICT* NORTHERN KENTUCKY HEALTH DEPARTMENT TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 7D: AVAILABLE UPON REQUEST WITHOUT CHARGE.PLEASE CONTACT TRIHEALTH MISSION AND CULTURE, 625 EDEN PARK DRIVE, 9TH FLOOR, CINCINNATI, OHIO 45202. TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 11: DUE TO THE PROXIMITY OF TRIHEALTH EVENDALE HOSPITAL (TEH) AND BETHESDA NORTH HOSPITAL (BNH) (LESS THAN 5 MILES) AS WELL AS TEH BEING ONLY A SURGERY CENTER, THESE TWO HOSPITALS WILL WORK TOGETHER IN ADDRESSING THE SIGNIFICANT NEEDS OF THE AREA WITH BNH BEING THE LEADER AS IT IS ONE OF THE FLAGSHIP HOSPITALS OF THE TRIHEALTH SYSTEM.1) SUBSTANCE ABUSE/MENTAL HEALTH - IN RESPONSE TO THE ESCALATING OPIOID ADDICTION EPIDEMIC IN THE MARKET SERVED, A RELATED HOSPITAL, GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO (GSH) AND THE TRIHEALTH SYSTEM ENGAGED THE COMMUNITY IN AN ORGANIZED AND FOCUSED SET OF TACTICS TO ADDRESS THIS. SINCE OCTOBER 2017, THE TRIHEALTH OPIATE STEERING COMMITTEE AND THE GSH OPIATE PILOT CONTINUES TO FOCUS ON FIVE KEY AREAS: PREVENTION, TREATMENT, FUNDING, COMMUNITY PARTNERSHIPS AND TEAM MEMBER SUPPORT. THE FOCUS ON KEY AREAS HAS HELPED BUILD THE INFRASTRUCTURE NECESSARY TO PROVIDE TREATMENT NOT ONLY AT GSH BUT TO EXPAND KEY INITIATIVES TO OTHER TRIHEALTH HOSPITALS. PREVENTION* NARCAN DISTRIBUTION: NARCAN SERVES TO BLOCK THE EFFECTS OF OPIOIDS IN CASE OF AN ACCIDENTAL OVERDOSE. NARCAN WILL CONTINUE TO BE PROVIDED TO ALL ER PATIENTS WHO NEED IT WITHOUT COST TO THE PATIENT, AND GSH WILL CONTINUE ITS EDUCATION OF FIRST RESPONDERS AS NEW INFORMATION ARISES AND NEW RESPONDERS ARE TRAINED. TREATMENT * SUBSTANCE USE TREATMENT COORDINATORS (SUTC): BY JULY 2019, TRIHEALTH WILL HAVE A RESPONSE TO A GRANT PROPOSAL IT SUBMITTED TO BETHESDA FOUNDATION TO EXPAND THE SUTC ROLE TO BETHESDA NORTH HOSPITAL AS A PLATFORM FOR UTILIZING TELEHEALTH FOR FURTHER EXPANSION TO BETHESDA ARROW SPRINGS AMBULATORY CENTER AND MCCULLOUGH HYDE MEMORIAL HOSPITAL. SUTC HAS SPECIFIC SUBSTANCE USE TRAINING, CERTIFICATION AND EXPERIENCE IN SUBSTANCE USE DISORDERS (ALCOHOL, OPIATES ETC.). THE ROLE OF THE SUTC IS TO ENGAGE, ASSESS AND PROVIDE AN APPOINTMENT TO A TREATMENT PROGRAM WITHIN 24-48 HOURS AFTER DISCHARGE. * IN COLLABORATION WITH COMMUNITY PARTNERS BNH/TEH WILL CONTINUE TO TEST THE EFFICACY OF THIS ROLE AND EFFECTIVENESS AT MEETING THESE TARGETS. * IF THE PEER RECOVERY SPECIALIST IDENTIFIED IN THE GOOD SAMARITAN HOSPITAL PROGRESS REPORT RE: 2016 PRIORITIES IS EFFECTIVE IN REACHING OUT TO PATIENTS THAT MIGHT OTHERWISE BE RELUCTANT TO ENTER INTO RECOVERY, THIS FUNCTION WILL BE EVALUATED FOR EXPANSION TO OTHER TRIHEALTH ERS. * TRACKING OUTCOMES: THE TASK FORCE WILL BE MONITORING AN OPIOID DASHBOARD TO TRACK OUTCOMES SUCH AS UTILIZATION OF SUBSTANCE USE WITHDRAWAL MANAGEMENT ORDER SETS, BUPRENORPHINE INDUCTION (MEDICATION USED TO TREAT OPIATE ADDICTION), NARCAN DISPENSING ETC. THIS ALLOWS US TO MONITOR THE EFFECTIVENESS OF OUR INITIATIVES.2). INFANT MORTALITY - BNH PROVIDES OBSTETRIC ("OB") AND GYNECOLOGICAL SERVICES TO ALL COMERS VIA ITS OB CLINICS. THE OB CLINICS HAVE ADOPTED AN INNOVATIVE WOMAN CENTERED MEDICAL HOME MODEL MEANT TO REINFORCE COMPLIANCE WITH PREGNANT PATIENT OFFICE VISITS AND FOLLOW UP CARE. TRIHEALTH PROVIDES A BREASTFEEDING SUPPORT LINE FREE TO THE COMMUNITY, WHICH INCLUDES THE BNH/TEH SERVICE AREA.BNH AND TEH, THROUGH TRIHEALTH, WILL ALSO CONTINUE ITS LONG-TIME PARTNERSHIP WITH AND FUNDING OF SEVERAL ORGANIZATIONS (PROVIDING FUNDING AND HUMAN/CLINICAL RESOURCES) THAT TARGET INFANT MORTALITY AND CHILD HEALTH CONCERNS, INCLUDING; * CRADLE CINCINNATI - AN ORGANIZATION AIMED AT REDUCING INFANT MORTALITY THROUGH EDUCATION AND AWARENESS. CRADLE CINCINNATI'S GOALS ARE TO PREVENT PREMATURE BIRTHS, REDUCING TOBACCO USE AND SUBSTANCE ABUSE, AND PROMOTING SAFE SLEEP FOR BABIES THROUGH THREE APPROACHES: COMMUNICATIONS, MEDICAL, AND COMMUNITY. * HEALTHY BEGINNINGS, WHICH PROVIDES COMPREHENSIVE PRE-NATAL CARE TO THE UNDERSERVED. * HEALTHY MOMS AND BABES, WHICH PROVIDES HOME SERVICES FOR BOTH PRE-NATAL AND POST-DELIVERY SUPPORT FOR UNDERSERVED POPULATIONS. * TRIHEALTH'S THINK FIRST FOR YOUR BABY IS AN INJURY PREVENTION PROGRAM WITH A GOAL TO REDUCE UNINTENTIONAL INJURIES IN INFANTS UNDER THE AGE OF ONE YEAR THROUGH PRENATAL EDUCATION AND POST-PARTUM FOLLOW-UP. * OTHER PARTNERS INCLUDE MARCH OF DIMES AND SWEET CHEEKS DIAPER BANK. FINALLY, BNH AND TEH, THROUGH TRIHEALTH, WILL ALSO PROVIDE FINANCIAL SUPPORT TO OTHER ORGANIZATIONS THAT FOCUS RESOURCES ON INFANT MORTALITY AND MATERNAL HEALTH: * URBAN HEALTH PROJECT (OFFICE SPACE) * OB CLINICS * OB WOMAN CENTERED MEDICAL HOME MODEL * FUNDING FOR CRADLE CINCINNATI NEIGHBORHOOD BASED WOMAN CENTERED MEDICAL HOME * GOOD SAMARITAN FREE HEALTH CLINIC * HEALTHY BEGINNINGS * HEALTHY MOMS AND BABES * THINK FIRST FOR YOUR BABY * START STRONG * MARCH OF DIMES * SWEET CHEEKS DIAPER BANK3. CANCER - BNH, TEH AND TRIHEALTH CANCER INSTITUTE WILL CONTINUE THE TARGETED (MELANOMA, LUNG) FREE SCREENINGS AND FOLLOW UPS. THERE IS A MOBILE MAMMOGRAPHY UNIT THAT WILL CONTINUE TO DO SCREENING IN HIGH NEED AREAS WITHIN HAMILTON COUNTY E.G. AVONDALE, AND THE CITY OF HAMILTON IN BUTLER COUNTY. PATIENTS WITH POSITIVE RESULTS IDENTIFIED AT THE GOOD SAMARITAN FREE HEALTH CENTER WILL CONTINUE TO BE REFERRED TO BNH CLINIC PROVIDERS AND OBTAIN COVERAGE FROM STATE FUNDED BREAST AND CERVICAL CANCER PREVENTION (BCCP) FUNDING. BNH AND TEH THROUGH TRIHEALTH JUST BEGAN A PARTNERSHIP WITH THE ERICA HOLLOMAN FOUNDATION TO SCREEN PRIMARILY AFRICAN AMERICAN WOMEN AT RISK FOR A SPECIFIC KIND OF BREAST CANCER. BNH'S AND TEH'S FOCUS ON PREVENTION WILL CONTINUE TO DEMONSTRATE ITS COMMITMENT VIA IN KIND AND FINANCIAL SUPPORT OF OHIO CANCER RESEARCH, WHICH IS AN INDEPENDENT, STATEWIDE, NONPROFIT ORGANIZATION DEDICATED TO THE CURE AND PREVENTION OF THE MANY FORMS OF CANCER AND THE REDUCTION OF ITS DEBILITATING EFFECTS THROUGH AGGRESSIVE BASIC SEED MONEY RESEARCH, CANCER INFORMATION, AND AWARENESS. THE HOSPITALS PLAN TO CONTINUE FINANCIAL SUPPORT TO THE AMERICAN CANCER SOCIETY AND AMERICAN LUNG ASSOCIATION. 4. ACCESS TO CARE - THIS PRIORITY APPLIES ONLY TO BNH DUE TO THE NATURE OF TEH. CURRENTLY, BNH PROVIDES TRANSPORTATION FOR NEEDY PATIENTS WITH BUS TOKENS AND PAID UBER RIDES. GSH/TRIHEALTH WILL SEEK NEW PARTNERS AND IDENTIFY OTHER AVENUES TO EXPAND THIS TYPE OF SERVICE. IT IS NOT SOMETHING THAT HAS A NATURAL CONNECTION TO A HOSPITAL OR HEALTH SYSTEM LIKE THE OTHER THREE PRIORITIES. IF SPECIFIC ACTIONS THAT ARE WITHIN BNH AREAS OF EXPERTISE ARE NOT FOUND, BNH AND TEH WILL FOCUS ON 1-3 ABOVE. TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 13B: SEE PART VI RESPONSE RELATED TO PART I, LINE 3C. TRIHEALTH EVENDALE HOSPITAL PART V, SECTION B, LINE 13H: SEE PART VI RESPONSE RELATED TO PART I, LINE 3C. 4 1 - TRIHEALTH SURGERY CENTER WEST 3660 EDGEWOOD DRIVE CINCINNATI OH 45211 OUTPATIENT SURGERY CENTER 2 - TRIHEALTH HAND SURGERY CENTER 538 OAK STREET SUITE 200 CINCINNATI OH 45219 OUTPATIENT SURGERY CENTER 3 - TRIHEALTH ENDOSCOPY CENTER NORTH 10600 MONTGOMERY ROAD CINCINNATI OH 45242 OUTPATIENT ENDOSCOPY CENTER 4 - TRIHEALTH SURGERY CENTER ANDERSON 7810 FIVE MILE ROAD CINCINNATI OH 45230 OUTPATIENT SURGERY 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. FINALLY, TRIHEALTH HOSPITAL, INC. 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 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 A REPORT PREPARED BY TRIHEALTH IN COMBINATION WITH ITS RELATED HOSPITALS - BETHESDA HOSPITAL, INC., THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND MCCULLOUGH-HYDE MEMORIAL HOSPITAL. 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 PART VI RESPONSE TO PART III, LINE 4. PART III, LINE 3: SEE PART VI RESPONSE TO PART III, LINE 4. PART III, LINE 4: TRIHEALTH HOSPITAL INC.'S FINANCIAL STATEMENTS ARE AUDITED AS PART OF THE TRIHEALTH AUDIT REPORT.PATIENT SERVICE REVENUE AND OTHER OPERATING REVENUE (PART OF FOOTNOTE D - PAGES 22-27)THE PROVISION FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY AS NECESSARY THE PROVISIONS FOR BAD DEBT AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. SIGNIFICANT PROVISION IS MADE FOR SELF-PAY PATIENT ACCOUNTS RECEIVABLE IN THE PERIOD OF SERVICE BASED UPON HISTORICAL WRITE-OFF EXPERIENCE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, TRIHEALTH FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY TRIHEALTH.AS A RESULT OF CERTAIN CHANGES REQUIRED BY ASU 2014-09, THE MAJORITY OF TRIHEALTH'S PROVISION FOR BAD DEBT IS RECORDED AS A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE INSTEAD OF BEING PRESENTED AS A SEPARATE LINE ON THE COMBINED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS.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 8: TRIHEALTH, INC. USES THE "STEPDOWN METHODOLOGY" IN DETERMINING THE MEDICARE ALLOWABLE COSTS REPORTED ON THE MEDICARE COST REPORT. THIS METHOD OF COST FINDING PROVIDES FOR THE ALLOCATION OF THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS WHICH UTILIZE SUCH SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. TRIHEALTH HOSPITAL,INC. DID NOT REPORT ANY MEDICARE SHORTFALL AS COMMUNITY BENEFIT IN PART III, LINE 7 OF THIS SCHEDULE. 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.AS A FOLLOW UP TO THE 2016 CHNA, TRIHEALTH, INC. AND ITS HOSPITALS JOINED THIRTY-ONE (31) OTHER HOSPITALS IN THE GREATER CINCINNATI-DAYTON REGION TO SPONSOR AND FUND A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT ENTITLED "SW OHIO, N KENTUCKY, SE INDIANA COMMUNITY HEALTH NEEDS ASSESSMENT REPORT 2019". THIS NEW COMPREHENSIVE CHNA SPANS TWENTY-FIVE (25) COUNTIES. THE REGIONAL CHNA REPORT COVERS GREATER DAYTON AND GREATER CINCINNATI, WHICH INCLUDES NORTHERN KENTUCKY AND SOUTHEASTERN INDIANA. THE 2019 CHNA REPORT SHARES DATA FOR THE WHOLE REGION AS WELL AS DETAILED COUNTY-LEVEL DATA. IT ALSO ADDED THE VOICE OF THE SOUTHWEST OHIO MEMBERS OF THE ASSOCIATION OF OHIO HEALTH COMMISSIONERS. DEVELOPING A BROAD CHNA HELPS FULFILL THE STATE OF OHIO'S REQUIREMENT MANDATING THAT HEALTH DEPARTMENTS AND HOSPITALS ALIGN THEIR ASSESSMENTS.HTTP://HEALTHCOLLAB.ORG/WP-CONTENT/UPLOADS/2019/02/2019-CHNA-REPORT-2-7-19.PDFFROM THIS LARGER REPORT, TRIHEALTH DEVELOPED A CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY FOR EACH OF ITS FACILITIES BASED ON THE COUNTY BREAKDOWN AND DISCUSSION WITH TRIHEALTH LEADERS WITH EXPERTISE IN THE AREAS WHICH NEED TO BE ADDRESSED. 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: LOCATED IN CINCINNATI, OHIO, TRIHEALTH HOSPITAL, INC. AND THE TRIHEALTH SYSTEM SERVE PRIMARILY HAMILTON, BUTLER, WARREN AND CLERMONT COUNTIES IN OHIO AS WELL AS SOME PERSONS FROM INDIANA AND KENTUCKY. HAMILTON COUNTY IS THE MOST POPULATED COUNTY IN THE REGION AND IS HOME TO THE LARGEST CITY, CINCINNATI. THE ESTIMATED POPULATION OF THE COUNTY IS 820,000 WITH APPROXIMATELY 15.5% IN POVERTY AND APPROXIMATELY 7% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. BUTLER COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $52,500 WITH 90% OF THE POPULATION OVER THE AGE OF 24 HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (36% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 4%. APPROXIMATELY 15% OF THE POPULATION IS 65 YEARS AND OLDER, 65% IS WHITE, 27% IS AFRICAN-AMERICAN, 4% IS HISPANIC, 3% ASIAN AND 1% OTHER.BUTLER COUNTY IS ONE OF THE MOST POPULATED COUNTIES IN THE REGION AND INCLUDES THE CITIES OF HAMILTON, MIDDLETOWN AND OXFORD. MANY OF THE CITIES IN THE COUNTY ARE EXPERIENCING GROWTH, AND ONLY ABOUT 9% IS CONSIDERED RURAL. THE ESTIMATED POPULATION OF THE COUNTY IS 385,000 WITH APPROXIMATELY 12.5% IN POVERTY AND APPROXIMATELY 7% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. BUTLER COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $62,000 WITH 90% OF THE POPULATION OVER THE AGE OF 24 HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (30% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 4%. APPROXIMATELY 15% OF THE POPULATION IS 65 YEARS AND OLDER, 80% IS WHITE, 9% IS AFRICAN-AMERICAN, 5% IS HISPANIC, 4% ASIAN AND 2% OTHER.CLERMONT COUNTY IS A LARGE COUNTY WHICH WAS ONCE MOSTLY RURAL BUT HAS BECOME MORE SUBURBAN AND IS ONE OF OHIO'S APPALACHIAN COUNTIES. THE ESTIMATED POPULATION OF THE COUNTY IS 205,000 WITH APPROXIMATELY 8.5% IN POVERTY AND APPROXIMATELY 6% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. CLERMONT COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $64,000 WITH 90% OF THE POPULATION OVER THE AGE OF 24 HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (28% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 4%. APPROXIMATELY 16% OF THE POPULATION IS 65 YEARS AND OLDER, 93% IS WHITE, 2% IS AFRICAN-AMERICAN, 2% IS HISPANIC, 1.5% ASIAN AND 1.5% OTHER.WARREN COUNTY IS ONE OF THE FASTEST GROWING COUNTIES IN OHIO, BOTH IN RESIDENTIAL AND COMMERCIAL GROWTH. THE ESTIMATED POPULATION OF THE COUNTY IS 232,000 WITH APPROXIMATELY 5% IN POVERTY AND APPROXIMATELY 5% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. CLERMONT COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $79,500 WITH 93% OF THE POPULATION OVER THE AGE OF 24 HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (42% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 3.5%. APPROXIMATELY 15% OF THE POPULATION IS 65 YEARS AND OLDER, 86% IS WHITE, 6% ASIAN, 4% IS AFRICAN-AMERICAN, 3% IS HISPANIC, AND 1% OTHER. PART VI, LINE 5: TRIHEALTH HOSPITAL, INC. IS COMPRISED OF VARIOUS MEDICAL SERVICES AT VARIOUS LOCATIONS INCLUDING TRIHEALTH EVENDALE HOSPITAL AND TRIHEALTH SURGERY CENTER WEST, EACH OF WHICH HAS AN OPEN MEDICAL STAFF. 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.TRIHEALTH HAND SURGERY CENTER IS A SPACIOUS, STATE-OF-THE-ART, OUTPATIENT SURGICAL FACILITY, EQUIPPED TO PERFORM SOPHISTICATED HAND SURGERY PROCEDURES.TRIHEALTH ENDOSCOPY CENTER NORTH PROVIDES COMPETENT, SAFE, HIGH QUALITY, COST EFFECTIVE AND ACCESSIBLE CARE. THE CENTER PROVIDES SERVICE TO INDIVIDUALS THAT RANGE IN AGE FROM ADOLESCENCE (14-17 WEIGHING GREATER THAN 100 POUNDS) THROUGH THE ELDERLY ADULT (80 YEARS PLUS). TRIHEALTH SURGERY CENTER ANDERSON OFFERS THE LATEST TECHNOLOGIES AND MINIMALLY INVASIVE PROCEDURES PROVEN TO ENHANCE CLINICAL OUTCOMES. IT FEATURES FOUR OPERATING ROOMS, ONE ENDOSCOPY ROOM AND A LABORATORY. THE CENTER FOCUSES ON PATIENT/FAMILY-CENTERED CARE INCLUDING PEDIATRICS. 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, FIVE (5) 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.HTTPS://WWW.TRIHEALTH.COM/ABOUT-TRIHEALTH/ 1 1 0 0 0 0 0 0 0 CRAIG EISENTROUT MD TRUSTEE 0 554870 0 8331 0 6837 0 24946 0 23359 0 618343 0 0 ROBERT COLLINS MD TRUSTEE (START 7/18) 0 12259 0 0 0 190202 0 26020 0 1361 0 229842 0 142080 MARK CLEMENT PRESIDENT/CEO 0 1107242 0 290035 0 66561 0 296751 0 19286 0 1779875 0 0 SCOTT FRIEDSTROM MD MED STAFF PRES-GOOD SAM 0 458855 0 31795 0 52093 0 53930 0 30742 0 627415 0 0 ANDREW DEVOE ASST TREASURER/CFO 0 556794 0 151014 0 64464 0 140748 0 29978 0 942998 0 0 STEVE GRACEY ASST SECRETARY/SVP LEGAL 0 354959 0 69720 0 25492 0 95586 0 29672 0 575429 0 0 KELVIN HANGER EXEC DIR-PERIOP OPERATIONS 0 291912 0 67004 0 11827 0 21130 0 25805 0 417678 0 0 SUELLEN JONES NURSING ADMIN-TRIHEALTH EVENDALE 163721 0 24920 0 8507 0 17293 0 9944 0 224385 0 0 0 GAIL DONOVAN EXEC VP & COO (END 6/19) 0 717014 0 165900 0 45330 0 191343 0 9341 0 1128928 0 0 DAVID COOK CHIEF HR OFFICER 0 369012 0 75090 0 16180 0 93499 0 29083 0 582864 0 0 KEVIN JOSEPH MD CHIEF MEDICAL OFFICER 0 508057 0 119688 0 15571 0 115848 0 29819 0 788983 0 0 MARY IRVIN CNE-TRIHEALTH (END 10/18) 0 319189 0 64450 0 15079 0 110735 0 19713 0 529166 0 0 JENNY SKINNER CNE-TRIHEALTH (START 11/18) 0 252891 0 41282 0 9108 0 44950 0 17277 0 365508 0 0 MARLA SILLIMAN VP-GOOD SAM REGION 0 339457 0 55000 0 38587 0 53884 0 10840 0 497768 0 0 MELISSA PAYNE PHARMACIST 142913 0 0 0 289 0 11023 0 24723 0 178948 0 0 0 JOHN PROUT FORMER OFFICER 0 0 0 0 0 1853100 0 0 0 0 0 1853100 0 1793100 DONNA NIENABER ESQ FORMER OFFICER 0 164891 0 0 0 196694 0 31603 0 205 0 393393 0 0 MICHAEL CROFTON FORMER OFFICER 0 307398 0 73892 0 13629 0 90608 0 27877 0 513404 0 0 WILLIAM GRONEMAN FORMER KEY EMPLOYEE 0 306929 0 87289 0 68198 0 119197 0 23733 0 605346 0 35213 JOHN ROBINSON MD FORMER KEY EMPLOYEE 0 0 0 0 0 250188 0 0 0 0 0 250188 0 250188 ROB CERCEK FORMER KEY EMPLOYEE 0 498005 0 113877 0 12883 0 126283 0 25868 0 776916 0 0 GERALD OLIPHANT FORMER KEY EMPLOYEE 0 0 0 0 0 1192978 0 0 0 0 0 1192978 0 1192978 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, LINES 4A-B ELIGIBLE EXECUTIVES (GENERALLY VICE PRESIDENTS AND ABOVE) PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FOLLOWING INDIVIDUAL(S) 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 - $1,793,100 GERALD OLIPHANT - $1,192,978 JOHN ROBINSON, MD - $250,188 ROBERT COLLINS, MD - $142,080 WILLIAM GRONEMAN - $35,213 PART I, LINE 4A: THE REPORTABLE INDIVIDUALS OF TRIHEALTH HOSPITAL, INC., WITH THE EXCEPTION OF A FEW, 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 POLICY, MAY BE ADDED TO THE SEVERANCE PACKAGE AND THE AMOUNT OF NOTICE PAY WILL BE DETERMINED BY HUMAN RESOURCES IN ACCORDANCE WITH TRIHEALTH POLICY. PAYMENTS OF SEVERANCE ARE CONDITIONED UPON SIGNING A SEPARATION AND RELEASE AGREEMENT. DURING THE 2018 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: DONNA NIENABER - $190,434 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. GAIL DONOVAN, KEVIN JOSEPH, MD, MARK CLEMENT AND STEVE GRACEY HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL, AN AFFILIATED ENTITY OF TRIHEALTH HOSPITAL, INC. WAYNE SHIRCLIFF, LISA KNUTSON, CRAIG EISENTROUT, MD, PHILLIP OBLINGER, MD, QUINT STUDER, AND BOB COLLINS, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF BETHESDA, INC., THE SINGLE CORPORATE MEMBER OF BETHESDA HOSPITAL, INC., AN AFFILIATED ENTITY OF TRIHEALTH HOSPITAL, INC. MARK CLEMENT, MARY IRVIN AND SR. SALLY DUFFY HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE, AN AFFILIATED ENTITY OF TRIHEALTH HOSPITAL, INC. MARK CLEMENT 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. MARK CLEMENT, MARLA SILLIMAN, KELVIN HANGAR, SUELLEN JONES, ANDREW DEVOE, DAVID COOK, GAIL DONOVAN, CRAIG EISENTROUT, MD, STEVE GRACEY, MARY IRVIN, KEVIN JOSEPH, MD, PHILLIP OBLINGER, MD, SCOTT FRIEDSTROM, MD AND JENNIFER SKINNER HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON RELATED ENTITY BOARDS OF TRIHEALTH, INC. AND ITS SUBSIDIARIES AND AFFILIATES AS WELL AS BEING EMPLOYED BY TRIHEALTH, INC. OR ITS AFFILIATES/SUBSIDIARIES. TRIHEALTH, INC. IS THE SINGLE CORPORATE MEMBER OF TRIHEALTH HOSPITAL, INC. 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 11B MEMBERS OF THE BOARD ARE PROVIDED AN ELECTRONIC COPY OF THIS FORM 990 PRIOR TO FILING AFTER REVIEW BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD, ALONG WITH THE COMMITTEE'S SUMMARY OF THE FORM 990. 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 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 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. 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