2017-05-09T08:21:53-05:00 2016-06-30 440160260 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2015-07-01 311438846 TRIHEALTH INC TRIH 5135696575 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 BRIAN KRAUSE VP FINANCE 5135695126 2017-05-09 1 P00961884 5136218300 2015 2021-01-29 14:40:06Z JOHN S PROUT 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 218352237 0 X WWW. 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("TRIHEALTH") WAS CREATED IN 1995 UNDER A JOINT OPERATING AGREEMENT BETWEEN BETHESDA HOSPITAL, INC. ("BETHESDA") AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO ("GOOD SAMARITAN"). TRIHEALTH'S PRIMARY PURPOSE IS TO OPERATE AND JOINTLY MANAGE BETHESDA, GOOD SAMARITAN AND THEIR VARIOUS SUBSIDIARIES AND AFFILIATES. IN CARRYING OUT ITS CHARITABLE PURPOSES, TRIHEALTH PROVIDES A COMPREHENSIVE AND INTEGRATED PROVIDER BASE TO OPTIMIZE THE HEALTH STATUS OF THE COMMUNITY. TRIHEALTH PROVIDES ADMINISTRATIVE SUPPORT SERVICES INCLUDING GENERAL ADMINISTRATION, INFORMATION SYSTEMS, FINANCE, HUMAN RESOURCES, AND OTHER GENERAL SUPPORT SERVICES TO ITS SUPPORTED ORGANIZATIONS. PART IV, SECTION A, LINE 1 THE AMENDED AND RESTATED ARTICLES OF INCORPORATION OF TRIHEALTH STATE THAT THE SPECIFIC PURPOSE FOR WHICH TRIHEALTH IS FORMED IS TO ACT FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF BETHESDA HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND TO CONDUCT ANY ACTIVITIES CONSISTENT WITH SUCH PURPOSE, THE NONPROFIT LAWS OF THE STATE OF OHIO AND INTERNAL REVENUE CODE SECTION 501(C)(3). THE MISSION OF EACH HOSPITAL IS TO IMPROVE THE HEALTH STATUS OF THE PEOPLE THEY SERVE. PART IV, SECTION A, LINE 6 SINCE ITS ESTABLISHMENT IN 1995, TRIHEALTH, AS THE OPERATING ORGANIZATION, HAS DEVELOPED AN INTEGRATED HEALTH CARE SYSTEM CONSISTING OF 5 HOSPITALS, 3 AMBULATORY LOCATIONS AND APPROXIMATELY 125 PRIMARY AND SPECIALIST PHYSICIAN LOCATIONS SERVING GREATER CINCINNATI AND THE SURROUNDING AREA. ALL OF THESE ORGANIZATIONS AND/OR LOCATIONS ARE PART OF ORGANIZATIONS THAT ARE RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) (SEE SCHEDULE R, PART II). ALTHOUGH NOT SPECIFICALLY IDENTIFIED BY NAME IN TRIHEALTH'S GOVERNING DOCUMENTS, TRIHEALTH SUPPORTS ORGANIZATIONS AND ACTIVITIES OF SUCH ORGANIZATIONS IN FURTHERANCE OF ITS CHARITABLE PURPOSE AND CONSISTENT WITH INTERNAL REVENUE CODE SECTION 501(C)(3). WITH RESPECT TO THESE ORGANIZATIONS, TRIHEALTH PROVIDES SUPPORT SERVICES INCLUDING GENERAL ADMINISTRATION, INFORMATION SYSTEMS, FINANCE, HUMAN RESOURCES, AND OTHER GENERAL SUPPORT SERVICES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15691 15691 0 PART II-B, LINE 1: DURING THE TAX YEAR, TRIHEALTH, INC. PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. 9749520 3960881 5788639 5206581 3590324 1616257 142553702 95167542 47386160 15193254 735712 14457542 69248598 DUE FROM RELATED ORGANIZATIONS 437155081 INVESTMENT IN UNCONSOLIDATED ORGANIZATIONS 2030047 ESCROW DEPOSIT 310000 MALPRACTICE ASSET 2945509 442440637 PENSION LIABILITY 15354244 ACCRUED EIB 5477603 ACCRUED WORKERS COMPENSATION 961260 MALPRACTICE LIABILITY 13953367 35746474 X PART X, LINE 2: FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE AUDITED COMBINED FINANCIAL STATEMENTS OF TRIHEALTH THAT REPORTS ITS AND ITS SUBSIDIARIES AND AFFILIATES LIABILITY, IF APPLICABLE, FOR UNCERTAIN TAX POSITIONS UNDER ASC 740-10-25: TRIHEALTH PERFORMED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT EITHER DATE. 1 UPTOWN CONSORTIUM INC 629 OAK STREET SUITE 306 CINCINNATI OH 45206 200688727 501(C)(3) 292500 GENERAL PURPOSES THE CENTER FOR CLOSING THE HEALTH GAP IN GREATER CINCINNATI 3120 BURNET AVE ROOM 201 CINCINNATI OH 45229 200902286 501(C)(3) 200000 GENERAL PURPOSES FREESTORE FOODBANK INC 1141 CENTRAL PARKWAY CINCINNATI OH 45202 237122205 501(C)(3) 158259 FUNDING OF THE HEALTHY HARVEST MOBILE MARKET HEALTHY MOMS & BABES INC 2270 BANNING ROAD NO 200 CINCINNATI OH 45239 311155292 501(C)(3) 125000 GENERAL PURPOSES HEALTHY BEGINNINGS INC 47 E HOLLISTER CINCINNATI OH 45219 311380939 501(C)(3) 100000 GENERAL PURPOSES CENTER FOR RESPITE CARE INC PO BOX 141301 CINCINNATI OH 45250 202544994 501(C)(3) 50000 GENERAL PURPOSES THE SPIRIT OF CINCINNATUS INC 4138 LINDEN AVE DEER PARK OH 45236 800352850 501(C)(3) 45000 GENERAL PURPOSES CINCINNATI ZOO AND BOTANICAL GARDENS 3400 VINE STREET CINCINNATI OH 45220 310537171 501(C)(3) 30000 SPONSORSHIP FRIARS CLUB INC 2316 HARRYWOOD COURT CINCINNATI OH 45239 310537485 501(C)(3) 29000 FUNDING OF TUTORIAL SERVICES/SPONSORSHIP AMERICAN CANCER SOCIETY INC 250 WILLIAMS STREET NW SUITE 400 ATLANTA GA 30303 131788491 501(C)(3) 22500 SPONSORSHIP JDRF INTERNATIONAL 26 BROADWAY 15 FLOOR NEW YORK NY 10004 231907729 501(C)(3) 20119 SPONSORSHIP CANCER SUPPORT COMMUNITY-GREATER CINCINNATINORTHERN KY 4918 COOPER ROAD CINCINNATI OH 45242 311287785 501(C)(3) 20000 SPONSORSHIP CINCINNATI ARTS ASSOCIATION 650 WALNUT STREET CINCINNATI OH 45202 311310256 501(C)(3) 12000 SPONSORSHIP UNITED SERVICE ORGANIZATIONS INC 2111 WILSON BLVD SUITE 1200 ARLINGTON VA 22201 131610451 501(C)(3) 10000 SPONSORSHIP PEOPLE WORKING COOPERATIVELY INC 4612 PADDOCK ROAD CINCINNATI OH 45229 310859104 501(C)(3) 10000 SPONSORSHIP MAYFIELD EDUCATION & RESEARCH FOUNDATION 506 OAK STREET CINCINNATI OH 45219 310921099 501(C)(3) 10000 SPONSORSHIP MONTESSORI CENTER ROOM INC 2505 RIVERSIDE DRIVE CINCINNATI OH 45202 310731908 501(C)(3) 10000 SPONSORSHIP MCCULLOUGH-HYDE MEMORIAL HOSPITAL 110 N POPLAR STREET OXFORD OH 45056 310650283 501(C)(3) 9500 SPONSORSHIP AMERICAN LUNG ASSOCIATION 55 W WACKER DRIVE CHICAGO IL 60601 131632524 501(C)(3) 7500 SPONSORSHIP INTERFAITH HOSPITALITY NETWORK OF GREATER CINCINNATI 990 NASSAU STREET CINCINNATI OH 45206 311335474 501(C)(3) 7500 GENERAL PURPOSES NAMI OF HAMILTON COUNTY 4790 RED BANK EXPRESSWAY 218 CINCINNATI OH 45227 310998076 501(C)(3) 7500 SPONSORSHIP 21 0 PART I, LINE 2: TRIHEALTH OBTAINS AND STORES ALL NECESSARY INFORMATION FROM THE RECIPIENT ORGANIZATION RELATIVE TO HOW THE FUNDS WILL BE SPENT. X X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 JOHN PROUT CEO (END 12/15) 965035 0 369675 0 1094617 0 34500 0 9260 0 2473087 0 1038567 0 ALAN ALTMAN MD MED STAFF PRES (END 12/15) 0 622409 0 6275 0 46794 0 42611 0 25169 0 743258 0 0 CRAIG EISENTROUT MD TRUSTEE 0 544176 0 351 0 3878 0 9966 0 26424 0 584795 0 0 MARK CLEMENT PRESIDENT/CEO 469331 0 40486 0 6930 0 50953 0 10722 0 578422 0 0 0 DONNA NIENABER ESQ SVP CORP COUNSEL/ASST SECR 365732 0 98337 0 26047 0 124769 0 10226 0 625111 0 0 0 MICHAEL CROFTON SVP CFO/ASST TREASURER 410902 0 134295 0 34494 0 119077 0 26136 0 724904 0 0 0 WILLIAM GRONEMAN EXEC VP SYSTEM DEVELOPMENT 443212 0 135707 0 83767 0 157191 0 35897 0 855774 0 25183 0 GERALD OLIPHANT EXEC VP & COO (END 9/15) 455494 0 171732 0 77577 0 106022 0 26176 0 837001 0 0 0 ROBERT COLLINS MD CHIEF MEDICAL OFFICER 394037 0 127465 0 17650 0 115738 0 15160 0 670050 0 0 0 JOHN ROBINSON MD SVP-HOSPITAL OPERATIONS 312225 0 89863 0 14810 0 62273 0 23686 0 502857 0 0 0 WALTER MCLARTY CHIEF HR OFFICER 305474 0 90465 0 50198 0 98956 0 13071 0 558164 0 0 0 MARY IRVIN SVP-CHIEF NURSING EXEC. 289871 0 85021 0 22913 0 91911 0 17089 0 506805 0 0 0 DWIGHT ELLINGWOOD SVP-STRATEGY/COMMUNICATIONS 300290 0 64505 0 20261 0 60419 0 22988 0 468463 0 0 0 RICHARD WELLING MD VP-ACADEMIC AFFAIRS 266773 0 67626 0 37085 0 83962 0 14927 0 470373 0 0 0 GEORGES FEGHALI MD FORMER 9850 0 0 0 139550 0 6528 0 815 0 156743 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS UP PAYMENTS: ALL DIRECTORS IN AN EMPLOYMENT POSITION OF VICE PRESIDENT AND HIGHER WITHIN TRIHEALTH, INC. ARE ELIGIBLE TO RECEIVE TAX GROSS-UP PAYMENTS ON THE FOLLOWING BENEFITS: * SUPPLEMENTAL OR SPLIT DOLLAR LIFE INSURANCE * EXECUTIVE HEALTH PROGRAM SERVICES * LONG-TERM DISABILITY INSURANCE * LONG-TERM CARE INSURANCE * FINANCIAL COUNSELING * BUSINESS CLUB MEMBERSHIPS * HEALTH CLUB MEMBERSHIPS IN ADDITION, DURING THE CALENDAR YEAR 2015, WILLIAM GRONEMAN RECEIVED A TAX INDEMNIFICATION AND GROSS UP PAYMENT ON A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PAYMENT. TRIHEALTH, INC. INCLUDED THE ENTIRE TAX INDEMNIFICATION AND GROSS UP PAYMENT AS TAXABLE INCOME ON THE INDIVIDUAL'S FORM W-2 FOR 2015. HEALTH OR SOCIAL CLUB OR INITIATION FEES: TRIHEALTH, INC. MAINTAINS A MEMBERSHIP IN A LOCAL SOCIAL CLUB IN THE NAME OF THE PRESIDENT & CEO AS THE SOCIAL CLUB REQUIRES THE MEMBERSHIP TO BE IN AN INDIVIDUAL'S NAME. THIS MEMBERSHIP IS A BUSINESS MEMBERSHIP FOR THE BENEFIT OF TRIHEALTH, INC. AS SUCH, THE MONTHLY DUES ARE PAID BY TRIHEALTH, INC. DURING THE CURRENT YEAR, THERE WAS NOT ANY PERSONAL USE BY THE PRESIDENT & CEO. PART I, LINES 4A-B ELIGIBLE EXECUTIVES (GENERALLY VICE PRESIDENT AND ABOVE) PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. TRIHEALTH, INC. CONTRIBUTED, ON BEHALF OF THE FOLLOWING INDIVIDUALS, TO A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE AMOUNTS AS NOTED: MARK CLEMENT - $23,678 DONNA NIENABER, ESQ. - $71,617 MICHAEL CROFTON - $82,575 WILLIAM GRONEMAN - $106,849 GERALD OLIPHANT - $91,626 ROBERT COLLINS, MD - $80,496 JOHN ROBINSON, MD - $50,617 WALTER MCLARTY - $57,843 MARY IRVIN - $49,724 DWIGHT ELLINGWOOD - $33,144 RICHARD WELLING, MD - $31,171 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 WILLIAM GRONEMAN - $25,183 PART I, LINE 4A: THE ORGANIZATION HAS A STANDARD EMPLOYEE SEVERANCE PACKAGE. GENERAL SEVERANCE PAY IS BASED ON LENGTH OF SERVICE. IN ADDITION, NOTICE PAY, IF APPLICABLE UNDER TRIHEALTH, INC. POLICY, MAY BE ADDED TO THE SEVERANCE PACKAGE AND THE AMOUNT OF NOTICE PAY WILL BE DETERMINED BY HUMAN RESOURCES IN ACCORDANCE WITH TRIHEALTH, INC. POLICY. PAYMENTS OF SEVERANCE ARE CONDITIONED UPON SIGNING A SEPARATION AND RELEASE AGREEMENT. DURING THE 2015 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: GERALD OLIPHANT - $56,179 KATHLEEN OLIPHANT FAMILY MEMBER GERALD OLIPHANT CURRENT KEY EMPLOYEE 147612 EMPLOYEE 0 TERRI CROFTON FAMILY MEMBER MICHAEL CROFTON CURRENT OFFICER 25327 EMPLOYEE 0 MICHAEL CROFTON JR FAMILY MEMBER MICHAEL CROFTON CURRENT OFFICER 12954 EMPLOYEE 0 FORM 990, PART III, LINE 1 THE MISSION OF TRIHEALTH, INC. IS TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. WE PURSUE OUR MISSION BY PROVIDING A FULL RANGE OF HEALTH RELATED SERVICES INCLUDING PREVENTION, WELLNESS AND EDUCATION. CARE IS PROVIDED WITH COMPASSION CONSISTENT WITH THE VALUES OF OUR ORGANIZATION. TRIHEALTH, INC. SERVES AS THE ENTITY THAT PROVIDES JOINT MANAGEMENT OF BETHESDA HOSPITAL AND GOOD SAMARITAN HOSPITAL UNDER AN AFFILIATION AGREEMENT BETWEEN BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES. FORM 990, PART III, LINE 4B TRIHEALTH, INC. ("TRIHEALTH") COMBINES THE STRENGTHS OF TWO OF GREATER CINCINNATI'S FINEST HEALTH CARE ORGANIZATIONS, BETHESDA HOSPITAL, INC. ("BETHESDA") AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO ("GOOD SAMARITAN"). FORMED IN 1995, TRIHEALTH CREATED AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE IT SERVES, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION. TRIHEALTH IS DEDICATED TO DELIVERING THE BEST CARE POSSIBLE. BETHESDA AND GOOD SAMARITAN HAVE VALUES ROOTED IN SPIRITUAL HERITAGE AND COMPASSIONATE SERVICES TO THE COMMUNITY. BETHESDA WAS FOUNDED IN 1896 BY GERMAN METHODIST DEACONESSES TO CARE FOR CINCINNATI'S SICK AND POOR. A CATHOLIC ORGANIZATION, GOOD SAMARITAN WAS ESTABLISHED IN 1852 UNDER THE SPONSORSHIP OF THE SISTERS OF CHARITY TO PROVIDE CARE FOR THE POOR AND MEDICALLY UNDERSERVED. IN KEEPING WITH THESE EARLY PURPOSES, TRIHEALTH CONTINUES TO PROVIDE UNCOMPENSATED CARE TO THOSE IN NEED. THE "TRI" IN TRIHEALTH REPRESENTS ITS HOSPITALS, PHYSICIANS AND COMMUNITY WORKING TOGETHER TO IMPROVE THE HEALTH AND WELLNESS OF THE PEOPLE IT SERVES. THE "TRI" ALSO EXPRESSES OUR COMMITMENT TO THE PHYSICAL, MENTAL AND SPIRITUAL ASPECTS OF HEALTH. IN SERVING THE COMMUNITY'S NEEDS, TRIHEALTH OFFERS COMPREHENSIVE SERVICES AT MORE THAN 50 CONVENIENT LOCATIONS IN THE GREATER CINCINNATI AND TRISTATE AREA. ITS SITES INCLUDE TWO HOSPITAL LOCATIONS AND PHYSICIAN OFFICE BUILDINGS IN ADDITION TO FITNESS, REHABILITATION, OCCUPATIONAL HEALTH AND OUTPATIENT CENTERS. TRIHEALTH ALSO PROVIDES SERVICES IN THE HOME AND IN THE WORKPLACE AND DELIVERS CARE AND EDUCATION COOPERATIVELY THROUGH COMMUNITY-BASED ORGANIZATIONS, SUCH AS CHURCHES, SCHOOLS, CLINICS AND SOCIAL AGENCIES. TRIHEALTH HOSPITALS HAVE BEEN RECOGNIZED LOCALLY AND NATIONALLY AS TOP-RATED IN MATERNITY CARE, NEONATAL INTENSIVE CARE, CARDIAC SURGERY AND CARDIOLOGY, ORTHOPEDICS, UROLOGY, NEUROLOGY/NEUROSURGERY, AND ENDOCRINOLOGY. TRIHEALTH PROVIDES ADMINISTRATIVE SUPPORT SERVICES FOR BOTH BETHESDA AND GOOD SAMARITAN AS WELL AS VARIOUS SUBSIDIARIES AND AFFILIATES. THE ADMINISTRATIVE SUPPORT SERVICES INCLUDE GENERAL ADMINISTRATION, INFORMATION SYSTEMS, FINANCE, HUMAN RESOURCES AND OTHER GENERAL SUPPORT SERVICES. THESE COSTS ARE ALLOCATED TO THE VARIOUS TRIHEALTH ENTITIES AND THE ENTITIES REIMBURSE TRIHEALTH AT COST. IN ADDITION, BETHESDA AND GOOD SAMARITAN EQUALLY FUND THE CASH FLOWS OF TRIHEALTH AND AS SUCH THE COSTS ALLOCATED BY TRIHEALTH ARE RECORDED AS EXPENSES ON THE FINANCIAL STATEMENTS OF BETHESDA AND GOOD SAMARITAN. THEREFORE, THE ALLOCATED SERVICE COSTS ARE PRESENTED ON TRIHEALTH'S FORM 990, PARTS VIII AND IX IN THE AGGREGATE AS THE EXPENSES ARE PRESENTED AS MANAGEMENT AND GENERAL EXPENSES ON THE FORMS 990 FOR BETHESDA AND GOOD SAMARITAN. FORM 990, PART VI, SECTION A, LINE 2 THE OFFICERS, DIRECTORS AND TRUSTEES OF TRIHEALTH, INC. LISTED IN PART VII, SECTION A HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARDS OF BETHESDA HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, BOTH AFFILIATED ENTITIES OF TRIHEALTH, INC. AS WELL AS TRIHEALTH HOSPITAL, INC. A SUBSIDIARY OF TRIHEALTH, INC. JOHN PROUT, MICHAEL CROFTON, GERALD OLIPHANT, ROBERT COLLINS, MD, MARK CLEMENT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL, AN AFFILIATED ENTITY OF TRIHEALTH, INC. WAYNE SHIRCLIFF, MARK DELWORTH, MD, ALAN ALTMAN, MD, CRAIG EISENTROUT, MD, ELLEN KATZ, 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. JOHN PROUT, MARK CLEMENT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE, AN AFFILIATED ENTITY OF TRIHEALTH, INC. JOHN PROUT, DONNA NIENABER, ESQ., WILLIAM GRONEMAN, GERALD OLIPHANT, GEORGES FEGHALI, MD, MARK CLEMENT, MICHAEL CROFTON, ROBERT COLLINS, MD, CRAIG EISENTROUT, MD AND ALAN ALTMAN, 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. JOHN PROUT, MARK CLEMENT AND MYRTIS POWELL HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE BETHESDA FOUNDATION, INC., AN AFFILIATED ENTITY. 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 TRIHEALTH, INC. HAS TWO CORPORATE MEMBERS, BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES, THE PARENT ORGANIZATION OF THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. FORM 990, PART VI, SECTION A, LINE 7A TRIHEALTH, INC. HAS TWO CORPORATE MEMBERS, BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES, THE PARENT ORGANIZATION OF THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, WHO HAVE THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF TRIHEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7B TRIHEALTH, INC. HAS TWO CORPORATE MEMBERS, BETHESDA, INC. AND CATHOLIC HEALTH INITIATIVES, THE PARENT ORGANIZATION OF THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, WHO MUST APPROVE AMENDMENTS TO TRIHEALTH INC.'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 MEMBERS OF THE BOARD ARE PROVIDED AN ELECTRONIC COPY OF FORM 990 PRIOR TO FILING. HOWEVER, FOR THE PROTECTION OF DONOR PRIVACY, SCHEDULE B - SCHEDULE OF CONTRIBUTORS WAS REMOVED FROM THE COPY PROVIDED TO THE BOARD. SUBSEQUENT TO PRESENTATION TO THE BOARD, THE ORGANIZATION FILES THE RETURNS MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH NON-SUBSTANTIVE CHANGES ARE NOT SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO ANNUALLY DISCLOSE CERTAIN FINANCIAL INTERESTS AND FIDUCIARY RELATIONSHIPS. THE EXECUTIVE COMMITTEE AND CORPORATE COUNSEL REVIEW RESPONSES, CONDUCT FURTHER INVESTIGATION (IF NECESSARY), AND DETERMINE WHEN A CONFLICT EXISTS WITH RESPECT TO A CERTAIN TRANSACTION. IF A CONFLICT EXISTS, THE TRANSACTION IS NOT TO BE ENTERED INTO UNLESS ALTERNATIVES ARE FULLY INVESTIGATED, AND IN THEIR ABSENCE, THE BOARD, WITHOUT THE PARTICIPATION OF THE INTERESTED MEMBER(S), DETERMINES THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. PLANS TO MANAGE THE CONFLICT DURING THE RELATIONSHIP ARE IMPLEMENTED. ALL DISCUSSIONS ARE APPROPRIATELY DOCUMENTED. ALL DIRECTORS AND MANAGERS, WHICH INCLUDE OFFICERS AND KEY EMPLOYEES, ARE REQUIRED TO ANNUALLY DISCLOSE ANY CIRCUMSTANCES, INCLUDING FAMILY AND BUSINESS RELATIONSHIPS, THAT MAY CREATE A CONFLICT OF INTEREST FOR THE ORGANIZATION. THESE RESPONSES ARE REVIEWED AND ACTED UPON BY A CONFLICT OF INTEREST COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE ANNUAL PROCESS PERFORMED BY TRIHEALTH, INC. INCLUDED: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANT; COMPENSATION SURVEY OR STUDY; AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ADDITIONALLY, ALL DISCUSSIONS AND DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 TRIHEALTH, INC.'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A - AVERAGE HOURS PER WEEK DIRECTORS (AS NOTED WITH A "MED STAFF PRES" REFERENCE) FOR TRIHEALTH, INC. SERVE ON THE BOARD IN THEIR CAPACITY AS MEDICAL STAFF PRESIDENT FOR EITHER BETHESDA HOSPITAL, INC. OR THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. COMPENSATION SHOWN OF $45,000 IS FOR HIS/HER DUTIES AS MEDICAL STAFF PRESIDENT OF THE RESPECTIVE HOSPITAL AND NOT FOR SERVING AS A DIRECTOR. IN ADDITION, THESE INDIVIDUALS ARE ALSO EMPLOYEES OF THE TRIHEALTH SYSTEM AND ANY REMAINING COMPENSATION SHOWN IS FOR THOSE DUTIES AND NOT FOR SERVING AS A DIRECTOR. FORM 990, PART IX, LINE 11G MEDICARE COMPLIANCE: PROGRAM SERVICE EXPENSES 798,976. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 798,976. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 18,892,588. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,892,588. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 3,274,009. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,274,009. RECRUITMENT/RELOCATION SERVICES: PROGRAM SERVICE EXPENSES 1,570,351. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,570,351. CONSULTING: PROGRAM SERVICE EXPENSES 11,852,118. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,852,118. STAFFING: PROGRAM SERVICE EXPENSES 2,071,298. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,071,298. LINGUISTIC SERVICES: PROGRAM SERVICE EXPENSES 817,633. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 817,633. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 332,077. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 332,077. FORM 990, PART XI, LINE 9: CAPITAL CONTRIBUTION UNDER JOINT OPERATING AGREEMENT 117,188,208. CHANGE IN PENSION PLAN/SERP FUNDED STATUS -12,017,484. CAPITAL CONTRIBUTION TO MCCULLOUGH HYDE MEMORIAL HOSPITAL INC. -7,623,913. NET LOSS OF GOOD SAMARITAN HOSPITAL FREE CLINIC (FILES FORM 990) -128,714. FORM 990, PART VI, LINE 1A THE BOARD OF TRUSTEES OF TRIHEALTH, INC. ("THE CORPORATION"), ESTABLISHED AN EXECUTIVE COMMITTEE WHICH MAY EXERCISE SUCH POWER AND AUTHORITY OF THE BOARD OF TRUSTEES IN INTERVALS BETWEEN MEETINGS OF THE BOARD AS AUTHORIZED BY THE BOARD. THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT & CEO, SECRETARY AND TWO OTHER BOARD MEMBERS ALL IN ACCORDANCE WITH THE NETWORK AFFILIATION AGREEMENT. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF TRIHEALTH, INC. ARE AUDITED WITH ITS SUBSIDIARIES AND AFFILIATES ("TRIHEALTH"). TRIHEALTH HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF BOTH ITS AND ITS SUBSIDIARIES AND AFFILIATES FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF THE INDEPENDENT AUDITOR. DURING THE TAX YEAR, THERE WAS NOT A CHANGE IN THE PROCESS OF AUDIT OVERSIGHT AND/OR SELECTION OF AN INDEPENDENT AUDITOR BY TRIHEALTH. BETHESDA HOSPITAL INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 310537122 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 310537486 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN ENTERPRISE CORP 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 311383365 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 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 GOOD SAMARITAN HOSPITAL FREE CLINIC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 273893817 FREE CLINIC OH SECTION 501(C)(3) SCHEDULE A, LINE 7 TRIHEALTH INC 1 TRIHEALTH HOSPITAL INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 461393755 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 BETHESDA HEALTHCARE INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311027660 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 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 11A 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 GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311778403 EDUCATION OH SECTION 501(C)(3) SCHEDULE A, LINE 2 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 COMMUNITY LIMITED CARE DIALYSIS CENTER 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 237419853 DIALYSIS OH SECTION 501(C)(2) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 MCCULLOUGH HYDE MEMORIAL HOSPITAL INC 110 N POPLAR STREET OXFORD OH 45056 310650283 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN SOLUTIONS INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 311444353 CLAIMS ADMINISTRATION OH N/A C 4413365 3565162 1.00000 1 TRIHEALTH PHYSICIANS OF INDIANA INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 461125130 PHYSICIAN PRACTICES OH N/A C 2173325 1.00000 1 TRIHEALTH CIPHO INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 463294306 PHYSICIAN HEALTH ORGANIZATION OH N/A C 17774 1.00000 1 1 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 1 1 1 TRIHEALTH PHYSICIAN ENTERPRISE CORP A 179715 FMV BETHESDA HOSPITAL INC A 6041 FMV MCCULLOUGH HYDE MEMORIAL HOSPITAL INC B 7629133 CASH TRIHEALTH PHYSICIAN ENTERPRISE CORP B 99611248 CASH BETHESDA HOSPITAL INC C 58594104 CASH THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO C 58594104 CASH BETHESDA PROPERTIES INC K 476153 FMV THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO K 3324 FMV BETHESDA HOSPITAL INC L 181142 FMV BETHESDA HOSPITAL INC L 91668734 COST THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO L 96589808 COST TRIHEALTH HOSPITAL INC L 3446160 COST BETHESDA HEALTHCARE INC L 474419 COST BETHESDA PROPERTIES INC L 56135 COST TRIHEALTH PHYSICIAN SOLUTIONS L 109439 COST HOSPICE OF CINCINNATI INCORPORATED L 275460 COST TRIHEALTH PHYSICIAN ENTERPRISE CORP L 1486152 COST BETHESDA HEALTHCARE INC M 1512205 FMV TRIHEALTH PHYSICIAN SOLUTIONS O 3109847 FMV GOOD SAMARITAN HOSPITAL FREE CLINIC O 417723 FMV THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO Q 205957713 COST BETHESDA HOSPITAL INC Q 201834387 COST TRIHEALTH PHYSICIAN ENTERPRISE CORP Q 101726844 COST TRIHEALTH PHYSICIAN INSTITUTE Q 20098339 COST TRIHEALTH PHYSICIAN SOLUTIONS Q 1736586 COST TRIHEALTH HOSPITAL INC Q 30322069 COST TRIHEALTH PHYSICIANS OF INDIANA INC Q 383804 COST TRIHEALTH CIPHO INC Q 657113 COST GOOD SAMARITAN HOSPITAL FREE CLINIC Q 239060 COST BETHESDA PROPERTIES INC Q 3857375 COST BETHESDA HEALTHCARE INC Q 7960669 COST HOSPICE OF CINCINNATI INCORPORATED Q 12832448 COST FERNSIDE INC A CENTER FOR GREIVING CHILDREN Q 211532 COST GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE Q 1076550 COST MCCULLOUGH HYDE MEMORIAL HOSPITAL INC Q 26302957 COST