2014-05-14T08:09:27-05:00 2013-06-30 440160260 BKD LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2012-07-01 310537122 BETHESDA HOSPITAL INC BETH 5135696575 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 MICHAEL CROFTON 5135696575 2014-05-14 1 P00961884 5136218300 2012 2015-11-30 17:44:51Z JOHN S PROUT 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 803446762 0 X WWW.TRIHEALTH.COM X 1896 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 12 9 4588 1400 3695060 0 1374854 1464202 527662857 492854572 11278871 28563530 6934856 14695001 547251438 537577305 407512 270235 0 0 235046180 235951491 0 0 0 259594841 229256169 495048533 465477895 52202905 72099410 717410479 745236425 367261093 326300852 350149386 418935573 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 381134088 270235 523476975 SEE SCHEDULE H 381134088 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 447 0 1 4588 1 1 1 0 0 0 0 0 0 0 0 0 X 12 9 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL CROFTON 5135696577 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 X MICHAEL HAVERKAMP 1.00 3.00 X 0 0 0 ROBERT WALKER 1.00 3.00 X X 0 0 0 JOHN PROUT 15.00 45.00 X X 0 1991921 331413 PAUL EDGETT III 1.00 3.00 X 0 0 0 THOMAS FINN 1.00 3.00 X X 0 0 0 MYRTIS POWELL 1.00 3.00 X 0 0 0 SR SALLY DUFFY 1.00 3.00 X 0 0 0 MICHAEL MCGRAW 1.00 3.00 X X 0 0 0 STEPHEN BLATT MD 1.00 18.00 X 0 168837 20252 STUART DONOVAN MD 8.00 3.00 X 45000 20793 0 CRAIG EISENTROUT MD 1.00 3.00 X 0 0 0 WAYNE SHIRCLIFF 1.00 3.00 X 0 0 0 DONNA NIENABER ESQ 15.00 45.00 X 0 540699 164782 CRAIG RUCKER 15.00 45.00 X 0 618981 143478 WILLIAM GRONEMAN 15.00 45.00 X 0 578641 178557 GERALD OLIPHANT 15.00 45.00 X 0 660542 139447 GEORGES FEGHALI MD 15.00 45.00 X 0 664294 181461 JOHN ROBINSON MD 25.00 35.00 X 0 353874 84193 BARB BOYNE 60.00 0.00 X 0 192551 63900 DAVE DORNHEGGEN 30.00 30.00 X 0 396095 120368 LOREN HIRATZKA MD 60.00 0.00 X 200904 200000 38748 SANDRA LOBERT 60.00 0.00 X 236841 0 40701 RAYMOND HELLMANN MD 60.00 0.00 X 236094 0 56309 ALAN ALTMAN MD 60.00 0.00 X 232716 0 87858 LAURA TRICE MD 60.00 0.00 X 221347 0 40369 MICHAEL CROFTON 15.00 45.00 X 0 300076 79447 SHER MCCLANAHAN 0.00 60.00 X 0 391477 114389 1172902 7078781 1885672 89 1 1 0 CATHOLIC HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 CLINICAL ENGINEERING 6160921 AMERICAN NURSING CARE INC 1700 EDISON DRIVE SUITE 300 MILFORD OH 45150 NURSE STAFFING 2268485 ARUP PO BOX 27964 SALT LAKE CITY UT 84127 LABORATORY RESEARCH & DVLPMT 1704411 PATIENT TRANSPORT SERVICES INC 1700 EDISON DRIVE SUITE 300 MILFORD OH 45150 PATIENT TRANSPORTATION 1555045 BUTLER PHYSICIAN'S MGMT LLC 6770 CINCINNATI-DAYTON RD 112 LIBERTY TWP OH 45044 MANAGEMENT 714596 43 1231157 94209 138836 1464202 PATIENT REVENUE 621990 487841217 485668398 2172819 JOA REVENUE 900099 3097026 3097026 JV REVENUE 900099 1081100 1081100 AFFILIATED ORG. RENTAL 532000 513337 513337 SENIOR SERVICES 900099 176700 176700 145192 145192 492854572 3912135 3912135 193703 0 193703 193703 193703 289920894 57083 265243092 83490 24677802 -26407 24651395 24651395 802736 542875 259861 259861 EHR MEANINGFUL USE 900099 7197394 7197394 APOTHECARY 621990 4129240 1087855 3041385 CAFETERIA 900099 1793845 1793845 1120958 686572 434386 14241437 537577305 523476975 3695060 8941068 270235 270235 3699151 3699151 177458182 150795940 26662242 12943130 10107589 2835541 28523400 22837304 5686096 13327628 11222814 2104814 3163433 3109179 54254 2473862 2473862 317178 317178 1308804 1308804 40893179 28807056 12086123 2871155 208634 2662521 5968904 3997496 1971408 9572107 632229 8939878 9051141 7339225 1711916 1008492 739682 268810 9494803 9494803 29405199 21483740 7921459 496546 496546 MEDICAL/DIETARY SUPPLY 93373209 93045254 327955 EQUIPMENT & REPAIRS 9788648 9314243 474405 OHIO HOSPITAL FEE 7199859 7199859 OVERHEAD ALLOCATION 1375925 1375925 1493725 528806 964919 465477895 381134088 84343807 0 9574427 4633981 33584848 43043237 683 683 1968887 2200187 2107129 1906667 525256889 292986311 234827445 232270578 222351696 214404703 152817466 128729515 6375525 23748065 19353337 21994285 34449036 72304524 717410479 745236425 39843942 38276775 3816013 2203519 223489752 213947487 100111386 71873071 367261093 326300852 X 339584163 407736039 10565223 11199534 350149386 418935573 717410479 745236425 X 72099410 9997155 -1470585 -11839793 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6206 6206 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: DURING THE TAX YEAR, BETHESDA HOSPITAL, INC. ("HOSPITAL") PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION ($2,051) OF WHICH RELATED TO LOBBYING ACTIVITIES. IN ADDITION, TRIHEALTH, INC., A RELATED ORGANIZATION OF HOSPITAL, WHICH PROVIDES ADMINISTRATIVE SUPPORT SERVICES TO HOSPITAL, PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. A PORTION OF THE AFOREMENTIONED ADMINISTRATIVE SUPPORT SERVICES ARE ALLOCATED TO HOSPITAL AND $4,155 OF THE AMOUNT SHOWN ON LINE 1I REPRESENTS HOSPITAL'S SHARE OF THESE LOBBYING EXPENSES. 3566136 716 415730 24268 3958314 3799868 1251 -156863 78120 3566136 3112953 79856 607059 3799868 2666720 1000 445233 3112953 3561775 -776353 118702 2666720 0.80000 0.20000 0 1 1 957693 957693 307587439 121014801 186572638 1941399 1275716 665683 203995811 169133050 34862761 10774547 1562744 9211803 232270578 EMERGING MARKETS 22425265 F PRIVATE EQUITY 16957904 F HEDGE FUNDS 28175436 F REAL ESTATE 21852668 F OTHER 39318242 F 128729515 DUE FROM RELATED ORGANIZATIONS 57368334 NETWORK AFFILIATION RECEIVABLE 4103248 INVESTMENT IN DIRECT AFFILIATE 4898225 MALPRACTICE INSURANCE/WORKERS COMPENSATION RECEIVABLE 5774717 ESCROW DEPOSIT 160000 72304524 THIRD PARTY SETTLEMENTS 6018879 PENSION LIABILITY 29765256 ACCRUED EIB 6214720 MALPRACTICE INSURANCE/WORKERS COMPENATION LIABILITY 26814231 ENVIRONMENTAL REMEDIATION LIABILITY 3059985 71873071 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: INVESTMENT PROCEEDS FROM ENDOWMENT FUNDS ARE USED TO SUPPORT BETHESDA HOSPITAL, INC. PROGRAMS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE FINANCIAL STATEMENTS OF BETHESDA HOSPITAL, INC. ARE AUDITED AS PART OF TRIHEALTH AND ITS SUBSIDIARIES AND AFFILIATES ("TRIHEALTH"). FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE AUDITED CONSOLIDATED 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, 2013, AND DETERMINED NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT JUNE 30, 2013. IN ADDITION, THE FINANCIAL STATEMENTS OF BETHESDA HOSPITAL, INC. ARE AUDITED AS PART OF ITS PARENT, BETHESDA, INC. FOLLOWING IS THE TEXT OF THE FOOTNOTE TO THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS OF BETHESDA, INC. ("COMPANY") THAT REPORTS ITS AND ITS SUBSIDIARIES LIABILITY, IF APPLICABLE, FOR CERTAIN TAX POSITIONS UNDER ASC 740-10-25: THE COMPANY COMPLETED AN ANALYSIS OF UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE AT JUNE 30, 2013 AND 2012, AND DETERMINED NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2013 AND 2012. 1 1 X 1 X 1 X 1 1 0 1 1 16174403 4539290 11635113 0.02500 49293842 31442284 17851558 0.03840 65468245 35981574 29486671 0.06340 4372570 2258094 2114476 0.00450 9123788 5878212 3245576 0.00700 109790 41292 68498 0.00010 47775 47775 0.00010 13653923 8177598 5476325 0.01170 79122168 44159172 34962996 0.07510 0 41101937 0 90886442 99882941 -8996499 X 1 1 1 BN NORTHEAST CARDIAC CENTER LLC CARDIAC CARE 0.57950 0.42050 2 HAND AMBULATORY SURGERY CENTER LLC HAND AMBULATORY SURGERY CENTER 0.50000 0.50000 2 1 BETHESDA NORTH HOSPITAL

10500 MONTGOMERY ROAD CINCINNATI OH 45242

WWW.TRIHEALTH.COM X X X X X 2 BETHESDA BUTLER HOSPITAL

3125 HAMILTON-MASON ROAD HAMILTON OH 45011

WWW.TRIHEALTH.COM X X X BETHESDA NORTH HOSPITAL 1 1 X X X X X X X X 12 1 1 1 X X X X X 0 0 1 1 100.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X 1 0 1 X 0 0 BETHESDA BUTLER HOSPITAL (ACQUIRED 312) 2 0 1 1 100.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X 1 0 1 X 0 0 21 BETHESDA MEDICAL CENTER-ARROW SPRINGS

100 ARROW SPRINGS BLVD LEBANON OH 45036

24-HOUR EMERGENCY ROOM AND COMPREHENSIVE OUTPATIENT SERVICES BETHESDA NORTH OBGYN CLINIC

10498 MONTGOMERY ROAD CINCINNATI OH 45242

WOMEN'S HEALTH BETHESDA OAK CAMPUS

619 OAK STREET CINCINNATI OH 45206

LAB, PHARMACY AND OUTPATIENT DRUG/ALCOHOL TREATMENT BNH AMBULATORY TREATMENT CENTER

10506 MONTGOMERY ROAD CINCINNATI OH 45242

OUTPATIENT INFUSION AND CHEMOTHERAPY TREATMENT BNH SLEEP CENTER

10475 MONTGOMERY ROAD CINCINNATI OH 45242

SLEEP CENTER NORTH AMBULATORY SURGERY CENTER

10506 MONTGOMERY ROAD CINCINNATI OH 45242

OUTPATIENT SURGICAL CENTER BETHESDA NORTH OUTPATIENT IMAGING CTR

10494 MONTGOMERY ROAD CINCINNATI OH 45242

OUTPATIENT IMAGING AND COMPREHENSIVE BREAST CARE CENTER SENIORLINK - COURT STREET

415 WEST COURT STREET CINCINNATI OH 45203

SENIOR CARE/DAY HEALTH CENTERS SENIORLINK - NORWOOD

4750 WESLEY AVENUE SUITE J CINCINNATI OH 45212

SENIOR CARE/DAY HEALTH CENTERS TRIHEALTH NURSE MIDWIVES

3440 BURNET AVENUE 120 CINCINNATI OH 45229

OUTPATIENT WOMEN'S HEALTH CLINIC BETHESDA SURGERY CENTER

10615 MONTGOMERY ROAD 300 CINCINNATI OH 45242

OUTPATIENT SURGICAL CENTER BETHESDA HAND REHABILITATION

10700 MONTGOMERY ROAD CINCINNATI OH 45242

PHYSICAL THERAPY BETHESDA LOVELAND PHYSICAL THERAPY

10675 LOVELAND-MADERIA ROAD LOVELAND OH 45140

PHYSICAL THERAPY BETHESDA FAMILY PRACTICE CENTER

4441 MONTGOMERY ROAD SUITE 206 CINCINNATI OH 45212

FAMILY MEDICINE CLINIC BETHESDA ALCOHOLDRUG TREATMENT

11305 REED HARTMAN HWY CINCINNATI OH 45242

OUTPATIENT ALCOHOL AND DRUG TREATMENT BETHESDA BUTLER PHYSICAL THERAPY

3035 HAMILTON-MASON ROAD HAMILTON OH 45011

PHYSICAL THERAPY BETHESDA BUTLER IMAGING CENTER

3075 HAMILTON-MASON ROAD HAMILTON OH 45011

MEDICAL IMAGING BETHESDA BUTLER SLEEP CENTER

3055 HAMILTON-MASON ROAD HAMILTON OH 45011

SLEEP MEDICINE CENTER BETHESDA HAND REHABILITATION

538 OAK STREET CINCINNATI OH 45219

PHYSICAL THERAPY BETHESDA ALCOHOLDRUG TREATMENT

619 OAK STREET CINCINNATI OH 45206

OUTPATIENT ALCOHOL AND DRUG TREATMENT BETHESDA REHABILITATION

6020 MASON MONTGOMERY RD MASON OH 45040

PHYSICAL THERAPY PART I, LINE 3C: BETHESDA HOSPITAL, INC. UTILIZES THE FEDERAL POVERTY GUIDELINES IN DETERMINING CHARITY CARE ELIGIBILITY. SEE THE RESPONSES TO PART I, LINES 3A AND 3B.AN INDIVIDUAL'S INCOME UNDER FPG IS A SIGNIFICANT FACTOR IN DETERMINING ELIGIBILITY FOR CHARITY CARE. 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. 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. THE COMMUNITY BENEFIT PROVIDED BY BETHESDA HOSPITAL, INC. IS TRACKED ON A STANDALONE BASIS, HOWEVER ITS COMMUNITY BENEFIT IS REPORTED IN COMBINATION WITH THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO'S COMMUNITY BENEFIT IN A REPORT PREPARED BY TRIHEALTH, INC. PART I, LINE 7: FOR THE AMOUNTS REPORTED AT COST, IN PART I, LINE 7, BETHESDA 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, LINE 7G: THE SUBSIDIZED HEALTH SERVICES COMMUNITY BENEFIT AMOUNT REPORTED IN PART I, LINE 7(G) DOES NOT INCLUDE COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART II: BETHESDA HOSPITAL, INC. DID NOT ENGAGE IN ANY COMMUNITY BUILDING ACTIVITIES DURING THE TAX YEAR. PART III, LINE 4: BETHESDA HOSPITAL, INC.'S FINANCIAL STATEMENTS ARE AUDITED AS PART OF THE TRIHEALTH AUDIT REPORT.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, 2012. TRIHEALTH HAS NOT EXPERIENCED SIGNIFICANT CHANGES INW RITE-OFF TRENDS AND HAS NOT CHANGED ITS CHARITY CARE POLICY SINCE JUNE 30, 2012. THE OVERALL ALLOWANCE PERCENTAGE FOR UNCOLLECTIBLE ACCOUNTS WENT FROM 56.2% (UNAUDITED) AT JUNE 30, 2012 TO 56.6% AT JUNE 30, 2013 AS A RESULT OF SLIGHT CHANGES IN PAYOR MIX AND THE TIMING OF WRITE-OFFS.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: 2013 - MEDICARE 19%, MEDICAID 3%, MANAGED CARE 22%, SELF PAY 23%, COMMERCIAL AND OTHER 33%2012 (UNAUDITED) - MEDICARE 17%, MEDICAID 4%, MANAGED CARE 22%, SELF PAY 22%, COMMERCIAL AND OTHER 35%TRIHEALTH HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. THE BASIS FOR PAYMENT UNDER THESE AGREEMENTS INCLUDES PROSPECTIVELY DETERMINED RATES, COST REIMBURSEMENT, NEGOTIATED DISCOUNTS FROM ESTABLISHED RATES, AND PER DIEMPAYMENTS. PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEW AND INVESTIGATIONS. THE DIFFERENCES BETWEEN THE ESTIMATED AND ACTUAL ADJUSTMENTS ARE RECORDED AS PART OF NET PATIENT SERVICE REVENUE IN FUTURE PERIODS, AS THE AMOUNTS BECOME KNOWN, OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS. TRIHEALTH RECOGNIZES A SIGNIFICANT AMOUNT OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED EVEN THOUGH IT DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBT IS PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS.AS FOR THE AMOUNT OF BAD DEBT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, BETHESDA HOSPITAL, INC. DOES NOT REPORT ACTUAL BAD DEBT EXPENSE AS COMMUNITY BENEFIT. IF UPON FURTHER RESEARCH, IT IS ULTIMATELY DETERMINED THAT A PORTION OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER TRIHEALTH'S CHARITY CARE POLICY, THOSE COSTS WOULD BE RECLASSIFIED, AS APPROPRIATE, TO COMMUNITY BENEFIT AT THAT TIME.PLEASE NOTE THAT BAD DEBT EXPENSE IS NOT DETERMINED UNTIL AFTER ALL DISCOUNTS AND ANY ASSOCIATED PAYMENTS ARE TAKEN INTO ACCOUNT. IF ANY PAYMENTS ARE RECEIVED AFTER A PATIENT ACCOUNT IS DETERMINED TO BE BAD DEBT, THE ACCOUNT WILL BE ADJUSTED ACCORDINGLY AT THAT TIME. PART III, LINE 8: BETHESDA HOSPITAL, 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. BETHESDA 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, BETHESDA 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. BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 3: DURING THE COMMUNITY HEALTH NEED ASSESSMENT ("CHNA") PROCESS, INPUT WAS RECEIVED FROM ORGANIZATIONS FROM EACH OF THE FOUR COUNTIES THAT BETHESDA NORTH HOSPITAL ("BNH") SERVES REPRESENTING UNDERSERVED POPULATIONS USING THE FOLLOWING THREE APPROACHES. THE COMBINATION OF THESE METHODS PROVIDED A WIDE-RANGE OF DATA-COLLECTION OPPORTUNITIES ON WHICH THE CHNA WAS BASED.GROUP LEVEL ASSESSMENTS ("GLA") - GLAS WERE CONDUCTED WITH PROVIDERS OF SERVICES IN BNH'S SERVICE AREA. THESE ASSESSMENTS WERE PARTICIPATORY LARGE GROUP APPROACH (SIMILAR TO FOCUS GROUPS) IN WHICH QUALITATIVE DATA ARE GENERATED ABOUT AN BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 4: ADAMS COUNTY REGIONAL MEDICAL CENTERATRIUM MEDICAL CENTERDEARBORN COUNTY HOSPITALFORT HAMILTON HOSPITALLINDNER CENTER OF HOPEMARGARET MAY COMMUNITY HOSPITALMCCULLOUGH-HYDE MEMORIAL HOSPITALMERCY HEALTHGOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIOUC HEALTH BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 7: OBESITY - BETHESDA NORTH HOSPITAL WILL ADDRESS THIS NEED IS HAMILTON AND BUTLER COUNTIES, HOWEVER, IT WILL NOT, AT THIS TIME, ENTER INTO SPECIFIC PROGRAMS IN WARREN AND CLERMONT COUNTIES. THESE COUNTIES HAVE POPULATIONS THAT ARE SIGNIFICANTLY SMALLER AND LESS DENSE THAN HAMILTON AND BUTLER COUNTIES, THEREBY PRESENTING ADDITIONAL CHALLENGES FOR AN EFFECTIVE AND COMPREHENSIVE STRATEGY.SUBSTANCE ABUSE/MENTAL HEALTH - THIS NEED WILL NOT BE ADDRESSED BY BETHESDA NORTH HOSPITAL AS ITS AFFILIATED HOSPITAL IN THE TRIHEALTH, INC. SYSTEM, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO PROVIDES THIS CARE THROUGH ITS GERIATRIC AND ADULT BEHAVIORAL HEALTH PATIENT UNITS. IT WILL NOT ADDRESS MENTAL HEALTH NEEDS OTHERWISE AS THERE IS A COMPREHENSIVE OUTPATIENT PROGRAM FOR SUBSTANCE ABUSE ELSEWHERE IN THE TRIHEALTH, INC. SYSTEM, TO WHICH GOOD SAMARITAN HOSPITAL BELONGS. BETHESDA NORTH HOSPITAL BELIEVES THAT IT CAN LEVERAGE THE TRIHEALTH NETWORK TO ASSIST IN ADDRESSING PORTIONS OF THIS SIGNIFICANT NEED, THEREBY PERMITTING IT TO ALLOCATE RESOURCES TO OTHER SIGNIFICANT NEEDS. BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 12H: 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. BETHESDA BUTLER HOSPITAL (ACQUIRED 3/12) PART V, SECTION B, LINE 12H: 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. BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 14G: BETHESDA NORTH 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 13A-13E.IN ADDITION, SUCH INFORMATION SHALL BE PROVIDED IN LANGUAGES CONSIDERED TO BE COMMONLY SPOKEN BY THE POPULATION BETHESDA NORTH 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. BETHESDA BUTLER HOSPITAL (ACQUIRED 3/12) PART V, SECTION B, LINE 14G: BETHESDA BUTLER COUNTY MEDICAL CENTER 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 13A-13E.IN ADDITION, SUCH INFORMATION SHALL BE PROVIDED IN LANGUAGES CONSIDERED TO BE COMMONLY SPOKEN BY THE POPULATION BETHESDA BUTLER COUNTY MEDICAL CENTER 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. BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 20D: BETHESDA NORTH HOSPITAL ("BNH") ISSUES A BILLING STATEMENT TO ALL FAP-ELIGIBLE INDIVIDUALS THAT STATE 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, BNH 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, BNH 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. BETHESDA BUTLER HOSPITAL (ACQUIRED 3/12) PART V, SECTION B, LINE 20D: BETHESDA BUTLER HOSPITAL ("BBH") 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 AN FAP-ELIGIBLE INDIVIDUAL 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, BBH 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, BBH 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. COMMUNITY HEALTH NEEDS ASSESSMENT AND NEWLY ACQUIRED HOSPITAL FACILITIES PART V, 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; ...BETHESDA BUTLER HOSPITAL WAS ACQUIRED BY BETHESDA HOSPITAL, INC. ON MARCH 1, 2012. THEREFORE, IT IS NOT REQUIRED TO MEET THE COMMUNITY HEALTH NEEDS ASSESSMENT REQUIREMENT UNTIL JUNE 30, 2014. AS SUCH, THE RESPONSE TO QUESTION 1 OF SECTION B IS ANSWERED "NO" FOR THE CURRENT TAX YEAR. PART VI, LINE 2: IN 1896, BETHESDA HOSPITAL, INC. ("BETHESDA") BEGAN AS A HOME VISITING MINISTRY OF THE METHODIST DEACONESSES TO SERVE THE HEALTH NEEDS OF THE GERMAN IMMIGRANTS LIVING IN CINCINNATI. NOW THAT MINISTRY, ONCE LED BY DEACONESS LOUISE GOLDER AND HER BROTHER REV. CHRISTIAN GOLDER, HAS GROWN INTO SEVERAL HEALTH SERVICES FOR GREATER CINCINNATI. IN 1995, BETHESDA, INC. AND GOOD SAMARITAN HOSPITAL FORMED A PARTNERSHIP TO CREATE A LOCAL HEALTH SYSTEM: TRIHEALTH, INC. ("TRIHEALTH"). THE MISSION OF TRIHEALTH IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY THROUGH A FULL RANGE OF HEALTH RELATED SERVICES-PREVENTION, WELLNESS AND EDUCATION AND THUS EXEMPLIFY THE FOUNDING SPIRIT OF THE BETHESDA DEACONESSES.THE SERVICES DESCRIBED BELOW, AND OTHERS NOT LISTED, PROMOTE COMMUNITY HEALTH IN ACUTE ILLNESS, IN MANAGEMENT OF CHRONIC DISEASE, AND IN EDUCATION AND PREVENTION MEASURES. PROGRAMS SEEK TO REDUCE THE BURDENS ON THE GOVERNMENT. FOR EXAMPLE, IF BETHESDA DID NOT ADDRESS THE ROOT CAUSES OF LOW BIRTH WEIGHT AND PREMATURITY, THE BURDEN TO GOVERNMENT MEDICAL PROGRAMS SUCH AS MEDICAID WOULD BE EVEN GREATER. IN 2011 AND 2012, BETHESDA, AS A PART OF 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, WAS THE BASIS FOR BETHESDA'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ADOPTED IN FISCAL YEAR 2013. FREE AND DISCOUNTED SERVICES ARE PROVIDED FOR THOSE UNABLE TO PAY AND MEETING ELIGIBILITY CRITERIA. THROUGH THE HOSPITAL CARE ASSURANCE PROGRAM (HCAP), BETHESDA SERVES PATIENTS MEETING CRITERIA SET FORTH BY THE OHIO DEPARTMENT OF JOBS AND FAMILY SERVICES. BETHESDA POLICY IS TO PROVIDE CHARITY CARE ON A SLIDING SCALE DISCOUNTING WHEN THE FAMILY INCOME IS UP TO 400 PERCENT OF THE ANNUALLY ESTABLISHED FEDERAL POVERTY GUIDELINE. IT OFFERS AN UNINSURED DISCOUNT FOR MEDICALLY NECESSARY SERVICES FOR THOSE WHO HAVE NO INSURANCE AND WHO DO NOT QUALIFY FOR OTHER FINANCIAL ASSISTANCE OPTIONS. FINANCIAL COUNSELORS ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION WHICH IS AVAILABLE ON TRIHEALTH'S WEBSITE AND BROCHURES ABOUT FINANCIAL ASSISTANCE ARE VISIBLE AND AVAILABLE IN HOSPITAL REGISTRATION AND ADMITTING AREAS.BETHESDA PROVIDED $32.2 MILLION IN TOTAL COMMUNITY BENEFIT FOR FISCAL YEAR 2012. OF THAT TOTAL, $25.4 MILLION REPRESENTED UNCOMPENSATED CARE. THE AMOUNT OF BENEFIT FOR BOTH TRADITIONAL CHARITY CARE AND FOR THE UNPAID COST OF MEDICAID IS ONE MANIFESTATION OF THE RISING RATES OF PERSONS WITHOUT HEALTH INSURANCE. THE MEDICAID PUBLIC PROGRAM REIMBURSES HOSPITALS FOR SERVICES BUT PAYMENTS MAY NOT ALWAYS COVER THE TOTAL COST OF CARE AND MEDICATIONS. THE UNPAID COST OF MEDICARE IS NOT INCLUDED IN TOTAL COMMUNITY BENEFIT. BETHESDA IS COMMITTED TO FULFILLING THE MISSION OF COMPASSION TO THE VULNERABLE MEMBERS OF THE COMMUNITIES THEY SERVE.BETHESDA PARTICIPATES IN THE REGIONAL TRAUMA SYSTEM THUS PROVIDING THE COMMUNITY WITH ACCESS TO TRAUMA CARE. THE TWO EMERGENCY ROOMS OF BETHESDA PROVIDE 24-HOUR EMERGENCY CARE TO COMMUNITY MEMBERS LIVING IN THE NORTHEAST CORRIDOR OF CINCINNATI AS WELL AS WARREN, BUTLER, AND CLERMONT COUNTIES. BETHESDA IS A LEVEL III TRAUMA CENTER AS VERIFIED BY THE COMMITTEE ON TRAUMA OF THE AMERICAN COLLEGE OF SURGEONS. ONE EXAMPLE OF ONGOING EFFORTS BY BETHESDA TO IMPROVE THE HEALTH OF THE BROADER COMMUNITY ARE PROGRAMS TO ADDRESS THE IDENTIFIED HEALTH NEED OF DIABETES. DIABETES EDUCATORS EXTEND THE EDUCATION TO THE COMMUNITY BY PROVIDING CLASSES TO A DIVERSE POPULATION, FROM AREA INDUSTRIES AND FIREHOUSE GROUPS TO RETIREMENT CENTERS. A DIABETES SUPPORT GROUP MEETS FOR CONTINUED EDUCATION IN CHRONIC DISEASE MANAGEMENT. THOUGH HEALTHY WOMEN HEALTHY LIVES WAS INSTITUTED IN JULY 2007 BY GOOD SAMARITAN HOSPITAL WOMEN'S SERVICES TO IMPROVE THE HEALTH OF THE GREATER CINCINNATI COMMUNITY, IT IS NOW FISCALLY SUPPORTED BY BETHESDA HOSPITAL AS WELL, MAKING IT A TRIHEALTH SYSTEM PROGRAM. HEALTHY WOMEN HEALTHY LIVES IS AN APPROACH BASED ON THE PREMISE THAT PREVENTION, EARLY DETECTION, TREATMENT AND ACCESS TO HEALTH CARE SERVICES IMPROVE INDIVIDUAL AND COMMUNITY HEALTH OUTCOMES. THE FOCUS IS ON HEALTH RISKS ASSOCIATED WITH THE ONSET OF MENOPAUSE. WELL ORGANIZED SCREENING AND EDUCATION EVENTS BRING THE SERVICES TO AT RISK POPULATIONS OF AFRICAN AMERICAN, APPALACHIAN, HISPANIC, UNINSURED AND UNDERINSURED WOMEN FORTY YEARS OF AGE OR OLDER. SCREENING INCLUDES OSTEOPOROSIS, MAMMOGRAPHY, CHOLESTEROL, HYPERTENSION, AND OBESITY. EVERY WOMAN RECEIVES A NURSE CONSULTATION, A COPY OF THEIR RESULTS AND A WRITTEN PRIMARY CARE REFERRAL. WOMEN WITH ABNORMAL RESULTS ARE CONTACTED AND ASSISTED IN ACCESSING PRIMARY CARE. IN ADDITION, WOMEN NEEDING PREGNANCY AND GYNECOLOGIC CARE CAN ACCESS THIS SERVICE AT THE OB/GYN CENTER AT BETHESDA NORTH HOSPITAL. CARE IS PROVIDED BY THE MEDICAL RESIDENTS IN OBSTETRICS AND GYNECOLOGY, SUPERVISED BY FACULTY PHYSICIANS. FINANCIAL COUNSELORS AND CARE COORDINATORS ASSIST IN FINDING APPROPRIATE COVERAGE, PAYMENT PLANS AND FINANCIAL AID. AS MANY OF THE WOMEN SERVED BY THE OB/GYN CENTER AT BETHESDA NORTH HOSPITAL HAVE LIMITED PROFICIENCY IN ENGLISH, QUALIFIED BILINGUAL STAFF ASSIST IN LANGUAGE INTERPRETATION. THE TRIHEALTH THINK FIRST PROGRAM IS AN ESTABLISHED BETHESDA SERVICE FOCUSED ON INJURY PREVENTION. THE THINK FIRST PROGRAM STAFF WORKS WITH COMMUNITY PARTNERS TO PROVIDE INJURY PREVENTION PROGRAMS AND COMMUNITY AWARENESS EVENTS. COLLABORATING WITH THE EDUCATORS, THE MEDIA, CIVIC CLUBS AND CORPORATIONS, THINK FIRST TEACHES INJURY PREVENTION TO ALL AGE GROUPS. THE GREATER CINCINNATI COMMUNITY HAS IDENTIFIED A SIGNIFICANT HEALTH NEED IN INFANT MORTALITY AND PREMATURITY. TRIHEALTH HAS COMBINED EFFORTS WITH THE LARGER MEDICAL COMMUNITY, AGENCIES AND OTHER STAKEHOLDERS TO ADDRESS THIS ISSUE. JUST AT BETHESDA NORTH HOSPITAL, THERE WERE 4,012 DELIVERIES IN FISCAL YEAR 2013. THE PERCENTAGE THAT WERE BORN WEIGHING LESS THAN 2500 GRAMS DECREASED BY ALMOST 1% FROM FISCAL YEAR 2012. AS A SYSTEM, TRIHEALTH WORKS TO REDUCE ELECTIVE DELIVERIES BEFORE THE 39TH WEEK. THE CARE MANAGEMENT PROVIDED TO MOTHERS BY BETHESDA PERINATAL SOCIAL WORKERS AND CARE COORDINATORS HELP IN THIS GOAL.BETHESDA, WITH OTHER ORGANIZATIONS, PROVIDE SUPPORT TO THE RESPITE CENTER, SERVING THE ADULT HOMELESS OF CINCINNATI. THE RESPITE CENTER, WITH 14 BEDS AND 24 HOUR COVERAGE, PROVIDES FREE MEDICAL SERVICES AND ACCOMMODATIONS FOR HOMELESS PERSONS NEEDING SOME MEDICAL OVERSIGHT. RESPITE HELPS PEOPLE WITHOUT HOMES TOWARD INDEPENDENT LIVING IN PERMANENT HOUSING. BETHESDA CONTINUES A COMMITMENT TO EDUCATING THE NEXT GENERATION OF HEALTH CARE PROVIDERS--PHYSICIANS AND ALLIED HEALTH PROFESSIONALS. COST IN EXCESS OF GOVERNMENTAL SUPPORT FOR MEDICAL EDUCATION PROGRAMS AT BETHESDA TOTALED APPROXIMATELY $2.7 MILLION IN FISCAL YEAR 2013.BETHESDA, AS PART OF TRIHEALTH, SPONSORS MEDICAL RESIDENCIES. THERE WERE 32 TOTAL RESIDENTS IN A JOINT OBSTETRICS AND GYNECOLOGY RESIDENCY AT TRIHEALTH HOSPITALS IN FISCAL YEAR 2013 WITH THREE GYNECOLOGY-UROLOGY FELLOWS. ALSO, THE BETHESDA FAMILY PRACTICE RESIDENCY INCLUDED 19 RESIDENTS AND TWO BETHESDA SPORTS MEDICINE FELLOWS IN FISCAL YEAR 2013.THE BETHESDA PARAMEDIC TRAINING PROGRAM IS A HOSPITAL-BASED PROGRAM ACCREDITED BY THE OHIO DEPARTMENT OF TRANSPORTATION. THROUGH THIS TRAINING PROGRAM, CERTIFIED EMERGENCY MEDICAL TECHNICIANS CAN ADVANCE TO THE PARAMEDIC LEVEL. EDUCATION IS COMPRISED OF DIDACTIC SESSIONS, WITH LAB, FIELD, AND HOSPITAL CLINICAL ROTATIONS. BETHESDA, AS A PART OF TRIHEALTH, COLLABORATES WITH LOCAL AND REGIONAL COLLEGES, UNIVERSITIES AND TRAINING CENTERS TO PROVIDE MENTORING, INTERNSHIPS, CLERKSHIPS, SUPERVISED EDUCATION AND CLINICAL ROTATIONS TO STUDENTS IN HEALTH FIELDS. THESE PARTNERSHIPS HELP STUDENTS LEARN ABOUT AND PREPARE FOR PROFESSIONS IN NURSE PRACTITIONER, RESPIRATORY THERAPY, RADIOLOGY TECHNOLOGY, STERILE PROCESSING, PHLEBOTOMY, MEDICAL LABORATORY, PHARMACY, SPEECH, AUDIOLOGY, PHYSICAL THERAPY, AND OCCUPATIONAL THERAPY. IN CONCLUSION, ASIDE FROM THE CHARITY CARE AND UNPAID COST OF MEDICARE PROGRAMS, BETHESDA PROVIDES THE COMMUNITY WITH HEALTH CARE SERVICES AND PROGRAMS, MEDICAL EDUCATION, AND CASH AND IN-KIND CONTRIBUTIONS FOR THE POOR AND THE BROADER COMMUNITY. THIS COMMITMENT TO COMMUNITY HEALTH REVEALS BETHESDA'S FOUNDING SPIRIT OF CONCERN FOR THE VULNERABLE. IT ALSO REFLECTS THE ONGOING, TANGIBLE EFFORTS AND CONTRIBUTIONS OF COUNTLESS EMPLOYEES, PHYSICIANS AND LEADERS LIVING THE CORE VALUES OF STEWARDSHIP AND RESPONSE TO COMMUNITY NEEDS. PART VI, LINE 3: TRIHEALTH, INC. PERFORMS THE BILLING SERVICES FOR ALL AFFILIATED HOSPITALS INCLUDING BETHESDA 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, BETHESDA 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 BETHESDA HOSPITAL, INC. AND TRIHEALTH, INC. IS ESTIMATED TO BE 1,663,000 AND 11.0 PERCENT OF THIS POPULATION IS UNINSURED. PART VI, LINE 5: BETHESDA HOSPITAL, INC. IS COMPRISED OF VARIOUS MEDICAL SERVICES INCLUDING BETHESDA NORTH HOSPITAL ("NORTH"), BETHESDA MEDICAL CENTER AT ARROW SPRINGS ("ARROW SPRINGS") AND BETHESDA BUTLER HOSPITAL ("HOSPITAL"). ITS BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY REPRESENTATIVES. NORTH IS A 458-BED ACUTE TERTIARY TEACHING HOSPITAL. NORTH PROVIDES A 24-HOUR EMERGENCY DEPARTMENT, INTENSIVE CARE UNITS AND A LEVEL II SPECIAL CARE NURSERY. SERVICES ARE OPEN TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. IN ADDITION, NORTH HAS AN OPEN MEDICAL STAFF AND A HISTORY OF TRAINING AND EDUCATING MEDICAL RESIDENTS AND HEALTH CARE PROFESSIONALS. FINALLY IN CONCERT WITH THE HATTON INSTITUTE AT THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, AN AFFILIATED HOSPITAL, NORTH CONDUCTS MEDICAL AND SCIENTIFIC RESEARCH PROGRAMS INCLUDING STUDIES THAT ARE NOT COMMERCIALLY SPONSORED. NORTH PARTICIPATES IN MEDICARE AND MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS, AND HAS AN ACTIVE CHARITY CARE PROGRAM.ARROW SPRINGS COMPRISES A FULLY STAFFED 24-HOUR EMERGENCY DEPARTMENT, PRIMARY CARE AND SPECIALIST PHYSICIANS, DIAGNOSTIC SERVICES, OCCUPATIONAL MEDICINE, PHYSICAL THERAPY AND A PHARMACY. IT PROVIDES THE SAME HIGH-QUALITY, PATIENT-CENTERED CARE AND SERVICES THAT IS PROVIDED BY NORTH. BUTLER IS A 10-BED SURGICAL HOSPITAL WITH EIGHT OPERATING ROOMS, THREE ENDOSCOPY SUITES, TWO PROCEDURE ROOMS AND A 24-HOUR EMERGENCY DEPARTMENT.THE BETHESDA HOSPITAL, INC. SERVICES DESCRIBED ABOVE, AND OTHERS NOT LISTED, PROMOTE COMMUNITY HEALTH IN ACUTE ILLNESS, IN MANAGEMENT OF CHRONIC DISEASE, AND IN EDUCATION AND PREVENTION MEASURES WHICH SEEK TO REDUCE THE BURDENS ON THE GOVERNMENT. PART VI, LINE 6: IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH, INC. TO CREATE AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION. TRIHEALTH, INC.'S SITES INCLUDE FOUR 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. 1 UPTOWN CONSORTIUM INC 629 OAK STREET SUITE 306 CINCINNATI OH 45206 200688727 501(C)(3) 142100 GENERAL PURPOSE BETHESDA FOUNDATION INC 619 OAK STREET CINCINNATI OH 45206 237374129 501(C)(3) 27930 SPONSORSHIP THE HEALTH COLLABORATIVE 2649 ERIE AVENUE 2ND FLOOR CINCINNATI OH 45208 311449807 501(C)(3) 20825 GENERAL PURPOSE CENTER FOR RESPITE CARE INC PO BOX 141301 CINCINNATI OH 45229 202544994 501(C)(3) 24500 GENERAL PURPOSE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI INC 619 OAK STREET CINCINNATI OH 45206 311206047 501(C)(3) 5880 SPONSORSHIP AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 49000 SPONSORSHIP 6 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: BETHESDA HOSPITAL, INC. ("HOSPITAL") PROVIDES GRANTS TO OTHER ORGANIZATIONS DIRECTLY ON A VERY LIMITED BASIS. IN THOSE INSTANCES, THE DEPARTMENT GRANTING THE FUNDS IS RESPONSIBLE FOR OBTAINING AND STORING ALL NECESSARY INFORMATION FROM THE OTHER ORGANIZATION RELATIVE TO HOW THE FUNDS WILL BE SPENT. GENERALLY, GRANTS ARE PROVIDED, ON BEHALF OF HOSPITAL THROUGH TRIHEALTH, INC. ("TRIHEALTH"), A SUPPORTING ORGANIZATION OF HOSPITAL, WHICH PROVIDES ADMINISTRATIVE SUPPORT SERVICES TO HOSPITAL. AS SUCH, TRIHEALTH IS RESPONSIBLE FOR MONITORING THE USE OF HOW THE FUNDS WILL BE SPENT. 0 1 0 0 0 0 0 0 0 JOHN PROUT 0 897189 0 440000 0 654732 0 322151 0 9262 0 2323334 0 623396 STEPHEN BLATT MD 0 123837 0 0 0 45000 0 20252 0 0 0 189089 0 0 DONNA NIENABER ESQ 0 317613 0 179465 0 43621 0 148484 0 16298 0 705481 0 0 CRAIG RUCKER 0 428317 0 166025 0 24639 0 132778 0 10700 0 762459 0 0 WILLIAM GRONEMAN 0 372208 0 147256 0 59177 0 152964 0 25593 0 757198 0 18369 GERALD OLIPHANT 0 461201 0 180472 0 18869 0 115686 0 23761 0 799989 0 0 GEORGES FEGHALI MD 0 378527 0 268943 0 16824 0 159727 0 21734 0 845755 0 0 JOHN ROBINSON MD 0 270570 0 71915 0 11389 0 59119 0 25074 0 438067 0 0 BARB BOYNE 0 149317 0 36648 0 6586 0 44665 0 19235 0 256451 0 0 DAVE DORNHEGGEN 0 275632 0 100029 0 20434 0 105199 0 15169 0 516463 0 0 LOREN HIRATZKA MD 200454 0 450 200000 0 0 38748 0 0 0 239652 200000 0 0 SANDRA LOBERT 178419 0 42616 0 15806 0 33743 0 6958 0 277542 0 0 0 RAYMOND HELLMANN MD 232619 0 200 0 3275 0 42503 0 13806 0 292403 0 0 0 ALAN ALTMAN MD 214216 0 0 0 18500 0 64780 0 23078 0 320574 0 0 0 LAURA TRICE MD 219319 0 200 0 1828 0 32786 0 7583 0 261716 0 0 0 MICHAEL CROFTON 0 214926 0 53626 0 31524 0 57136 0 22311 0 379523 0 0 SHER MCCLANAHAN 0 276370 0 95188 0 19919 0 103522 0 10867 0 505866 0 0 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 - $270,273 DONNA NIENABER, ESQ. - $80,229 MICHAEL CROFTON - $19,219 CRAIG RUCKER - $90,400 SHER MCCLANAHAN - $48,246 WILLIAM GRONEMAN - $91,107 GERALD OLIPHANT - $94,160 GEORGES FEGHALI, MD - $101,398 JOHN ROBINSON, MD - $33,755 DAVE DORNHEGGEN - $48,639 SANDRA LOBERT - $11,304 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 - $623,396 WILLIAM GRONEMAN - $18,369 SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: TRIHEALTH, INC., A RELATED ORGANIZATION OF BETHESDA 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 4A - SEVERANCE PAYMENTS: 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 2012 CALENDAR YEAR. FORM 990, PART VI, SECTION A, LINE 2 THE OFFICERS, DIRECTORS AND TRUSTEES OF BETHESDA HOSPITAL, INC. LISTED IN PART VII, SECTION A HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARDS OF TRIHEALTH, INC., TRIHEALTH HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, ALL AFFILIATED ENTITIES OF BETHESDA HOSPITAL, INC. WAYNE SHIRCLIFF, STUART DONOVAN, MD, CRAIG EISENTROUT, 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. 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. 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 BETHESDA HOSPITAL, INC. JOHN PROUT, DONNA NIENABER, ESQ., CRAIG RUCKER, WILLIAM GRONEMAN, GERALD OLIPHANT, STUART DONOVAN, MD, STEPHEN BLATT, MD, GEORGES FEGHALI, MD, JOHN ROBINSON, MD, BARB BOYNE AND DAVE DORNHEGGEN 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. 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 BETHESDA HOSPITAL, INC. HAS TWO CORPORATE MEMBERS - BETHESDA, INC. (VOTING MEMBER) AND TRIHEALTH, INC. (NON-VOTING MEMBER). FORM 990, PART VI, SECTION A, LINE 7A BETHESDA, INC. HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF BETHESDA HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B BETHESDA, INC. MUST APPROVE CERTAIN FINANCIAL TRANSACTIONS, AMENDMENTS TO BETHESDA HOSPITAL, INC.'S GOVERNING DOCUMENTS AND THOSE MATTERS RESERVED 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. 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 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 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 BETHESDA HOSPITAL, INC.'S OFFICERS AND KEY EMPLOYEES, 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 BETHESDA HOSPITAL, INC.'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CONTRIBUTED CAPITAL TO PARENT -10,000,000. LOSS ON UNCONSOLIDATED ORGANIZATIONS -28,593,284. CHANGE IN PENSION PLAN/SERP FUNDED STATUS 26,007,221. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS HELD AT FOUNDATION 754,806. MISCELLANEOUS -8,536. VOLUNTEER INFORMATION FORM 990, PART I, LINE 6 DURING THE TAX YEAR, BETHESDA HOSPITAL, INC. WAS ASSISTED BY 1,400 VOLUNTEERS WHO DONATED APPROXIMATELY 143,300 HOURS. VOLUNTEERS HELPED THROUGH THE FOLLOWING: BETHESDA NORTH HOSPITAL AND BETHESDA CENTER - ARROW SPRINGS ("HOSPITALS") THESE FACILITIES WERE ASSISTED BY 1,333 VOLUNTEERS WHO DONATED APPROXIMATELY 139,000 HOURS IN ALMOST EVERY DEPARTMENT OF THE HOSPITALS. VOLUNTEERS PROVIDED SERVICES IN THE VARIOUS WAITING ROOMS (E.G. ENDOSCOPIC CATHETERIZATION, SURGERY) AS WELL AS BOTH THE INPATIENT AND OUTPATIENT PHARMACIES AND ALL AREAS OF PHYSICAL THERAPY. ESCORT VOLUNTEERS DISCHARGED A LARGE PERCENTAGE OF BOTH INPATIENTS AND OUTPATIENTS AS WELL AS PERFORMING ERRANDS FOR THE HOSPITALS. ALSO VOLUNTEERS OF THE HOSPITALS PROVIDED HEALING TOUCH TO PATIENTS AND OUTPATIENTS, VISITED WITH PATIENTS AND THEIR FAMILIES, PROVIDED PASTORAL CARE SERVICES TO PATIENTS AND PROVIDED THE BOOK CART TO PATIENTS EACH DAY. FINALLY, CRAFTER VOLUNTEERS, WORKING FROM THEIR HOMES, MADE VARIOUS ITEMS FOR PATIENTS AND NEWBORNS. SENIOR SERVICES (SENIORITY AND SENIORLINK) - 4 VOLUNTEERS VOLUNTEERS OF SENIORITY, WHICH PROVIDES CONTINUING EDUCATION FOR OLDER ADULTS AND THEIR FAMILIES, ASSISTED IN VARIOUS SPECIAL EVENTS/PROJECTS AS WELL AS PROVIDED OFFICE HELP. SENIORLINK HELPS PEOPLE 55 AND OLDER WITH CHRONIC CARE NEEDS TO STAY HEALTHY AND INDEPENDENT AS LONG AS POSSIBLE BY PROVIDING PARTICIPANTS WITH MEDICAL AND SOCIAL SERVICES DELIVERED IN THEIR HOMES AND AT ONE OF THREE SENIORLINK DAY HEALTH CENTERS. VOLUNTEERS ASSISTED IN VARIOUS SERVICES OFFERED BY SENIORLINK. EXECUTIVE COMMITTEE COMPOSITION AND AUTHORITY FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF TRUSTEES OF BETHESDA HOSPITAL, 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, THE SECRETARY AND TWO OTHER BOARD MEMBERS ALL IN ACCORDANCE WITH THE NETWORK AFFILIATION AGREEMENT. CHANGE IN PROCESS OF AUDIT OVERSIGHT OR SELECTION OF INDEPENDENT AUDITOR FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF BETHESDA HOSPITAL, INC. ("HOSPITAL") 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. IN ADDITION, HOSPITAL'S FINANCIAL STATEMENTS ARE AUDITED WITH BETHESDA, INC., THE PARENT ORGANIZATION OF HOSPITAL. BETHESDA, INC. HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF BOTH ITS AND ITS SUBSIDIARIES 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 EITHER TRIHEALTH OR BETHESDA, INC. ADOPTION OF WRITTEN POLICY AND PROCEDURES EVALUATING JV ARRANGEMENTS FORM 990, PART VI, SECTION B, LINE 16B DURING THE YEAR, BETHESDA HOSPITAL, INC. PARTICIPATED IN A JOINT VENTURE WITH ONE OR MORE TAXABLE PERSONS AND/OR ORGANIZATIONS. AS OF THE END OF THE FISCAL YEAR, BETHESDA HOSPITAL, INC. HAD NOT ADOPTED A WRITTEN POLICY OR PROCEDURE THAT REQUIRES THE ORGANIZATION TO NEGOTIATE, IN ITS TRANSACTIONS AND ARRANGEMENTS WITH OTHER MEMBERS OF THE VENTURE OR ARRANGEMENT, SUCH TERMS AND SAFEGUARDS AS ARE ADEQUATE TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. HOWEVER, ALL JOINT VENTURES, WHEN ENTERED INTO, HAVE OUTSIDE LEGAL COUNSEL REVIEW OF THE OPERATING AGREEMENT OR OTHER ORGANIZATIONAL DOCUMENTS TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED PRIOR TO THE COMMENCEMENT OF THE JOINT VENTURE. ONCE THE JOINT VENTURE COMMENCES, BETHESDA HOSPITAL, INC. PERSONNEL MONITORS ITS ACTIVITITES TO ENSURE THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. AVERAGE HOURS PER WEEK FORM 990, PART VII, SECTION A THE OFFICERS AND DIRECTORS FOR BETHESDA 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. 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 SERVE AS FACULTY AT THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. REMAINING COMPENSATION SHOWN IS FOR THOSE DUTIES AND NOT FOR SERVING AS A DIRECTOR. BETHESDA INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311108895 INVESTMENT MANAGEMENT OH SECTION 501(C)(3) SCHEDULE A, LINE 11C N/A 0 BETHESDA FOUNDATION INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 237374129 FUNDRAISING OH SECTION 501(C)(3) SCHEDULE A, LINE 7 BETHESDA 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 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 TRIHEALTH INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311438846 SUPPORT AFFILIATED HOSPITALS OH SECTION 501(C)(3) SCHEDULE A, LINE 11B N/A 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 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 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 HOSPITALINC 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 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 BN NORTHEAST CARDIAC CENTER LLC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 201297322 CARDIAC CARE OH N/A RELATED -193256 0 1 0.57950 10600 MONTGOMERY LLC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 261964995 PROPERTY MANAGEMENT OH N/A TJ CUBEDMONTGOMERY INC 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 261964885 HOLDING COMPANY OH N/A S 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 1 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 BETHESDA HEALTHCARE INC A 32454 FMV TRIHEALTH PHYSICIAN ENTERPRISE CORP A 325433 FMV TRIHEALTH PHYSICIAN INSTITUTE A 155449 FMV BETHESDA INC B 10000000 CASH BETHESDA FOUNDATION INC C 1231157 CASH GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO K 11440 FMV BETHESDA PROPERTIES INC K 1625583 FMV BETHESDA HEALTHCARE INC K 412467 FMV TRIHEALTH PHYSICIAN ENTERPRISE CORP K 8400 FMV TRIHEALTH INC K 5693 FMV TRIHEALTH INC L 176700 FMV TRIHEALTH PHYSICIAN SOLUTIONS INC M 274245 FMV TRIHEALTH INC P 81903207 COST TRIHEALTH INC P 188611040 COST HOSPICE OF CINCINNATI INCORPORATED O 32831230 FMV BETHESDA INC O 2004479 FMV FERNSIDE INC A CENTER FOR GRIEVING CHILDREN O 397029 FMV BETHESDA FOUNDATION INC O 1024561 FMV BETHESDA PROPERTIES INC O 463716 FMV