2013-05-10T11:38:06-05:00 2012-06-30 861065772 DELOITTE TAX LLP 250 EAST FIFTH STREET SUITE 1900 CINCINNATI OH 45202 990 2011-07-01 311383365 TRIHEALTH PHYSICIAN ENTERPRISE CORP TRIH 5135696575 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 MICHAEL CROFTON 5135696575 2013-05-10 1 5137847100 2011 2016-02-24 21:20:13Z WILLIAM GRONEMAN 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 174929516 0 X WWW.TRIHEALTH.COM X 1993 OH PROVIDES THE COMMUNITY NECESSARY MEDICAL CARE THROUGH PRIMARY CARE & SPECIALTY PHYSICIANS. 12 2 1454 2 37356 34726 0 0 166139485 174534183 -5309 -109864 716621 395333 166850797 174819652 3090 2170 0 0 122373848 126325514 0 0 0 57436311 63036769 179813249 189364453 -12962452 -14544801 34311566 35366218 81074337 36122886 -46762771 -756668 TRIHEALTH PHYSICIAN ENTERPRISE CORP. PROVIDES THE COMMUNITY WITH NECESSARY MEDICAL CARE THROUGH PRIMARY CARE AND SPECIALTY PHYSICIANS SUPPORTING THE MISSIONS OF BETHESDA HOSPITAL, INC. AND THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. 0 0 160542026 2170 160634650 TRIHEALTH PHYSICIAN ENTERPRISE CORP. ("TPEC") IS THE SOLE MEMBER OF VARIOUS PHYSICIAN GROUPS ALIGNED WITH TRIHEALTH, INC. THE MORE THAN 200 PHYSICIANS PRACTICING WITHIN THESE GROUPS BENEFIT FROM AN INTERCONNECTIVITY WITH SERVICES AND INFORMATION AT TRIHEALTH HOSPITALS AND AMBULATORY CARE CENTERS. THIS RESULTS IN MORE STREAMLINED, PATIENT-FOCUSED CARE, PROVIDED WITH AN EMPHASIS ON QUALITY AND SAFETY. THE PHYSICIAN GROUPS INCLUDE PRIMARY CARE PHYSICIANS (FAMILY PRACTICE, GENERAL PRACTICE, GYNECOLOGY, INTERNAL MEDICINE, AND PEDIATRICS) AS WELL AS SPECIALIST PHYSICIANS (ALLERGY MEDICINE, COLORECTAL SURGERY, DERMATOLOGY, ENDOCRINOLOGY, GASTROENTEROLOGY, PHYSICIAL REHABILITATION, PODIATRY, OTOLARYNGOLOGY, RHEUMATOLOGY, ORTHOPEDICS). 160542026 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 177 0 1 1454 1 1 1 0 0 0 0 0 0 0 0 0 X 12 2 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL CROFTON 5135696577 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 CHRISTOPHER HAYNER MD 60.00 X 383591 0 57208 STEPHEN BIRD MD 60.00 X 430868 0 47388 STEPHEN CLEVES MD 60.00 X 442391 0 55753 SCOTT MASSA MD 60.00 X 265846 0 45423 DAVID MORAD MD 60.00 X 610883 0 68289 JOHN MCDONOUGH MD 1.00 X 0 0 0 ROBERT STAUTBERG 1.00 X 0 0 0 JOHN PROUT 1.00 X 0 1226184 296426 GEORGES FEGHALI MD 1.00 X 0 513570 155997 WILLIAM GRONEMAN 1.00 X X 0 548818 164974 CRAIG RUCKER 1.00 X X 0 543549 129732 JERRY OLIPHANT 1.00 X 0 598073 124115 DONNA NIENABER ESQ 1.00 X 0 481624 151957 VESTA JOHNS 60.00 X 251611 0 86109 TIMOTHY GRAMMAN 60.00 X 279305 0 46471 MARC ORLANDO MD 60.00 X 1451843 0 66401 STEVEN WUNDER MD 60.00 X 925996 0 73322 GEORGE KERLAKIAN MD 60.00 X 921618 0 74338 JOHN SCHWEGMANN MD 60.00 X 793809 0 53886 NANCY MCDONOUGH MD 60.00 X 714303 0 92793 7472064 3911818 1790582 259 0 1 0 ATHENA HEALTH INC 311 ARSENAL ST WATERTOWN MA 02472 BILLING 1626660 GE HEALTHCARE IITS USA PO BOX 277475 ATLANTA GA 30384 SOFTWARE 648163 QCP MANAGEMENT SERVICES LLC 2753 ERIE AVENUE CINCINNATI OH 45208 MEDICAL OFFICE MANAGEMENT 624996 EQUATION CONSULTING INC 2650 S DECKER LAKE BLVD SALT LAKE CITY UT 84119 CONSULTING 342668 NUANCE COMMUNICATIONS INC 1 WAYSIDE ROAD BURLINGTON MA 01803 TECHNOLOGY 302025 19 PATIENT SERVICES 621990 160474565 160474565 PHARMACY REVENUE 446110 14051218 14051218 AFFILIATED ORG. RENT 531120 8400 8400 174534183 88028 0 88028 88028 88028 109864 -109864 -109864 -109864 TRANSCRIPTION REVENUE 621990 142798 142798 MEDICAL RECORDS 621990 115409 115409 MISCELLANEOUS 900099 49098 11742 37356 307305 174819652 160634650 37356 14147646 2170 2170 3071136 2407640 663496 339546 339546 105872122 100332420 5539702 4143556 2668300 1475256 7589002 6509190 1079812 5310152 5052603 257549 1000934 625934 375000 19248 19248 4845500 2935707 1909793 708470 51617 656853 2984336 1329503 1654833 1476744 1399599 77145 8621250 3422077 5199173 162039 108836 53203 222 222 1829635 844258 985377 2123351 534206 1589145 MEDICAL & DIETARY 30581930 30104058 477872 BAD DEBTS 3610114 632347 2977767 ALLOCATIONS 3352824 3352824 UBI TAX 3900 700 3200 1716272 1241093 475179 189364453 160542026 28822427 0 2308115 2080261 11032338 12108962 1807978 1650539 282666 3106 14826105 7702089 7049659 7124016 11558810 12399334 272000 0 34311566 35366218 30614687 35980060 109239 43222 50350411 99604 81074337 36122886 X -46762771 -756668 -46762771 -756668 34311566 35366218 X -14544801 60550904 X X 0 0 0 X 119490067 126443822 137413461 151990725 160459562 695797637 17100398 15722137 15202529 14438620 14074621 76538305 136590465 142165959 152615990 166429345 174534183 772335942 0 0 0 772335942 84283 50138 121320 127969 88028 471738 6583 34032 29517 70132 84283 50138 127903 162001 117545 541870 132452 542898 556014 269949 1501313 136674748 142348549 153286791 167147360 174921677 774379125 0.99740 0.99750 0.00070 0.00070 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: EMR REIMBURSEMENT MISCELLANEOUS TRANSCRIPTION REVENUE MEDICAL RECORDS 0 0 0 0 0 0 0 0 1 12886 12886 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: DURING THE TAX YEAR, TRIHEALTH PHYSICIAN ENTERPRISE CORP. PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. 270000 270000 1878489 999801 878688 2093705 887010 1206695 8229505 5815278 2414227 2354406 2354406 7124016 LONG-TERM DEBT 33550 ACCRUED UNEMPLOYMENT 66054 99604 0 1 0 0 0 0 0 0 0 CHRISTOPHER HAYNER MD 383260 0 0 0 331 0 38369 0 18839 0 440799 0 0 0 STEPHEN BIRD MD 430454 0 0 0 414 0 26949 0 20439 0 478256 0 0 0 STEPHEN CLEVES MD 297985 0 143400 0 1006 0 37843 0 17910 0 498144 0 0 0 SCOTT MASSA MD 212355 0 52459 0 1032 0 38618 0 6805 0 311269 0 0 0 DAVID MORAD MD 589909 0 20200 0 774 0 41359 0 26930 0 679172 0 0 0 JOHN PROUT 0 859109 0 338532 0 28543 0 286218 0 10208 0 1522610 0 0 GEORGES FEGHALI MD 0 360606 0 122375 0 30589 0 133633 0 22364 0 669567 0 0 WILLIAM GRONEMAN 0 360315 0 120587 0 67916 0 141510 0 23464 0 713792 0 16587 CRAIG RUCKER 0 395101 0 130118 0 18330 0 120190 0 9542 0 673281 0 0 JERRY OLIPHANT 0 433802 0 145983 0 18288 0 102679 0 21436 0 722188 0 0 DONNA NIENABER ESQ 0 301071 0 139124 0 41429 0 135545 0 16412 0 633581 0 0 VESTA JOHNS 197243 0 47349 0 7019 0 62245 0 23864 0 337720 0 0 0 TIMOTHY GRAMMAN 218371 0 52130 0 8804 0 25822 0 20649 0 325776 0 0 0 MARC ORLANDO MD 1451590 0 0 0 253 0 37046 0 29355 0 1518244 0 0 0 STEVEN WUNDER MD 925222 0 0 0 774 0 43891 0 29431 0 999318 0 0 0 GEORGE KERLAKIAN MD 886344 0 34500 0 774 0 47518 0 26820 0 995956 0 0 0 JOHN SCHWEGMANN MD 793395 0 0 0 414 0 26786 0 27100 0 847695 0 0 0 NANCY MCDONOUGH MD 713911 0 0 0 392 0 62790 0 30003 0 807096 0 0 0 PART I, LINE 4B 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., THE RELATED ORGANIZATION THAT PAID THE SALARIES OF THE FOLLOWING INDIVIDUALS LISTED IN SCHEDULE J, PART II, CONTRIBUTED TO A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN THE AMOUNTS AS NOTED: JOHN PROUT - $236,082 DONNA NIENABER, ESQ. - $68,563 GEORGES FEGHALI, M.D. - $76,814 WILLIAM GRONEMAN - $80,979 CRAIG RUCKER - $78,831 GERALD OLIPHANT - $82,817 FINALLY,THE FOLLOWING INDIVIDUALS LISTED IN SCHEDULE J, PART II, RECEIVED A PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WHICH WAS TREATED AS TAXABLE COMPENSATION BY TRIHEALTH, INC. AS APPROPRIATE: WILLIAM GRONEMAN - $16,587 SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: TRIHEALTH, INC., A RELATED ORGANIZATION OF TRIHEALTH PHYSICIAN ENTERPRISE CORP. ("TPEC"), USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF TPEC'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 TRIHEALTH PHYSICIAN ENTERPRISE CORP. 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 2011 CALENDAR YEAR. QCP MGMT SERVICES LLC MORE THAN 5% MEMBER STEPHEN CLEVES, M.D. CURRENT TRUSTEE 624996 MGMT FEES 0 JAY HAYNER MD FAMILY MEMBER CHRISTOPHER HAYNER, M.D. CURRENT TRUSTEE 339546 EMPLOYEE 0 FORM 990, PART VI, SECTION A, LINE 2 JOHN PROUT, GEORGES FEGHALI, M.D., WILLIAM GRONEMAN, CRAIG RUCKER, JERRY OLIPHANT, DONNA NIENABER, ESQ. THE ABOVE-MENTIONED OFFICERS, DIRECTORS AND TRUSTEES OF TRIHEALTH PHYSICIAN ENTERPRISE CORP. (TPEC) LISTED IN PART VII, SECTION A 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., THE SINGLE CORPORATE MEMBER OF TPEC. FORM 990, PART VI, SECTION A, LINE 6 TRIHEALTH PHYSICIAN ENTERPRISE CORP. HAS A SINGLE CORPORATE MEMBER, TRIHEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7A TRIHEALTH PHYSICIAN ENTERPRISE CORP. (TPEC) HAS A SINGLE CORPORATE MEMBER, TRIHEALTH, INC. WHICH HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF TPEC. FORM 990, PART VI, SECTION A, LINE 7B TRIHEALTH, INC. MUST APPROVE CERTAIN FINANCIAL TRANSACTIONS, BUDGETS AND COMPENSATION, CHANGES TO TRIHEALTH PHYSICIAN ENTERPRISE CORP.'S GOVERNING DOCUMENTS OR MISSION, FORMATION OF SUBSIDIARIES AND CERTAIN OPERATIONAL PROCESS. FORM 990, PART VI, SECTION B, LINE 11 MEMBERS OF THE BOARD ARE PROVIDED AN ELECTRONIC COPY OF FORM 990 PRIOR TO FILING ALONG WITH SENIOR MANAGEMENT COMMENTARY PRIOR TO FILING. SUBSEQUENT TO BOARD REVIEW, THE RETURNS ARE FILED MAKING NON-SUBSTANTIVE CHANGES AS 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. DURING THIS TAX YEAR, THE ORGANIZATION INADVERTENTLY FAILED TO SOLICIT INFORMATION REGARDING CERTAIN FINANCIAL INTERESTS AS REQUIRED UNDER ITS POLICY; HOWEVER, IT CONTINUED TO ENFORCE AND MONITOR COMPLIANCE AS OTHERWISE REQUIRED WITH ALL OTHER INFORMATION IT SOLICITED AND RECEIVED. FORM 990, PART VI, SECTION B, LINE 15 IN DETERMINING COMPENSATION OF THE TRIHEALTH PHYSICIAN ENTERPRISE CORP.'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 TRIHEALTH PHYSICIAN ENTERPRISE CORP.'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 5: RECLASS OF INTER-COMPANY PAYABLE TO NET ASSETS 60,550,904. TOTAL TO FORM 990, PART XI, LINE 5: 60,550,904. ESTIMATE OF HOURS DEVOTED TO RELATED ORGANIZATION FORM 990, PART VII, SECTION A DIRECTORS AND OFFICERS (AS NOTED WITH A "SCH O" REFERENCE) FOR TRIHEALTH PHYSICIAN ENTERPRISE CORP. PROVIDE SERVICES TO TRIHEALTH, INC. (A RELATED ORGANIZATION WHO PAID THE INDIVIDUALS) AND ITS SUBSIDIARIES/AFFILIATES ("TRIHEALTH"). HOURS WORKED ARE NOT TRACKED ON AN ENTITY BY ENTITY BASIS. THE COMPENSATION REPORTED ON THE FORM 990, PART VII WAS PAID TO THESE INDIVIDUALS IN FULFILLMENT OF THEIR DUTIES AS FULL-TIME, 60 HOURS-PER-WEEK EMPLOYEES OF TRIHEALTH. TRIHEALTH G LLC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 202305158 PHYSICIAN PRACTICES OH 119950866 26658733 N/A TRIHEALTH Q LLC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 202305015 PHYSICIAN PRACTICES OH 21537173 2818806 N/A TRIHEALTH PHYSICIAN PRACTICES LLC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 311444353 PHYSICIAN PRACTICES OH 28283286 5033469 N/A TRIHEALTH HF LLC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 273473834 PHYSICIAN PRACTICES OH 5048327 746162 N/A TRIHEALTH U LLC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 455135559 URGENT CARE CENTERS OH 0 0 N/A 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 0 TRIHEALTH PHYSICIAN INSTITUTE 619 OAK STREET-ACCOUNTING 3 WEST CINCINNATI OH 45206 311074519 PHYSICIAN SPECIALTY 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 HEALTH CLINIC OH SECTION 501(C)(3) SCHEDULE A, LINE 7 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN SOLUTIONS INC 619 OAK STREET - ACCOUNTING 3 WEST CINCINNATI OH 45206 311444353 CLAIMS ADMINISTRATION OH N/A C 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 TRIHEALTH INC R 1861201 COST TRIHEALTH INC J 438120 FMV TRIHEALTH INC C 14543703 FMV TRIHEALTH PHYSICIAN SOLUTIONS INC L 68040 FMV