2024-05-13T10:33:08-05:00 2023-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2022-07-01 311242442 BETHESDA FAMILY PRACTICE CENTER BETH 5135696575 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 MICHAEL CROFTON VP-FINANCE 5135696577 2024-05-13 1 MICHAEL CROFTON 999009999 1 SHAWNA M JANSONS P01222873 3174648600 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARK CLEMENT 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 0 0 X WWW.TRIHEALTH.COM X 1989 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 13 10 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED BY OPERATING A FAMILY MEDICAL PRACTICE THAT PROVIDES PRIMARY CARE, VIA ATTENDING PHYSICIANS AND MEDICAL RESIDENTS, TO MEMBERS OF THE LOCAL COMMUNITY FROM ALL SOCIO-ECONOMIC BACKGROUNDS. 0 0 0 0 0 SEE SCHEDULE O 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 0 0 X MICHAEL CROFTON 5135696577 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 X SR SALLY DUFFY SECRETARY 1.00 3.00 X X 0 0 0 RALPH MICHAEL VICE CHAIRPERSON 1.00 3.00 X X 0 0 0 ROBERT COLLINS MD TRUSTEE 1.00 3.00 X 0 0 0 MARK CLEMENT PRESIDENT/CEO 1.00 60.00 X X 0 2238265 79463 PHILLIP CASTELLINI TRUSTEE 1.00 3.00 X 0 0 0 KATHY KELLY CHAIRPERSON 1.00 3.00 X X 0 0 0 THEODORE TORBECK TREASURER 1.00 3.00 X X 0 0 0 PHILIP FOSTER TRUSTEE 1.00 3.00 X 0 0 0 QUINT STUDER TRUSTEE 1.00 3.00 X 0 0 0 RANCE DUKE TRUSTEE 1.00 3.00 X 0 0 0 CYNTHIA BOOTH TRUSTEE 1.00 3.00 X 0 0 0 KRISTIN COPPAGE MD MED STAFF PRESIDENT-GOOD SAM 1.00 3.00 X 0 940721 97227 LORRAINE STEPHENS MD MED STAFF PRESIDENT-BETHESDA 1.00 3.00 X 0 244008 74007 ANDREW DEVOE ASST TREASURER/EVP CFO 1.00 60.00 X 0 1284173 95684 STEVE GRACEY ASST SECRETARY/SVP LEGAL 1.00 60.00 X 0 675796 84250 HELEN KOSELKA MD CHIEF MEDICAL OFFICER 1.00 60.00 X 0 770817 100206 JOHN WARD SVP-BETHESDA REGION 1.00 60.00 X 0 775177 89387 TERRI HANLON-BREMER CHIEF OPERATING OFFICER 1.00 60.00 X 0 830439 79566 KEVIN JOSEPH MD FORMER KEY EMPLOYEE 0.00 0.00 X 0 660175 46579 0 8419571 746369 0 1 1 0 0 X 0 0 0 0 X 0 0 0 0 X 0 0 0 0 X 0 0 0 0 0 0 0 0 0 0 X 0 X X 0 1 X 1 0 X X 1 BETHESDA HOSPITAL INC 310537122 3 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE A, PART I, LINE 11G, COLUMN (VI) BETHESDA FAMILY PRACTICE CENTER ("BFPC") CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF BETHESDA HOSPITAL, INC. (THE "SUPPORTED ORGANIZATION"), AS REQUIRED BY TREAS. REG. 1.509(A)-4(F)(3)(II). THE SUPPORTED ORGANIZATION SPONSORS THE BETHESDA FAMILY MEDICINE RESIDENCY PROGRAM. BFPC FUNCTIONS AS A PRIVATE PRACTICE TO ENABLE THE SUPPORTED ORGANIZATION'S MEDICAL RESIDENTS TO PROVIDE SERVICES TO PATIENTS. BFPC PROVIDES THE MEDICAL RESIDENTS WITH AN OFFICE MANAGER, MEDICAL RECORDS AND BUSINESS OFFICE PERSONNEL, AND NURSING STAFF. BFPC OFFERS 16 EXAMINATION ROOMS, PROVIDES SERVICES USING ITS ON-SITE X-RAY EQUIPMENT, AND ENABLES MEDICAL RESIDENTS TO PERFORM MINOR SURGICAL PROCEDURES IN ITS ON-SITE SURGICAL ROOM. BFPC IS LOCATED NEAR NORWOOD, OHIO (A SUBURB OF CINCINNATI) AND SERVES PATIENTS FROM ALL SOCIO-ECONOMIC BACKGROUNDS. SCHEDULE A, PART IV, SECTION A, LINE 1 BETHESDA FAMILY PRACTICE CENTER ("BFPC") IS AN UNINCORPORATED NONPROFIT ASSOCIATION AS DESCRIBED IN CHAPTER 1745 OF THE OHIO REVISED CODE ("R.C."). R.C. 1745.05(M) DEFINES AN UNINCORPORATED NONPROFIT ASSOCIATION AS "AN UNINCORPORATED ORGANIZATION, CONSISTING OF TWO OR MORE MEMBERS JOINED BY MUTUAL CONSENT PURSUANT TO AN AGREEMENT, WRITTEN, ORAL, OR INFERRED FROM CONDUCT, FOR ONE OR MORE COMMON, NONPROFIT PURPOSES." BFPC DOES NOT HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS, ALTHOUGH IT DOES HAVE GOVERNING PRINCIPLES, WHICH ARE "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS," AS DEFINED IN R.C. 1745.05(D). BFPC'S GOVERNING PRINCIPLES DESIGNATE THE SUPPORTED ORGANIZATION. THERE IS A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN BFPC AND THE SUPPORTED ORGANIZATION. THE SUPPORTED ORGANIZATION HAS MAINTAINED THE BETHESDA FAMILY MEDICINE RESIDENCY PROGRAM SINCE 1987. THE MAJORITY OF TRAINING FOR THE SUPPORTED ORGANIZATION'S MEDICAL RESIDENTS IN THE PROGRAM OCCURS AT THE SUPPORTED ORGANIZATION AND AT BFPC. BFPC FUNCTIONS AS A PRIVATE PRACTICE FOR THE SUPPORTED ORGANIZATION'S MEDICAL RESIDENTS, PROVIDING THEM WITH AN OFFICE MANAGER, MEDICAL RECORDS AND BUSINESS OFFICE PERSONNEL, AND NURSING STAFF. WITHOUT THE SUPPORT IT OBTAINS FROM BFPC, THE SUPPORTED ORGANIZATION WOULD NEED TO CREATE OR OTHERWISE OBTAIN OTHER EQUIVALENT TRAINING OPPORTUNITIES FOR ITS MEDICAL RESIDENTS. BFPC EXISTS TO FACILITATE TRAINING OF MEDICAL RESIDENTS PARTICIPATING IN THE SUPPORTED ORGANIZATION'S BETHESDA FAMILY MEDICINE RESIDENCY PROGRAM BY CREATING THE OPPORTUNITY FOR THE RESIDENTS TO PROVIDE MEDICAL SERVICES TO PATIENTS. THUS, BECAUSE OF THE HISTORIC AND CONTINUING RELATIONSHIP BETWEEN BFPC AND THE SUPPORTED ORGANIZATION, A SUBSTANTIAL IDENTITY OF INTERESTS HAS DEVELOPED BETWEEN THE TWO ORGANIZATIONS, AS CONTEMPLATED BY TREAS. REG. 1.509(A)-4(D)(2)(IV). SCHEDULE A, PART IV, SECTION B, LINE 1 BETHESDA FAMILY PRACTICE CENTER ("BFPC") OPERATES AS A DIVISION OR DEPARTMENT OF THE SUPPORTED ORGANIZATION AND NOT AS A SEPARATE ENTITY. BFPC DOES NOT MAINTAIN ITS OWN BOARD OF DIRECTORS; RATHER, ITS ACTIVITIES ARE OVERSEEN BY THE BOARD OF DIRECTORS OF THE SUPPORTED ORGANIZATION. THE GOVERNING BODY OF BFPC IS THE GOVERNING BODY OF THE SUPPORTED ORGANIZATION. THUS, THE SUPPORTED ORGANIZATION EXERCISES A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS, CONDUCT, AND ACTIVITIES OF BFPC, AS REQUIRED BY TREAS. REG. 1.509(A)-4(F)(4) AND TREAS. REG. 1.509(A)-4(G)(1)(I), BECAUSE THE SUPPORTED ORGANIZATION EFFECTIVELY CONTROLS THE POLICIES, PROGRAMS, AND ACTIVITIES OF BFPC. THE PURPOSES OF BFPC ARE CARRIED OUT BY BENEFITING THE SUPPORTED ORGANIZATION, AS REQUIRED BY TREAS. REG. 1.509(A)-4(G)(1)(II). BFPC EXISTS TO FACILITATE TRAINING OF MEDICAL RESIDENTS PARTICIPATING IN THE SUPPORTED ORGANIZATION'S BETHESDA FAMILY MEDICINE RESIDENCY PROGRAM BY CREATING THE OPPORTUNITY FOR THE RESIDENTS TO PROVIDE MEDICAL SERVICES TO PATIENTS. 0 X PART X, LINE 2: BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION AS DEFINED IN OHIO REVISED CODE SECTION 1745.05(M) AND AS SUCH IT IS NOT REQUIRED TO REGISTER WITH THE OHIO SECRETARY OF STATE NOR IS IT REQUIRED TO HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS. HOWEVER, THE CENTER DOES HAVE GOVERNING PRINCIPLES WHICH ARE DEFINED IN OHIO REVISED CODE SECTION 1745.05(D) AS "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS,". AS SUCH, NO GOVERNING DOCUMENTS ARE AVAILABLE TO PROVIDE UPON REQUEST. UNDER THESE GOVERNING PRINCIPLES, BETHESDA HOSPITAL, INC. ("HOSPITAL") IS DESIGNATED AS ITS SOLE MEMBER AND THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF THE HOSPITAL. AS AN UNINCORPORATED DIVISION OF THE HOSPITAL, THE CENTER DOES NOT MAINTAIN ITS OWN STANDALONE FINANCIAL STATEMENTS BUT RATHER THE FINANCIAL STATEMENTS ARE INCLUDED WITH THE HOSPITAL. WITH THAT SAID, 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 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 COMPLETED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AT JUNE 30, 2023 OR 2022. 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 UNCERTAIN TAX POSITIONS UNDER ASC 740-10-25: THE COMPANY COMPLETED AN ANALYSIS OF UNCERTAIN TAX POSITIONS AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED ON THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2023 OR 2022. 1 1 0 0 0 0 0 0 0 MARK CLEMENT PRESIDENT/CEO 0 1519500 0 527124 0 191641 0 55675 0 23788 0 2317728 0 0 ANDREW DEVOE ASST TREASURER/EVP CFO 0 738138 0 488508 0 57527 0 58175 0 37509 0 1379857 0 0 KRISTIN COPPAGE MD MED STAFF PRESIDENT-GOOD SAM 0 886848 0 6251 0 47622 0 60135 0 37092 0 1037948 0 0 TERRI HANLON-BREMER CHIEF OPERATING OFFICER 0 594629 0 164565 0 71245 0 58558 0 21008 0 910005 0 0 HELEN KOSELKA MD CHIEF MEDICAL OFFICER 0 575564 0 148657 0 46596 0 62752 0 37454 0 871023 0 0 JOHN WARD SVP-BETHESDA REGION 0 586982 0 152196 0 35999 0 58486 0 30901 0 864564 0 0 STEVE GRACEY ASST SECRETARY/SVP LEGAL 0 500083 0 140225 0 35488 0 47484 0 36766 0 760046 0 0 KEVIN JOSEPH MD FORMER KEY EMPLOYEE 0 28084 0 0 0 632091 0 37234 0 9345 0 706754 0 0 LORRAINE STEPHENS MD MED STAFF PRESIDENT-BETHESDA 0 186842 0 6037 0 51129 0 36849 0 37158 0 318015 0 0 PART I, LINES 4A-B ELIGIBLE EXECUTIVES (GENERALLY VICE PRESIDENTS AND ABOVE) PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NONE OF THE INDIVIDUAL(S) LISTED IN SCHEDULE J, PART II, RECEIVED A PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WHICH WAS TREATED AS TAXABLE COMPENSATION BY TRIHEALTH, INC. PART I, LINE 3 TRIHEALTH, INC., A RELATED ORGANIZATION OF BETHESDA FAMILY PRACTICE CENTER, 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 THE REPORTABLE INDIVIDUALS OF BETHESDA FAMILY PRACTICE CENTER ARE PAID BY TRIHEALTH, INC., A RELATED ORGANIZATION, RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN INTERNAL REVENUE CODE SECTION 501(C)(3). TRIHEALTH, INC. HAS A STANDARD EMPLOYEE SEVERANCE PACKAGE. GENERAL SEVERANCE PAY IS BASED ON LENGTH OF SERVICE. IN ADDITION, NOTICE PAY, IF APPLICABLE UNDER TRIHEALTH, 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 2022 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC. KEVIN JOSEPH, MD - $572,594 FORM 990, PART III, PROGRAM SERVICE ACCOMPLISHMENTS: IN 1987, THE BETHESDA FAMILY MEDICINE RESIDENCY PROGRAM ("PROGRAM") WAS STARTED BY BETHESDA HOSPITAL, INC., AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE PROGRAM PROVIDES MEDICAL RESIDENTS WITH VALUABLE GENERAL MEDICAL PRACTICE EXPERIENCE. BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS AN INTEGRAL PART OF THE PROGRAM AS IT PROVIDES A SIGNIFICANT PORTION OF THE CLINICAL TRAINING ALONG WITH BETHESDA NORTH HOSPITAL. JUST 12 MILES AWAY FROM BETHESDA NORTH HOSPITAL, THE CENTER IS A STATE-OF-THE-ART FACILITY LOCATED NEAR NORWOOD, OHIO (A SUBURB OF CINCINNATI). IT FUNCTIONS AS A PRIVATE FAMILY MEDICAL PRACTICE THAT PROVIDES PRIMARY CARE TO MEMBERS OF THE LOCAL COMMUNITY FROM ALL SOCIO-ECONOMIC BACKGROUNDS AND THE RESIDENTS ARE TRAINED IN POPULATION HEALTH AND OTHER EMERGING MODELS OF CARE. ITS STAFF INCLUDES ATTENDING PHYSICIANS, MEDICAL RESIDENTS, MEDICAL ASSISTANTS, NURSES, OFFICE MANAGER AND VARIOUS OTHER OFFICE PERSONNEL. THERE ARE 16 EXAM ROOMS, ON SITE ARE X-RAY EQUIPMENT AND A SURGICAL ROOM USED TO PERFORM MINOR SURGICAL PROCEDURES. MEDICAL RESIDENTS COMPLETE THE PROGRAM'S FAMILY MEDICINE RESIDENCE CURRICULUM THROUGH PRIMARY CARE TREATMENT OF THEIR PATIENTS AT THE CENTER, WITH THE GUIDANCE OF THE ATTENDING PHYSICIANS. THERE ARE THREE TEAMS AT THE CENTER. EACH TEAM HAS TWO ATTENDING PHYSICIANS, SIX RESIDENTS (TWO RESIDENTS FROM EACH PGY YEAR), AND TWO MEDICAL ASSISTANTS. THERE ARE ALSO TWO SPORTS MEDICINE FELLOWS. IN GENERAL, FIRST-YEAR RESIDENTS ARE ASSIGNED TO THE CENTER ONE HALF-DAY PER WEEK, SECOND-YEAR RESIDENTS ARE ASSIGNED TWO HALF-DAYS PER WEEK, AND THIRD-YEAR RESIDENTS ARE ASSIGNED THREE HALF-DAYS PER WEEK. CONTINUITY OF CARE IS ENCOURAGED AND EXPECTED IN OFFICE PATIENT ASSIGNMENTS. THE RESIDENTS ARE TAUGHT TO FACILITATE PARTNERSHIPS WITH THEIR PATIENTS, PROVIDING PERSONAL ACUTE, CHRONIC, AND PREVENTATIVE SERVICES THAT ARE COMPREHENSIVE, CONTINUOUS, EVIDENCE-BASED, ACCESSIBLE, AND AFFORDABLE. SEE FORM 990, SCHEDULE A, PART VI-SUPPLEMENTAL INFORMATION FOR ADDITIONAL INFORMATION. THE CENTER IS A STATE OF OHIO UNINCORPORATED ASSOCIATION WHOSE SOLE MEMBER AND SUPPORTED ORGANIZATION IS BETHESDA HOSPITAL, INC. AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF BETHESDA HOSPITAL, INC., THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE MEMBER AND NOT AS A SEPARATE ENTITY. AS SUCH, ALL FINANCIAL INFORMATION, GENERALLY REPORTED ON FORM 990, PART VIII, PART IX, PART X AND PART XI, IS REPORTED ON THE FORM 990 OF BETHESDA HOSPITAL, INC. (EIN: 31-0537122) AND NOT SEPARATELY ON THIS RETURN. IN ADDITION, DUE TO THIS TREATMENT, THE CENTER DOES NOT MAINTAIN ITS OWN GOVERNING BODY RATHER, ITS ACTIVITIES ARE OVERSEEN BY THE BOARD OF DIRECTORS OF BETHESDA HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 2 THE OFFICERS, DIRECTORS AND TRUSTEES OF THE BETHESDA FAMILY PRACTICE CENTER, BY VIRUTE OF IT BEING AN UNINCORPORATED DIVISION 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. MARK CLEMENT, JOHN WARD, HELEN KOSELKA, MD AND STEVE GRACEY HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL, AN AFFILIATED ENTITY OF BETHESDA HOSPITAL, INC. KATHY KELLY, RANCE DUKE, CYNTHIA BOOTH, BOB COLLINS, MD AND QUINT STUDER 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. MARK CLEMENT, TERRI HANLON-BREMER, ANDREW DEVOE, JOHN WARD, STEVE GRACEY, AND HELEN KOSELKA, 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. FORM 990, PART VI, SECTION A, LINE 6 BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION AS DEFINED IN OHIO REVISED CODE SECTION 1745.05(M) AND AS SUCH IT IS NOT REQUIRED TO REGISTER WITH THE OHIO SECRETARY OF STATE NOR IS IT REQUIRED TO HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS. HOWEVER, THE CENTER DOES HAVE GOVERNING PRINCIPLES WHICH ARE DEFINED IN OHIO REVISED CODE SECTION 1745.05(D) AS "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS,". UNDER THESE GOVERNING PRINCIPLES, BETHESDA HOSPITAL, INC. ("HOSPITAL") IS DESIGNATED AS ITS SOLE MEMBER AND THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION AS DEFINED IN OHIO REVISED CODE SECTION 1745.05(M) AND AS SUCH IT IS NOT REQUIRED TO REGISTER WITH THE OHIO SECRETARY OF STATE NOR IS IT REQUIRED TO HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS. HOWEVER, THE CENTER DOES HAVE GOVERNING PRINCIPLES WHICH ARE DEFINED IN OHIO REVISED CODE SECTION 1745.05(D) AS "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS,". UNDER THESE GOVERNING PRINCIPLES, BETHESDA HOSPITAL, INC. ("HOSPITAL") IS DESIGNATED AS ITS SOLE MEMBER AND THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF THE HOSPITAL. AS AN UNINCORPORATED DIVISION OF THE HOSPITAL, THE CENTER DOES NOT MAINTAIN ITS OWN GOVERNING BODY. INSTEAD, THE CENTER IS OVERSEEN BY THE GOVERNING BODY OF THE HOSPITAL AS IT IS VIEWED AS PART OF IT. FORM 990, PART VI, SECTION A, LINE 7B BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION AS DEFINED IN OHIO REVISED CODE SECTION 1745.05(M) AND AS SUCH IT IS NOT REQUIRED TO REGISTER WITH THE OHIO SECRETARY OF STATE NOR IS IT REQUIRED TO HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS. HOWEVER, THE CENTER DOES HAVE GOVERNING PRINCIPLES WHICH ARE DEFINED IN OHIO REVISED CODE SECTION 1745.05(D) AS "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS,". UNDER THESE GOVERNING PRINCIPLES, BETHESDA HOSPITAL, INC. ("HOSPITAL") IS DESIGNATED AS ITS SOLE MEMBER AND THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF THE HOSPITAL. AS AN UNINCORPORATED DIVISION OF THE HOSPITAL, THE CENTER DOES NOT MAINTAIN ITS OWN GOVERNING BODY. INSTEAD, THE CENTER IS OVERSEEN BY THE GOVERNING BODY OF THE HOSPITAL AS IT IS VIEWED AS PART OF IT. AS SUCH, ALL DECISIONS ARE SUBJECT TO THE GOVERNING BODY OF THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B MEMBERS OF THE BOARD OF BETHESDA HOSPITAL, INC. (THE ORGANIZATION' SOLE MEMBER) ARE PROVIDED AN ELECTRONIC COPY OF THIS FORM 990 PRIOR TO FILING AFTER REVIEW BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD, ALONG WITH THE COMMITTEE'S SUMMARY OF THE FORM 990. SUBSEQUENT TO PRESENTATION TO THE BOARD, THE ORGANIZATION FILES THE RETURN MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH NON-SUBSTANTIVE CHANGES ARE NOT SUBMITTED TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION AS DEFINED IN OHIO REVISED CODE SECTION 1745.05(M) AND AS SUCH IT IS NOT REQUIRED TO REGISTER WITH THE OHIO SECRETARY OF STATE NOR IS IT REQUIRED TO HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS. HOWEVER, THE CENTER DOES HAVE GOVERNING PRINCIPLES WHICH ARE DEFINED IN OHIO REVISED CODE SECTION 1745.05(D) AS "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS,". UNDER THESE GOVERNING PRINCIPLES, BETHESDA HOSPITAL, INC. ("HOSPITAL") IS DESIGNATED AS ITS SOLE MEMBER AND THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF THE HOSPITAL. AS AN UNINCORPORATED DIVISION OF THE HOSPITAL, THE CENTER DOES NOT MAINTAIN ITS OWN GOVERNING BODY. INSTEAD, THE CENTER IS OVERSEEN BY THE GOVERNING BODY OF THE HOSPITAL AS IT IS VIEWED AS PART OF IT. HOWEVER, BETHESDA HOSPITAL, INC. HAS THE FOLLOWING PROCESS: 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 C, LINE 19 BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION AS DEFINED IN OHIO REVISED CODE SECTION 1745.05(M) AND AS SUCH IT IS NOT REQUIRED TO REGISTER WITH THE OHIO SECRETARY OF STATE NOR IS IT REQUIRED TO HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS. HOWEVER, THE CENTER DOES HAVE GOVERNING PRINCIPLES WHICH ARE DEFINED IN OHIO REVISED CODE SECTION 1745.05(D) AS "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS,". AS SUCH, NO GOVERNING DOCUMENTS ARE AVAILABLE TO PROVIDE UPON REQUEST. UNDER THESE GOVERNING PRINCIPLES, BETHESDA HOSPITAL, INC. ("HOSPITAL") IS DESIGNATED AS ITS SOLE MEMBER AND THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF THE HOSPITAL. AS AN UNINCORPORATED DIVISION OF THE HOSPITAL, THE CENTER DOES NOT MAINTAIN ITS OWN STANDALONE FINANCIAL STATEMENTS AND AS SUCH THEY ARE NOT AVAILABLE UPON REQUEST. HOWEVER, AS MENTIONED ABOVE THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL, BETHESDA HOSPITAL, INC.'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A - AVERAGE HOURS PER WEEK: THE OFFICERS AND DIRECTORS FOR THE BETHESDA FAMILY PRACTICE CENTER, BY VIRTUE OF IT BEING AN UNINCORPORATED DIVISION OF 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) OF THE BETHESDA FAMILY PRACTICE CENTER, BY VIRTUE OF IT BEING AN UNINCORPORATED DIVISION OF BETHESDA HOSPITAL, INC., SERVE ON THE BOARD IN THEIR CAPACITY AS MEDICAL STAFF PRESIDENT FOR EITHER BETHESDA HOSPITAL, INC. OR THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. IN ADDITION, THESE INDIVIDUALS PROVIDE SERVICES AS EMPLOYEES OF VARIOUS RELATED ENTITIES FOR WHICH THEY RECEIVE COMPENSATION. NONE OF THE COMPENSATION SHOWN IS FOR SERVING AS A DIRECTOR. FORM 990, PART VIII, STATEMENT OF REVENUE: BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION WHOSE SOLE MEMBER AND SUPPORTED ORGANIZATION IS BETHESDA HOSPITAL, INC. ("HOSPITAL"). AS THE CENTER CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF HOSPITAL, IT IS TREATED AS AN UNINCORPORATED DIVISION OF HOSPITAL AND NOT AS A SEPARATE ENTITY. AS SUCH, THE CENTER DOES NOT MAINTAIN ITS OWN STANDALONE FINANCIAL STATEMENTS BUT RATHER THE FINANCIAL STATEMENTS ARE INCLUDED WITH HOSPITAL AND ALL FINANCIAL INFORMATION GENERALLY REPORTED ON FORM 990, PART VIII IS REPORTED ON THE FORM 990 OF HOSPITAL (EIN 31-0537122) AND NOT SEPARATELY ON THIS RETURN. FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES: BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION WHOSE SOLE MEMBER AND SUPPORTED ORGANIZATION IS BETHESDA HOSPITAL, INC. ("HOSPITAL"). AS THE CENTER CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF HOSPITAL, IT IS TREATED AS AN UNINCORPORATED DIVISION OF HOSPITAL AND NOT AS A SEPARATE ENTITY. AS SUCH, THE CENTER DOES NOT MAINTAIN ITS OWN STANDALONE FINANCIAL STATEMENTS BUT RATHER THE FINANCIAL STATEMENTS ARE INCLUDED WITH HOSPITAL AND ALL FINANCIAL INFORMATION GENERALLY REPORTED ON FORM 990, PART IX IS REPORTED ON THE FORM 990 OF HOSPITAL (EIN 31-0537122) AND NOT SEPARATELY ON THIS RETURN. FORM 990, PART X, BALANCE SHEET: BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION WHOSE SOLE MEMBER AND SUPPORTED ORGANIZATION IS BETHESDA HOSPITAL, INC. ("HOSPITAL"). AS THE CENTER CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF HOSPITAL, IT IS TREATED AS AN UNINCORPORATED DIVISION OF HOSPITAL AND NOT AS A SEPARATE ENTITY. AS SUCH, THE CENTER DOES NOT MAINTAIN ITS OWN STANDALONE FINANCIAL STATEMENTS BUT RATHER THE FINANCIAL STATEMENTS ARE INCLUDED WITH HOSPITAL AND ALL FINANCIAL INFORMATION GENERALLY REPORTED ON FORM 990, PART X IS REPORTED ON THE FORM 990 OF HOSPITAL (EIN 31-0537122) AND NOT SEPARATELY ON THIS RETURN. FORM 990, PART XII, LINE 2C: BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION AS DEFINED IN OHIO REVISED CODE SECTION 1745.05(M) AND AS SUCH IT IS NOT REQUIRED TO REGISTER WITH THE OHIO SECRETARY OF STATE NOR IS IT REQUIRED TO HAVE ARTICLES OF INCORPORATION OR SIMILAR GOVERNING DOCUMENTS. HOWEVER, THE CENTER DOES HAVE GOVERNING PRINCIPLES WHICH ARE DEFINED IN OHIO REVISED CODE SECTION 1745.05(D) AS "AGREEMENTS, WHETHER ORAL, IN A RECORD, OR IMPLIED FROM ITS ESTABLISHED PRACTICES, OR ANY COMBINATION OF THEM, THAT GOVERN THE PURPOSE OR OPERATION OF AN UNINCORPORATED NONPROFIT ASSOCIATION AND THE RIGHTS AND OBLIGATIONS OF ITS MEMBERS AND MANAGERS,". AS SUCH, NO GOVERNING DOCUMENTS ARE AVAILABLE TO PROVIDE UPON REQUEST. UNDER THESE GOVERNING PRINCIPLES, BETHESDA HOSPITAL, INC. ("HOSPITAL") IS DESIGNATED AS ITS SOLE MEMBER AND THE CENTER IS TREATED AS AN UNINCORPORATED DIVISION OF THE HOSPITAL AS IT CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF THE HOSPITAL. AS AN UNINCORPORATED DIVISION OF THE HOSPITAL, THE CENTER DOES NOT MAINTAIN ITS OWN STANDALONE FINANCIAL STATEMENTS BUT RATHER THE FINANCIAL STATEMENTS ARE INCLUDED WITH THE HOSPITAL. HOWEVER, THE FINANCIAL STATEMENTS OF 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. FORM 990, PART XI, RECONCILIATION OF NET ASSETS: BETHESDA FAMILY PRACTICE CENTER ("THE CENTER") IS A STATE OF OHIO UNINCORPORATED ASSOCIATION WHOSE SOLE MEMBER AND SUPPORTED ORGANIZATION IS BETHESDA HOSPITAL, INC. ("HOSPITAL"). AS THE CENTER CONSTITUTES AN INTEGRAL PART OF THE OPERATIONS OF HOSPITAL, IT IS TREATED AS AN UNINCORPORATED DIVISION OF HOSPITAL AND NOT AS A SEPARATE ENTITY. AS SUCH, THE CENTER DOES NOT MAINTAIN ITS OWN STANDALONE FINANCIAL STATEMENTS BUT RATHER THE FINANCIAL STATEMENTS ARE INCLUDED WITH HOSPITAL AND ALL FINANCIAL INFORMATION GENERALLY REPORTED ON FORM 990, PART XI IS REPORTED ON THE FORM 990 OF HOSPITAL (EIN 31-0537122) AND NOT SEPARATELY ON THIS RETURN. BETHESDA INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311108895 POPULATION HEALTH OH SECTION 501(C)(3) SCHEDULE A, LINE 12C N/A 0 BETHESDA HOSPITAL INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310537122 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 0 BETHESDA FOUNDATION INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 237374129 FUNDRAISING OH SECTION 501(C)(3) SCHEDULE A, LINE 7 BETHESDA INC 0 BETHESDA HEALTHCARE INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311027660 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 12B TRIHEALTH INC 0 BETHESDA PROPERTIES INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311352694 PROPERTY MANAGEMENT OH SECTION 501(C)(2) BETHESDA HOSPITAL INC 1 HOSPICE OF CINCINNATI INCORPORATED 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310917155 HOSPICE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 BETHESDA HOSPITAL INC 1 FERNSIDE INC A CENTER FOR GRIEVING CHILDREN 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311179234 COUNSELING TO GRIEVING CHILDREN OH SECTION 501(C)(3) SCHEDULE A, LINE 7 HOSPICE OF CINCINNATI INCORPORATED 1 TRIHEALTH INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311438846 SUPPORT AFFILIATED HOSPITALS OH SECTION 501(C)(3) SCHEDULE A, LINE 12B N/A 0 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310537486 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 0 GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311778403 EDUCATION OH SECTION 501(C)(3) SCHEDULE A, LINE 2 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 COMMUNITY LIMITED CARE DIALYSIS CENTER 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 237419853 DIALYSIS OH SECTION 501(C)(2) THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 1 GOOD SAMARITAN HOSPITAL FREE CLINIC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 273893817 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 7 TRIHEALTH INC 1 TRIHEALTH HOSPITALINC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 461393755 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN ENTERPRISE CORP 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311383365 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 TRIHEALTH INC 1 TRIHEALTH PHYSICIAN INSTITUTE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311074519 PHYSICIAN PRACTICES OH SECTION 501(C)(3) SCHEDULE A, LINE 10 TRIHEALTH INC 1 MCCULLOUGH HYDE MEMORIAL HOSPITAL INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310650283 INPATIENT AND OUTPATIENT SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 3 TRIHEALTH INC 1 10600 MONTGOMERY LLC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 261964995 PROPERTY MANAGEMENT OH N/A 0 0 HEALTHCARE SOLUTIONS NETWORK LLC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 472103334 PHYSICIAN HOSPITAL ORGANIZATION OH N/A 0 0 PREFERRED LAB PARTNERS LLC ONE MEDICAL VILLAGE DRIVE SUITE B EDGEWOOD KY 41017 824758763 LABORATORY SERVICES KY N/A 0 0 TJ CUBEDMONTGOMERY INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 261964885 HOLDING COMPANY OH N/A S 1 TRIHEALTH PHYSICIANS OF INDIANA INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 461125130 PHYSICIAN PRACTICES OH N/A C 1 TRIHEALTH PHYSICIAN SOLUTIONS INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311444353 CLAIMS ADMINISTRATION OH N/A C 1 TRIHEALTH CIPHO INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 463294306 PHYSICIAN HEALTH ORGANIZATION OH N/A C 1 PREMIERE MEDICAL OWNERS ASSOCIATION 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 141913019 CONDO ASSOCIATION OH N/A C 1 SERVE INSURANCE LTD PO BOX 69 CAMANA BAY GRAND CAYMAN CJ 981529310 ALTERNATIVE RISK FINANCING CJ N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0