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 311179234 FERNSIDE INC A CENTER FOR GRIEVING CHILDREN FERN 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 GAYLE MATTSON 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 1942172 0 X WWW.FERNSIDE.ORG X 1986 OH PEER SUPPORT AND ADVOCACY FOR GRIEVING CHILDREN AND FAMILIES. 6 3 0 133 0 0 547830 1941616 0 0 0 0 654 556 548484 1942172 0 0 0 0 0 0 0 0 0 651508 652636 651508 652636 -103024 1289536 223021 536477 3510430 3520894 -3287409 -2984417 X SEE SCHEDULE O 0 0 652636 0 556 SEE SCHEDULE O 652636 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 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 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 3 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X MICHAEL CROFTON - VP FINANCE 5135696577 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 GAYLE MATTSON PRESIDENT & CEO 1.00 60.00 X X 0 474633 59681 TERRI SIMPSON TREASURER (END 6/23) 1.00 60.00 X X 0 151209 25346 VICTORIA OTT SECRETARY/EXEC. DIRECTOR 60.00 0.00 X X 0 120749 56208 BARBARA TOBIAS TRUSTEE 1.00 1.00 X 0 0 0 LUANN SCHERER TRUSTEE 1.00 0.00 X 0 0 0 ED GOLDSTEIN TRUSTEE 1.00 0.00 X 0 0 0 0 746591 141235 0 0 1 0 0 1320000 621616 6814 1941616 GRIEF PUBLICATIONS 624100 556 556 556 1942172 556 0 0 422 422 7676 7676 7491 7491 110454 110454 8045 8045 585 585 PAYROLL MANAGEMENT 481870 481870 SUPPORT GRP/CAMP OUTING 29163 29163 EQUIPMENT 1796 1796 SUPPLIES 156 156 4978 4978 652636 652636 0 0 27413 27413 0 0 223021 536477 223021 536477 157 3510273 3520894 3510430 3520894 X -3510430 -3520894 223021 536477 -3287409 -2984417 223021 536477 X 1289536 -986544 X X 0 1 X 1 0 X 596909 491638 435284 547830 641616 2713277 596909 491638 435284 547830 641616 2713277 434703 2278574 2713277 3606 0.83980 0.83990 X SCHEDULE A, PART VI, LIST OF UNUSUAL GRANTS: DESCRIPTION: ENDOWMENT DATE: 03/23/23 AMOUNT: 1300000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 88317 1005000 11778 0 1105095 88720 0 -403 0 88317 69961 0 18759 0 88720 72567 0 -915 1691 69961 82527 0 1691 11651 72567 0.98970 0.01030 0 1 1 27413 27413 0 0 DUE FROM RELATED ORGANIZATIONS 536477 536477 DUE TO RELATED ORGANIZATIONS 3520894 3520894 X PART V, LINE 4: INVESTMENT PROCEEDS FROM ENDOWMENT FUNDS ARE USED TO SUPPORT THE PROGRAMS OF FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN. PART X, LINE 2: THE FINANCIAL STATEMENTS OF FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN ARE AUDITED AS PART OF TRIHEALTH AND ITS SUBSIDIARIES AND AFFILIATES ("TRIHEALTH"). FOLLOWING IS THE TEXT OF THE FOOTNOTE TO TRIHEALTH'S AUDITED COMBINED FINANCIAL STATEMENTS 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 FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN ARE AUDITED WITH 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. 0 1 0 0 0 0 0 0 0 GAYLE MATTSON PRESIDENT & CEO 0 363782 0 85400 0 25451 0 58175 0 1506 0 534314 0 0 VICTORIA OTT SECRETARY/EXEC. DIRECTOR 0 104229 0 8694 0 7826 0 32284 0 23924 0 176957 0 0 TERRI SIMPSON TREASURER (END 6/23) 0 129633 0 11889 0 9687 0 14818 0 10528 0 176555 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. THERE WERE NO DISTRIBUTIONS FROM A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN DURING THE 2022 CALENDAR YEAR. PART I, LINE 3: TRIHEALTH, INC., A RELATED ORGANIZATION OF FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN, 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 FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN 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. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC. DURING THE 2022 CALENDAR YEAR. FORM 990, PART III, LINE 1 FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN OFFERS SUPPORT AND ADVOCACY TO GRIEVING FAMILIES WHO HAVE EXPERIENCED A DEATH. THIS IS ACCOMPLISHED BY PEER SUPPORT FOR GRIEVING CHILDREN, TEENS AND ADULTS. THE ORGANIZATION ALSO WORKS TO INCREASE COMMUNITY AWARENESS OF GRIEF ISSUES THROUGH COMMUNITY OUTREACH. FORM 990, PART III, LINE 4A BEGINNING IN 1986, FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN ("FERNSIDE") OFFERS SUPPORT AND ADVOCACY TO GRIEVING FAMILIES WHO HAVE EXPERIENCED A DEATH. THIS IS ACCOMPLISHED BY PEER SUPPORT FOR GRIEVING CHILDREN, TEENS AND ADULTS. THE ORGANIZATION ALSO WORKS TO INCREASE COMMUNITY AWARENESS OF GRIEF ISSUES THROUGH COMMUNITY OUTREACH. ALL SERVICES OFFERED BY FERNSIDE ARE PROVIDED FREE OF CHARGE. SERVICES INCLUDE: EVENING PROGRAM FERNSIDE OFFERS GROUPS FOR CHILDREN AND TEENS AGES 3-18, WHO ARE GRIEVING THE DEATH OF A FAMILY MEMBER OR FRIEND. PARENTS AND GUARDIANS ALSO MEET IN THEIR OWN SUPPORT GROUP. DURING THE TAX YEAR, 792 INDIVIDUALS BENEFITED FROM THIS PROGRAM PROVIDED BY FERNSIDE. SPECIAL COLLABORATIONS FERNSIDE PROVIDES GRIEF SUPPORT FOR CHILDREN AND ADULTS WITH SPECIAL NEEDS IN COLLABORATIONS WITH SCHOOLS AND OTHER SOCIAL SERVICE AGENCIES. DURING THE TAX YEAR, 12 INDIVIDUALS BENEFITED FROM THIS PROGRAM PROVIDED BY FERNSIDE. SCHOOL PROGRAM FERNSIDE COLLABORATES WITH ELEMENTARY SCHOOLS, JUNIOR HIGH AND HIGH SCHOOLS TO PROVIDE ON-SITE GRIEF SUPPORT FOR GRIEVING STUDENTS. DURING THE TAX YEAR, 534 INDIVIDUALS BENEFITED FROM THIS PROGRAM PROVIDED BY FERNSIDE. CAMP PROGRAM FERNSIDE'S CAMP PROGRAM INCLUDES AN OVERNIGHT SUMMER CAMP FOR CHILDREN AGES 7-12 AND A WEEKEND RETREAT FOR TEENS AGES 13-18. DURING THE TAX YEAR, 74 INDIVIDUALS BENEFITED FROM THIS PROGRAM PROVIDED BY FERNSIDE. PHONE CONSULTATIONS FERNSIDE STAFF CONSULTS WITH HELPING PROFESSIONALS, PARENTS/GUARDIANS AND OTHER COMMUNITY MEMBERS WHO HAVE GRIEF-RELATED QUESTIONS OR CONCERNS. DURING THE TAX YEAR, 1,030 INDIVIDUALS BENEFITED FROM THIS PROGRAM PROVIDED BY FERNSIDE. CRISIS RESPONSE FERNSIDE PROVIDES IMMEDIATE AND LONG-TERM SUPPORT TO SCHOOLS AND OTHER ORGANIZATIONS FOLLOWING A DEATH. DURING THE TAX YEAR, 115 INDIVIDUALS BENEFITED FROM THIS PROGRAM PROVIDED BY FERNSIDE. COMMUNITY OUTREACH & EDUCATION FERNSIDE PROVIDES PRESENTATIONS ON A VARIETY OF TOPICS RELATED TO GRIEF IN ADDITION TO SHARING INFORMATION ABOUT OUR HISTORY AND SERVICES. DURING THE TAX YEAR, 1,224 INDIVIDUALS BENEFITED FROM THIS PROGRAM PROVIDED BY FERNSIDE. LITERATURE & MATERIALS FERNSIDE HAS DESIGNED AND DEVELOPED LITERATURE AND MATERIALS FOR GRIEVING PEOPLE AND HELPING PROFESSIONALS. FORM 990, PART VI, SECTION A, LINE 2 GAYLE MATTSON AND BARBARA TOBIAS, MD HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF SITTING ON THE BOARD OF HOSPICE OF CINCINNATI, INCORPORATED, THE SINGLE CORPORATE MEMBER OF FERNSIDE. GAYLE MATTSON, RN, TERRI SIMPSON AND VICKY OTT HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF BEING EMPLOYED BY TRIHEALTH, INC. OR ITS AFFILIATES/SUBSIDIARIES. FORM 990, PART VI, SECTION A, LINE 6 FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN HAS A SINGLE CORPORATE MEMBER, HOSPICE OF CINCINNATI, INCORPORATED. FORM 990, PART VI, SECTION A, LINE 7A FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN ("FERNSIDE") HAS A SINGLE CORPORATE MEMBER, HOSPICE OF CINCINNATI, INCORPORATED, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF FERNSIDE. FORM 990, PART VI, SECTION A, LINE 7B HOSPICE OF CINCINNATI, INCORPORATED MUST APPROVE DISSOLUTION OF FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN ("FERNSIDE") AND AMENDMENTS TO FERNSIDE'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B 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 C, LINE 19 FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET INCREASE IN TEMPORARILY RESTRICTED NET ASSETS 313,456. CONTRIBUTION REVENUE RECOGNITION ADJUSTMENT -1,300,000. FORM 990, PART I, LINE 6 DURING THE TAX YEAR, FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN ("FERNSIDE") WAS ASSISTED BY 133 VOLUNTEERS WHO DONATED APPROXIMATELY 5,668 HOURS. VOLUNTEERS HELPED THROUGH THE FOLLOWING SERVICES: SUPPORT GROUP FACILITATOR INDIVIDUALS CO-LEAD A SUPPORT GROUP IN FERNSIDE'S EVENING PROGRAM AND CAMP PROGRAM. THEY ARE RESPONSIBLE FOR HELPING TO CREATE A CARING ENVIRONMENT IN WHICH GROUP MEMBERS SHARE THEIR STORIES, FEELINGS AND MEMORIES AND DISCUSS HOW TO COPE WITH CHALLENGES IN THEIR LIVES. VOLUNTEER FACILITATORS ARE REQUIRED TO ATTEND A 20-HOUR TRAINING PROGRAM WHERE THEY LEARN ABOUT GRIEVING CHILDREN AND ADULTS, GROUP PROCESS AND HAVE THE OPPORTUNITY TO HEAR FIRST HAND FROM EXPERIENCED VOLUNTEERS AND FAMILIES WHO HAVE PARTICIPATED IN FERNSIDE'S PROGRAM. THE TRAINING IS OFFERED TWO TIMES EACH YEAR. GREETER INDIVIDUALS PICK UP AND SERVE PIZZA AND BEVERAGES. MOST IMPORTANTLY, THEY PROVIDE A WARM WELCOME TO ALL THOSE ATTENDING FERNSIDE'S GRIEF SUPPORT GROUPS. FUNDRAISING INDIVIDUALS ASSIST WITH VARIOUS EVENTS THAT BENEFITS PROGRAMMING AT FERNSIDE. PHILANTHROPISTS IN TRAINING (PIT) CREW HIGH SCHOOL STUDENTS WORK TO RAISE AWARENESS FOR FERNSIDE. OTHER ASSISTANCE INDIVIDUALS AND GROUPS PROVIDE CLERICAL SUPPORT AND OTHER ASSISTANCE WITH PREPARATION OF MATERIALS FOR USE IN FERNSIDE'S SUPPORT GROUPS. FORM 990, PART VII, SECTION A - AVERAGE HOURS PER WEEK THE OFFICERS AND DIRECTORS FOR FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN THAT SHOW AT LEAST 60 HOURS PER WEEK, EXCLUDING THE FILING ORGANIZATION'S EXECUTIVE DIRECTOR, 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. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF FERNSIDE, INC.: A CENTER FOR GRIEVING CHILDREN ("FERNSIDE") ARE AUDITED AS PART OF TRIHEALTH, INC. ("TRIHEALTH"). TRIHEALTH HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF BOTH ITS AND ITS SUBSIDIARIES FINANCIAL STATEMENTS AS WELL AS THE SELECTION OF THE INDEPENDENT AUDITOR. IN ADDITION, FERNSIDE'S FINANCIAL STATEMENTS ARE AUDITED WITH BETHESDA, INC., THE PARENT ORGANIZATION OF HOSPICE. BETHESDA, INC. HAS A COMMITTEE THAT ASSUMES THE RESPONSIBILITY FOR THE 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. BETHESDA INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311108895 INVESTMENT MANAGEMENT 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 BETHESDA INC 0 BETHESDA FAMILY PRACTICE CENTER 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311242442 HEALTHCARE SERVICES OH SECTION 501(C)(3) SCHEDULE A, LINE 12A BETHESDA HOSPITAL 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 0 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 0 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 0 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 0 TRIHEALTH HOSPITAL INC 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 0 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 0 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 0 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 0 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 0 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 0 TRIHEALTH PHYSICIANS OF INDIANA INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 461125130 PHYSICIAN PRACTICES OH N/A C 0 TRIHEALTH PHYSICIAN SOLUTIONS INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311444353 CLAIMS ADMINISTRATION OH N/A C 0 TRIHEALTH CIPHO INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 463294306 PHYSICIAN HEALTH ORGANIZATION OH N/A C 0 PREMIERE MEDICAL OWNERS ASSOCIATION 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 141913019 CONDO ASSOCIATION OH N/A C 0 SERVE INSURANCE LTD PO BOX 69 CAMANA BAY GRAND CAYMANS CJ 981529310 ALTERNATIVE RISK FINANCING CJ N/A C 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 1 BETHESDA INC C 1320000 CASH HOSPICE OF CINCINNATI INCORPORATED K 110454 FMV BETHESDA HOSPITAL INC O 481870 FMV TRIHEALTH INC P 60312 COST BETHESDA FOUNDATION INC S 641616 CASH