2025-05-15T08:54:16-05:00 2024-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2023-07-01 237374256 MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND MCCU 5136643850 110 NORTH POPLAR STREET OXFORD OH 45056 TYLER WASH EXECUTIVE DIRECTOR 5136643850 2025-05-15 1 1 SHAWNA M JANSONS P01222873 3174648600 2023 2025-03-06 01:10:19Z MCCULLOUGH-HYDE FOUNDATION TYLER WASH 110 NORTH POPLAR STREET OXFORD OH 45056 2721444 0 X WWW.TRIHEALTH.COM/MHMHFOUNDATION X 1942 OH THE FOUNDATION PROVIDES SUPPORT TO MCCULLOUGH-HYDE MEMORIAL HOSPITAL AND THE SURROUNDING COMMUNITY. 10 10 0 22 0 0 477761 344487 0 0 725766 984877 -23244 70525 1180283 1399889 435210 482820 0 0 0 0 0 0 104124 644628 535956 1079838 1018776 100445 381113 19240518 20727608 399332 191211 18841186 20536397 X SEE SCHEDULE O 0 0 234814 234814 0 COMMUNITY GRANTING PROGRAM: THE FOUNDATION MADE INVESTMENTS THAT ADDRESS SIGNIFICANT HEALTH NEEDS OF LOCAL COMMUNITIES. IT PARTNERED WITH AND PROVIDED FUNDING TO LOCAL ORGANIZATIONS THAT ARE LEADING THE WAY TO BUILD HEALTHIER COMMUNITIES. EACH YEAR, THE EMPHASIS IS ON PROGRAMS AND PROJECTS THAT FOCUS ON EDUCATION, PREVENTION PROGRAMS, AWARENESS EFFORTS, WELLNESS OPPORTUNITIES AND DIRECT CARE IN THE FOLLOWING AREAS - MENTAL HEALTH, ALCOHOL AND DRUGS ABUSE, ACCESS TO HEALTHCARE, FOOD INSECURITIES AND OBESITY AND HEALTHY BEHAVIORS. THESE FIVE FUNDING PRIORITIES ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, PUBLISHED TRIENNIALLY BY MCCULLOUGH-HYDE MEMORIAL HOSPITAL. 213801 213801 0 SUPPORT FOR HEALTH PROGRAMS AND HOSPITAL DEPARTMENTS: THE FOUNDATION PROVIDED SUPPORT FOR HOSPITAL STRATEGIC ADVANCEMENTS AND CURRENT NEEDS THAT SUPPORTED THE COMMUNITIES IN BUTLER COUNTY, OHIO, FRANKLIN COUNTY, INDIANA, PREBLE COUNTY, OHIO, UNION COUNTY, INDIANA AND OTHER NEARBY COMMUNITIES SERVED BY THE HOSPITAL. DURING THE YEAR, THE FOUNDATION FOCUSED ON PROVIDING HOSPITAL DEPARTMENT SUPPORT (SURGERY, RESPIRATORY, LABORATORY, INPATIENT CARE, IMAGING, CARDIAC, ONCOLOGY, PHARMACY, PHYSICAL THERAPY AND OBSTETRICS), EMPLOYEE ASSISTANCE SUPPORT, PROGRAM SUPPORT (E.G. OXFORD FREE CLINIC), PATIENT SUPPORT (MEDICAL GAP FUNDING, TEMPORARY ASSISTANCE AND EMERGENCY FUNDING) AND HOSPITAL CAPITAL PROJECTS (FACILITY RENOVATIONS, EQUIPMENT PURCHASES AND CLINICAL INNOVATION). 199229 0 82655 SUPPORT FOR DEVELOPMENT AND COMMUNITY ENGAGEMENT ACTIVITIES TO SUPPORT THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL: THE FOUNDATION REPRESENTS THE INTERESTS OF THE COMMUNITIES SERVED BY MCCULLOUGH-HYDE MEMORIAL HOSPITAL AND SERVES AS A CONDUIT BETWEEN COMMUNITY MEMBERS AND DONORS AND THE HOSPITAL AS IT RELATES TO PHILANTHROPY AND ENGAGEMENT. THE EFFORTS OF THE FOUNDATION OVER THE YEARS HAS PRODUCED AN ENDOWMENT OF $20.5 MILLION, WITH $16.2 MILLION UNRESTRICTED AND $4.3 MILLION DESIGNATED. 34205 34205 0 SUPPORT FOR EDUCATIONAL NEEDS: THE FOUNDATION FUNDED ACADEMIC SCHOLARSHIPS AND CONTINUING EDUCATION FOR EMPLOYEES OF MCCULLOUGH-HYDE. THE EDUCATIONAL SUPPORT FROM THE FOUNDATION FOCUSED ON GENERAL ACADEMIC ADVANCEMENT (BACHELOR'S DEGREES, MASTER'S DEGREE AND DOCTORATES RELATED TO HEALTHCARE, HEALTHCARE ADMINISTRATION OR OTHER RELATED FIELDS OF STUDY), CERTIFICATIONS (REGISTERED NURSES, LICENSED PRACTICAL NURSES, TECHNICIANS AND OTHER POSITION-SPECIFIC CERTIFICATIONS) AND CONTINUING EDUCATION OPPORTUNITIES (SPECIALIZED TRAINING, SEMINARS, TRAININGS AND CONFERENCES). 34205 34205 0 682049 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 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 1 1 0 0 0 0 0 0 X 10 10 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X TYLER WASH - EXECUTIVE DIRECTOR 5135245650 110 NORTH POPLAR STREET OXFORD OH 45056 X MARY BUTTERFIELD VICE CHAIR 1.00 0.00 X X 0 0 0 AMY LONGCAMP TRUSTEE 1.00 0.00 X 0 0 0 DELORIS ROME HUDSON TRUSTEE 1.00 0.00 X 0 0 0 JULIE JOLLIFF TRUSTEE 1.00 0.00 X 0 0 0 TRAVIS ROBINSON TRUSTEE 1.00 0.00 X 0 0 0 PAT SIDLEY TRUSTEE 1.00 0.00 X 0 0 0 TIM MCGOWAN CHAIR 1.00 0.00 X X 0 0 0 SIBYL MILLER TRUSTEE 1.00 0.00 X 0 0 0 STEPHEN SNYDER TRUSTEE 1.00 0.00 X 0 0 0 KAREN BAKER SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 TYLER WASH EXECUTIVE DIRECTOR 60.00 0.00 X 138239 0 39505 138239 0 39505 1 0 1 1 TRIHEALTH INC 625 EDEN PARK DRIVE CINCINNATI OH 45202 ADMINISTRATIVE SUPPORT 381889 1 37775 25000 281712 5898 344487 574583 574583 31522 44477 -12955 -12955 -12955 1683622 1273328 410294 410294 410294 4575 37775 3750 825 825 HRSA GRANT ADMIN FEE 900099 81995 81995 MISCELLANEOUS 900099 660 660 82655 1399889 82655 0 972747 442125 442125 40695 40695 340889 195317 72035 73537 52875 52875 16944 16944 20487 3829 2147 14511 30001 16801 13200 21973 20124 1849 22544 22544 18234 18234 489 489 925 925 5566 5566 COMMUNICATIONS 1730 1730 INTERN STIPEND 1600 1600 BUSINESS MEALS 1189 162 1027 DUES & LICENSES 110 110 400 83 317 1018776 682049 232603 104124 434846 269403 21249 29975 4282 3511 416658 158228 255590 258430 18524551 20166289 19240518 20727608 202032 86500 197300 104711 399332 191211 X 14893135 16166418 3948051 4369979 18841186 20536397 19240518 20727608 381113 1314098 0 X X 1 X 0 1 0 X X 1 MCCULLOUGH-HYDE MEMORIAL HOSPITAL INC 310650283 3 1 159730 0 1 159730 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 PART D, LINE 3 THERE IS A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN THE MCCULLOUGH-HYDE FOUNDATION ("FOUNDATION") AND ITS SUPPORTED ORGANIZATION, MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("HOSPITAL"). THE ORIGINAL RESOURCES THAT CREATED THE FOUNDATION WERE GIVEN FOR THE PURPOSE OF ERECTING, MAINTAINING AND OPERATING A HOSPITAL IN OXFORD, OHIO, WHICH ULTIMATELY BECAME THE HOSPITAL IN 1957. EFFECTIVE JULY 1, 2019, THE FOUNDATION TRANSFERRED ITS OWNERSHIP PERCENTAGE IN THE HOSPITAL TO TRIHEALTH, INC. SINCE THE TRANSACTION, THE FOUNDATION HAS ONE OF ITS TRUSTEES ELECTED TO THE HOSPITAL'S BOARD OF DIRECTORS ALLOWING FOR INPUT IN HOSPITAL OPERATIONS. THE FOUNDATION IS RESPONSIBLE FOR RECEIVING ALL CHARITABLE CONTRIBUTIONS FROM COMMUNITY MEMBERS FOR THE BENEFIT OF THE HOSPITAL, MANAGING AND DISTRIBUTING THOSE FUNDS, AND ENSURING THEIR USE IS IN ACCORDANCE WITH DONOR WISHES. THE FOUNDATION LEADERSHIP WORKS WITH THE HOSPITAL LEADERSHIP TO DETERMINE HOW FUNDS ARE DISTRIBUTED. HOSPITAL NEEDS ARE EVALUATED ANNUALLY TO ENSURE THE GREATEST NEEDS ARE MET FIRST. THE HOSPITAL'S PRESIDENT AND OTHER EXECUTIVES ATTEND THE FOUNDATION'S BOARD OF TRUSTEES MEETINGS ON A MONTHLY BASIS. PART E, LINE 2A THERE IS A HISTORIC AND CONTINUING RELATIONSHIP BETWEEN THE MCCULLOUGH-HYDE FOUNDATION ("FOUNDATION") AND ITS SUPPORTED ORGANIZATION, MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("HOSPITAL"). THE ORIGINAL RESOURCES THAT CREATED THE FOUNDATION WERE GIVEN FOR THE PURPOSE OF ERECTING, MAINTAINING AND OPERATING A HOSPITAL IN OXFORD, OHIO, WHICH ULTIMATELY BECAME THE HOSPITAL IN 1957. THE FOUNDATION IS RESPONSIBLE FOR RECEIVING ALL CHARITABLE CONTRIBUTIONS FOR THE BENEFIT OF THE HOSPITAL, MANAGING AND DISTRIBUTING THOSE FUNDS, AND ENSURING THEIR USE IS IN ACCORDANCE WITH DONOR WISHES. THE FOUNDATION LEADERSHIP WORKS WITH THE HOSPITAL LEADERSHIP TO DETERMINE HOW FUNDS ARE DISTRIBUTED. HOSPITAL NEEDS ARE EVALUATED ANNUALLY TO ENSURE THE GREATEST NEEDS ARE MET FIRST. THE SUPPORT FROM THE FOUNDATION FOCUSED ON HOSPITAL DEPARTMENT SUPPORT (SURGERY, RESPIRATORY, LABORATORY, INPATIENT CARE, IMAGING, CARDIAC, ONCOLOGY, PHARMACY, PHYSICAL THERAPY AND OBSTETRICS), EMPLOYEE SUPPORT, PROGRAM SUPPORT (OXFORD FREE CLINIC, COALITION FOR A HEALTHY COMMUNITY, HEALING ARTS AND PRENATAL AND POSTPARTUM EDUCATION), PATIENT SUPPORT (MEDICAL GAP FUNDING, TEMPORARY ASSISTANCE AND EMERGENCY FUNDING) AND HOSPITAL CAPITAL PROJECTS (FACILITY RENOVATIONS, EQUIPMENT PURCHASES AND CLINICAL INNOVATION). PART E, LINE 2B THE SUPPORTED ORGANIZATION, MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("HOSPITAL"), GENERALLY WOULD NEED TO RAISE AND MANAGE FUNDS IN ORDER TO FURTHER ITS EXEMPT MISSION. INSTEAD, THE MCCULLOUGH-HYDE FOUNDATION ("FOUNDATION") RECEIVES ALL CHARITABLE CONTRIBUTIONS FROM COMMUNITY MEMBERS FOR THE BENEFIT OF THE HOSPITAL, MANAGES AND DISTRIBUTES THOSE FUNDS FOR HOSPITAL DEPARTMENT SUPPORT (SURGERY, RESPIRATORY, LABORATORY, INPATIENT CARE, IMAGING, CARDIAC, ONCOLOGY, PHARMACY, PHYSICAL THERAPY AND OBSTETRICS), EMPLOYEE SUPPORT, PROGRAM SUPPORT (OXFORD FREE CLINIC, COALITION FOR A HEALTHY COMMUNITY, HEALING ARTS AND PRENATAL AND POSTPARTUM EDUCATION), PATIENT SUPPORT (MEDICAL GAP FUNDING, TEMPORARY ASSISTANCE AND EMERGENCY FUNDING) AND HOSPITAL CAPITAL PROJECTS (FACILITY RENOVATIONS, EQUIPMENT PURCHASES AND CLINICAL INNOVATION). THIS ALLOWS THE HOSPITAL TO FOCUS ON DELIVERING PATIENT CARE IN FURTHERANCE OF ITS EXEMPT PURPOSE. PART I, LINE 12G, COLUMN (VI) THE MCCULLOUGH-HYDE FOUNDATION ("FOUNDATION") RECEIVED ALL CHARITABLE CONTRIBUTIONS FROM COMMUNITY MEMBERS FOR THE BENEFIT OF THE HOSPITAL, MANAGES AND DISTRIBUTES THOSE FUNDS FOR HOSPITAL DEPARTMENT SUPPORT (SURGERY, RESPIRATORY, LABORATORY, INPATIENT CARE, IMAGING, CARDIAC, ONCOLOGY, PHARMACY, PHYSICAL THERAPY AND OBSTETRICS), EMPLOYEE SUPPORT, PROGRAM SUPPORT (OXFORD FREE CLINIC, COALITION FOR A HEALTHY COMMUNITY, HEALING ARTS AND PRENATAL AND POSTPARTUM EDUCATION), PATIENT SUPPORT (MEDICAL GAP FUNDING, TEMPORARY ASSISTANCE AND EMERGENCY FUNDING) AND HOSPITAL CAPITAL PROJECTS (FACILITY RENOVATIONS, EQUIPMENT PURCHASES AND CLINICAL INNOVATION). PART IV, SECTION A, LINE 6 BEGINNING IN TAX YEAR 2022, THE MCCULLOUGH-HYDE FOUNDATION ("FOUNDATION") BEGAN PROVIDING GRANTS TO LOCAL ORGANIZATIONS THAT LEAD THE WAY IN BUILDING HEALTHIER COMMUNITIES. THESE ORGANIZATIONS ARE CHOSEN AS THEY ADDRESS SIGNIFICANT HEALTH NEEDS OF LOCAL COMMUNITIES THROUGHOUT BUTLER AND PREBLE COUNTIES IN OHIO AND FRANKLIN AND UNION COUNTIES IN INDIANA WHICH IS THE SERVICE AREA OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL, THE SUPPORTED ORGANIZATION OF THE FOUNDATION. IN ADDITION, THE FUNDING PRIORITIES ALIGN WITH THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, PUBLISHED TRIENNIALLY BY MCCULLOUGH-HYDE MEMORIAL HOSPITAL. THE COMMUNITY HEALTH NEEDS ASSESSMENT INCORPORATES INPUT FROM A WIDE VARIETY OF SOURCES, IDENTIFIES THE GREATEST HEALTH NEEDS IN BUTLER, FRANKLIN, PREBLE AND UNION COUNTIES AND PROVIDES LOCATION-SPECIFIC DATA POINTS RELATED TO HEALTH. ULTIMATELY, THIS ACTIVITY FURTHERS THE EXEMPT PURPOSE OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 18841186 349062 2393748 1047599 20536397 17831323 495416 1666690 1152243 18841186 21423438 411245 -2414502 1588858 17831323 17556230 99623 3893561 125976 21423438 13004388 4813690 177095 438943 17556230 0.78721 0.21279 0.00000 0 0 62370 62370 344389 148329 196060 9899 9899 0 258430 DUE TO MCCULLOUGH-HYDE MEMORIAL HOSPITAL 100772 MISCELLANEOUS 3939 104711 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE FOCUSED ON HOSPITAL DEPARTMENT SUPPORT (SURGERY, RESPIRATORY, LABORATORY, INPATIENT CARE, IMAGING, CARDIAC, ONCOLOGY, PHARMACY, PHYSICAL THERAPY AND OBSTETRICS), EMPLOYEE SUPPORT, PROGRAM SUPPORT (OXFORD FREE CLINIC, COALITION FOR A HEALTHY COMMUNITY, HEALING ARTS AND PRENATAL AND POSTPARTUM EDUCATION), PATIENT SUPPORT (MEDICAL GAP FUNDING, TEMPORARY ASSISTANCE AND EMERGENCY FUNDING) AND HOSPITAL CAPITAL PROJECTS (FACILITY RENOVATIONS, EQUIPMENT PURCHASES AND CLINICAL INNOVATION). PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE FOUNDATION IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FOUNDATION, AND HAS CONCLUDED THAT, AS OF JUNE 30, 2024 AND 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE FOUNDATION'S INFORMATION RETURNS FOR THE YEARS 2021 THROUGH 2024 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE, ALTHOUGH THAT AGENCY HAS NOT INDICATED ANY INTENT TO DO SO. THE LLC IS A DISREGARDED ENTITY AND IS REPORTED AS A DIVISION OF THE FOUNDATION ON THE FOUNDATION'S INFORMATION RETURN. CHEF'S CELEBRATION 42350 37775 4575 3750 42350 37775 4575 3750 3750 825 1 MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED 110 N POPLAR ST OXFORD OH 45056 310650283 501(C)(3) 159730 0 GENERAL PROGRAM SUPPORT TALAWANDA CITY SCHOOL DISTRICT 131 W CHESTNUT ST OXFORD OH 45056 316005340 GOVERNMENT 80000 0 DEFIBRILLATOR; COALITION FOR A HEALTHY COMMUNITY SUSTAINABILITY OXFORD SENIOR CITIZENS INC 922 TOLLGATE DR OXFORD OH 45056 310934786 501(C)(3) 36500 0 TRANSPORTATION SERVICES; ACTIVITIES DEPARTMENT UPDATE & EXPANSION TALAWANDA OXFORD PANTRY AND SOCIAL SERVICES PO BOX 391 OXFORD OH 45056 510596248 501(C)(3) 29500 0 FRESH MILK PROGRAM; PURCHASE HYGIENE PRODUCTS YOUNG WOMEN CHRISTIANS ASSOCIATION (YWCA HAMILTON) 1570 GRAND BLVD HAMILTON OH 45011 310537167 501(C)(3) 22500 0 DOVE HOUSE DOMESTIC VIOLENCE SHELTER OXFORD FREE CLINIC PO BOX 390 OXFORD OH 45056 204253386 501(C)(3) 21500 0 MEDICAL EQUIPMENT UPGRADES; PROGRAM SUPPORT UNION COUNTY FRIENDS OF THE LIBRARY 2 EAST SEMINARY ST LIBERTY IN 47353 351856533 501(C)(3) 20000 0 COMMUNITY PLAYGROUND COLLEGE CORNER LOCAL SCHOOL DISTRICT 230 RAMSEY ST PO BOX 337 COLLEGE CORNER OH 45003 316015118 GOVERNMENT 15000 0 BACKPACK PROGRAM BIG BROTHERS BIG SISTERS OF BUTLER COUNTY INC 1755 S ERIE BLVD SUITE D HAMILTON OH 45011 310846147 501(C)(3) 10000 0 COMMUNITY-BASED PROGRAMMING SERVE CITY INC 622 EAST AVENUE HAMILTON OH 45011 311746150 501(C)(3) 10000 0 MOVE FORWARD PROGRAM COUNCIL ON AGING OF SOUTHWESTERN OHIO 4601 MALSBARY RD BLUE ASH OH 45242 310807186 501(C)(3) 10000 0 FASTTRACK HOME OXFORD TALAWANDA COMMUNITY SERVICES INC PO BOX 108 OXFORD OH 45056 310958091 501(C)(3) 10000 0 HOUSING AND SUPPORTIVE SERVICES PARACHUTE SPECIAL ADVOCATES FOR CHILDREN OF BUTLER COUNTY 284 N FAIR AVE HAMILTON OH 45011 311230170 501(C)(3) 10000 0 EVERY CHILD HAS A CHANCE PROGRAM MIAMI UNIVERSITY 501 HIGH STREET OXFORD OH 45056 316402089 501(C)(3) 5500 0 MEALS TO THE COMMUNITY 14 0 MHMH EMPLOYEE EDUCATIONAL ASSISTANCE 12 23198 MHMH EMPLOYEE RELIEF 7 9394 MHMH PATIENT MEDICAL EXPENSE RELIEF 7 8103 PART I, LINE 2 RECIPIENTS OF GRANTS FROM THE MCCULLOUGH-HYDE FOUNDATION ("FOUNDATION") ARE REQUIRED TO SIGN A DOCUMENT ESTABLISHING THE TERMS AND CONDITIONS OF THE AWARD. THESE INCLUDE: * GRANT PAYMENT & DOCUMENTATION - GRANTEE WILL MAINTAIN ACCURATE RECORDS OF ALL PROJECTS/PROGRAM EXPENSES. THE FOUNDATION RESERVES THE RIGHT TO REQUEST SUPPORTING DOCUMENTS ON GRANT EXPENDITURES AT ANY TIME. * BUDGET AND TIMELINE MANAGEMENT - GRANTEE WILL PROMPTLY CONTACT THE FOUNDATION FOR ANY PROPOSED CHANGES TO THE PROJECT'S BUDGET AND/OR TIMELINE. GRANTEE WILL INFORM THE FOUNDATION IMMEDIATELY OF PERSONNEL CHANGES RELATED TO POSITIONS SUPPORTED BY GRANT FUNDS OR POSITIONS DIRECTLY MANAGING GRANT DOLLARS. * UNUSED GRANT FUNDS - ANY GRANT FUNDS NOT UTILIZED BY THE LAST DAY OF THE FOUNDATION'S FISCAL YEAR MUST BE RETURNED. UNREIMBURSED GRANT FUNDS HELD BY THE FOUNDATION AFTER THE END OF THE FISCAL YEAR WILL BE FORFEITED UNLESS PRIOR WRITTEN APPROVAL IS SUBMITTED AND OBTAINED. * REPORTING REQUIREMENTS - GRANTEE WILL SUBMIT AN ANNUAL EVALUATION REPORT WITHIN ONE YEAR OF GRANT RECEIPT OR UPON PROJECT COMPLETION. FAILURE TO COMPLY MAY RESULT IN EXCLUSION FROM FUTURE FUNDING CONSIDERATION. * IMPACT REPORTING - GRANTEE MAY BE REQUESTED TO MAKE A PRESENTATION TO THE FOUNDATION'S BOARD OF TRUSTEES. THE GRANTEE MAY BE ASKED TO HOST MEMBERS OF THE FOUNDATION'S PROFESSIONAL STAFF AND BOARD OF TRUSTEES FOR A SITE VISIT. 0 0 0 0 0 0 0 0 0 TYLER WASH EXECUTIVE DIRECTOR 124750 0 12659 0 830 0 7204 0 32301 0 177744 0 0 0 FORM 990, PART VII, SECTION A, LINE 5: TRIHEALTH, INC., AN UNRELATED ORGANIZATION OF MCCULLOUGH-HYDE FOUNDATION, PAID THE FOLLOWING INDIVIDUALS COMPENSATION (I.E. SALARIES AND BENEFITS) FOR SERVICES RENDERED AS AN EMPLOYEE OF THE FILING ORGANIZATION. TRIHEALTH, INC. WAS SUBSEQUENTLY REIMBURSED BY MCCULLOUGH-HYDE FOUNDATION FOR THE AMOUNTS: TYLER WASH - $177,744 FORM 990, PART III, LINE 1, BRIEFLY DESCRIBE THE ORGANIZATION'S MISSION: THE FOUNDATION PROVIDES A VARIETY OF FINANCIAL SUPPORT, THROUGH GRANTS, TO MCCULLOUGH-HYDE MEMORIAL HOSPITAL ('HOSPITAL") AND THE SURROUNDING COMMUNITY. IT FOCUSES ON PROVIDING FINANCIAL SUPPORT TO THE HOSPITAL FOR DEPARTMENTS AND SPECIALTIES, EDUCATION, EMPLOYEES, HEALTHCARE PROGRAMS, PATIENTS AND GENERAL INFRASTRUCTURE. IN ADDITION, IT MAKES INVESTMENTS IN THE SURROUNDING COMMUNITY SERVED BY THE HOSPITAL TO ADDRESS SIGNIFICANT HEALTH NEEDS. EACH YEAR, THE EMPHASIS IS ON PROGRAMS AND PROJECTS THAT FOCUS ON EDUCATION, PREVENTION PROGRAMS, AWARENESS EFFORTS, WELLNESS OPPORTUNITIES AND DIRECT CARE IN THE FOLLOWING AREAS - MENTAL HEALTH, ALCOHOL AND DRUGS ABUSE, ACCESS TO HEALTHCARE, FOOD INSECURITIES AND OBESITY AND HEALTHY BEHAVIORS. THESE FIVE FUNDING PRIORITIES ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, PUBLISHED TRIENNIALLY BY THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A THE MAYOR OF THE CITY OF OXFORD APPOINTS, WITH THE APPROVAL OF THE OXFORD CITY COUNCIL, THE BOARD MEMBERS OF THE MCCULLOUGH-HYDE FOUNDATION TO FIVE-YEAR TERMS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BOARD PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY ("POLICY") APPLIES TO ANY TRUSTEE OR OFFICER OF THE BOARD, OR MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS ("INTERESTED PARTY"). ANY PERSON WHO HOLDS A SIMILAR POSITION WITH THE MCCULLOUGH-HYDE MEMORIAL HOSPITAL ("HOSPITAL"), THE SUPPORTED ORGANIZATION OF THE FOUNDATION, OR ANY ENTITY IN ANY HEALTH CARE SYSTEM OR NETWORK OF WHICH THE HOSPITAL IS A PART IN ALSO CONSIDERED AN INTERESTED PARTY FOR PURPOSES OF THIS POLICY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF HIS/HER INTEREST, AS WELL AS ALL MATERIAL FACTS RELATING THERETO, TO THE CHAIR AND TO OTHER TRUSTEE OR COMMITTEE MEMBERS WHO ARE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE INFORMATION SHOULD BE MADE A MATTER OF RECORD BEFORE ANY MATTER TO WHICH THE INTEREST RELATES BECOMES A MATTER OF TRUSTEE ACTION. DETERMINING WHETHER A CONFLICT OF FINANCIAL INTEREST EXISTS - AFTER DISCLOSURE OF A FINANCIAL INTEREST, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE WHETHER A CONFLICT OF INTEREST EXISTS. PROCEDURES FOR ADDRESSING THE CONFLICT OF FINANCIAL INTEREST - IF IT IS DETERMINED THAT THE INFORMATION DISCLOSED BY THE INTERESTED PERSON CONCERNING A FINANCIAL INTEREST CONSTITUTES A CONFLICT OF INTEREST ON THE PART OF SUCH INTERESTED PERSON, THE FOLLOWING PROCEDURES SHALL APPLY: * AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. * THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. *AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE FOUNDATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. *IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE FOUNDATION'S BEST INTEREST AND FOR ITS BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE FOUNDATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST NOT INVOLVING A FINANCIAL INTEREST - ANY INTERESTED PERSON HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER (EVEN IF IT DOES NOT INVOLVE A FINANCIAL INTEREST) SHOULD NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER. THE MINUTES OF THE MEETING SHOULD REFLECT THAT A DISCLOSURE WAS MADE AND THE ABSTENTION FROM VOTING. THE FOREGOING REQUIREMENTS SHOULD NOT BE CONSTRUED AS PREVENTING A BOARD OR COMMITTEE MEMBER FROM BRIEFLY STATING HIS/HER POSITION IN THE MATTER, NOR FROM ANSWERING PERTINENT QUESTIONS OF OTHER MEMBERS SINCE HIS/HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY - IF THE BOARD OR ANY COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE CORRECTIVE ACTION. RECORDS OF PROCEEDINGS - THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: * THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. *THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: TRIHEALTH, INC., AN UNRELATED ORGANIZATION OF MCCULLOUGH-HYDE FOUNDATION, PAID THE COMPENSATION (I.E. SALARIES AND BENEFITS) FOR SERVICES RENDERED AS AN EMPLOYEE OF THE FILING ORGANIZATION. TRIHEALTH, INC. WAS SUBSEQUENTLY REIMBURSED BY MCCULLOUGH-HYDE FOUNDATION FOR THE AMOUNTS. TRIHEALTH, INC. PERFORMED THE TAX REPORTING REQUIREMENTS (I.E. FORM W-2) ASSOCIATED WITH THE COMPENSATION PAID. MCCULLOUGH-HYDE MEMORIAL HOSPITAL TRUST REAL ESTATE LLC 110 NORTH POPLAR STREET OXFORD OH 45056 REAL ESTATE HOLDINGS OH 31520 268964 MCCULLOUGH-HYDE MEMORIAL HOSPITAL ENDOWMENT FUND MCCULLOUGH-HYDE MEMORIAL HOSPITAL INCORPORATED 110 NORTH POPLAR STREET OXFORD OH 45056 310650283 HOSPITAL OH 501(C)(3) LINE 3 N/A 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0