2026-05-13T07:47:46-05:00 2025-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2024-07-01 311206047 GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI INC GOOD 5138623786 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 MICHAEL CROFTON VP-FINANCE 5135696577 2026-05-13 1 1 SHAWNA M JANSONS P01222873 3174648600 2024 2025-03-06 01:10:19Z ANDREW SWALLOW 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 12990201 0 0928 X WWW.GSHFOUNDATION.COM X 1852 OH TO OPERATE EXCLUSIVELY TO STEWARD PHILANTHROPIC GIFTS FOR THE GOOD SAMARITAN HOSPITAL. 21 18 0 269 0 0 12971930 7147748 0 0 3636555 5718753 -103371 -98435 16505114 12768066 4140123 3818941 0 0 0 0 0 0 1149892 1795605 1853824 5935728 5672765 10569386 7095301 105149189 115697758 144906 133600 105004283 115564158 X SEE SCHEDULE O 0 0 3899986 3818941 0 SEE SCHEDULE O 3899986 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 7 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 21 18 0 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 X MARY RAFFERTY PRES.-FOUNDATION (END 1/25) 60.00 0.00 X X 0 330742 64071 CHRISTOPHER HEEKIN TRUSTEE (END 6/25) 1.00 0.00 X 0 0 0 MARK CLEMENT CEO-TRIHEALTH 1.00 60.00 X 0 2558073 75684 ELIZABETH MANGAN CHAIRPERSON 1.00 0.00 X X 0 0 0 JAMES SHANAHAN JR TRUSTEE 1.00 0.00 X 0 0 0 ROBERT SCHILLER TRUSTEE 1.00 0.00 X 0 0 0 MARK WALTON VICE CHAIRPERSON 1.00 0.00 X X 0 0 0 FRED BRINK SECRETARY 1.00 0.00 X X 0 0 0 SETH ISAACS MD TRUSTEE (END 6/25) 1.00 0.00 X 0 0 0 CHRISTINA SCALO TRUSTEE (END 6/25) 1.00 0.00 X 0 0 0 NEAL SCHEAR TRUSTEE 1.00 0.00 X 0 0 0 BRENDAN WHITE TREASURER 1.00 0.00 X X 0 0 0 DARLENE AMBACH TRUSTEE (END 6/25) 1.00 0.00 X 0 0 0 SHANNON LAWSON TRUSTEE 1.00 0.00 X 0 0 0 JENNIFER LYKENS-SCHNAKE MD TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL VASSAR TRUSTEE 1.00 0.00 X 0 0 0 PAUL EDGETT III TRUSTEE 1.00 0.00 X 0 0 0 SISTER ANNIE KLAPHEKE SC TRUSTEE 1.00 60.00 X 0 69813 12817 MELODY WEIL TRUSTEE 1.00 0.00 X 0 0 0 ANDREW SWALLOW PRES.-FOUNDATION (START 1/25) 60.00 0.00 X X 0 375085 83739 ANGEL MENA AGUILAR MD TRUSTEE (START 7/24) 1.00 0.00 X 0 0 0 BARRETT ALBRECHT TRUSTEE (START 7/24) 1.00 0.00 X 0 0 0 KELLY ROWLAND DIRECTOR OF DEVELOPMENT 60.00 0.00 X 0 197178 45580 KELLY VANCE MANAGER 60.00 0.00 X 0 105838 46338 0 3636729 328229 0 0 1 0 0 398300 3982752 50000 2716696 87537 7147748 1624499 1624499 4094254 0 4094254 4094254 4094254 123700 398300 222135 -98435 -98435 12768066 0 0 5620318 3780414 3780414 38527 38527 234284 234284 93046 256 92790 22283 22283 119645 13886 105759 60101 60101 479 13 466 4862 4862 PAYROLL SVCS ALLOCATION 834933 22262 40169 772502 OVERHEAD ALLOCATION 463526 58596 318685 86245 BAD DEBT EXPENSE 12000 187 2067 9746 EQUIPMENT 4903 4903 3762 3762 5672765 3899986 622887 1149892 2142189 3872803 5217504 4255454 32128 11698 5457 20430 95942422 105237129 728790 677517 1112827 1634425 105149189 115697758 144906 133600 144906 133600 X 46552794 50937739 58451489 64626419 105004283 115564158 105149189 115697758 7095301 3464574 0 X X 0 1 X 1 0 X X 1 GOOD SAMARITAN HOSPITAL OF CINTI 310537486 3 1 1890366 0 1 1890366 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 PART I, LINE 11(G), COLUMN (VI) THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. ("FOUNDATION") PERFORMS FUNDRAISING FOR THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO ("HOSPITAL") AND MANAGES THE FUNDS UNTIL NEEDED BY THE HOSPITAL. AT THAT TIME, THE FOUNDATION PROVIDES THE FUNDS TO HOSPITAL. PART IV, SECTION B, LINE 2 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO ("HOSPITAL") IS THE SOLE MEMBER OF THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. ("FOUNDATION") AND AS SUCH IT OPERATES, SUPERVISES OR CONTROLS THE FOUNDATION. THE FOUNDATION'S ARTICLES OF INCORPORATION INDICATE THAT IT WILL EXTEND FINANCIAL AND OTHER AID AND ASSISTANCE FOR THE SUPPORT OF HOSPITAL AND ITS SUCCESSORS AND CONTROLLED OR SUBSIDIARY OR RELATED ENTITIES ENGAGED IN PROVIDING HOSPITAL, MEDICAL CARE, RESEARCH OR EDUCATIONAL SERVICES OR IN PROVIDING RELIEF FOR THE SICK AND AGED AND WHICH ARE RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE OTHER ORGANIZATIONS THAT RECEIVE SUPPORT FROM THE FOUNDATION MEET THESE REQUIREMENTS AND ARE OPERATED, SUPERVISED OR CONTROLLED BY THE HOSPITAL. THEREFORE, IT CARRIES OUT THE PURPOSE OF HOSPITAL. PART IV, SECTION A, LINE 6 SEE EXPLANATION FOR PART IV, SECTION B, LINE 2. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25167719 514044 1393553 -2864934 29940250 23012879 188637 851095 -1115108 25167719 20285232 1233822 480111 -1013714 23012879 17404282 994654 991198 -895098 20285232 16788184 182391 1282919 849212 17404282 0.95339 0.04661 0 0 21645 3137 18508 10483 8561 1922 20430 X PART V, LINE 4: INVESTMENT PROCEEDS FROM ENDOWMENT FUNDS ARE USED TO SUPPORT PROGRAMS AT THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND ITS SUBSIDIARIES. PART X, LINE 2: THE FINANCIAL STATEMENTS OF GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC.'S FINANCIAL INFORMATION ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH ("COMMONSPIRIT"), A RELATED ORGANIZATION. COMMONSPIRIT'S FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2025 READS AS FOLLOWS: INCOME TAXES- COMMONSPIRIT HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES, AND AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, COMMONSPIRIT'S EXEMPT ORGANIZATIONS ARE SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, WHICH DOES NOT FURTHER THE ORGANIZATIONS' EXEMPT PURPOSES. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS. COMMONSPIRIT'S FOR-PROFIT SUBSIDIARIES ACCOUNT FOR INCOME TAXES RELATED TO THEIR OPERATIONS. THE FOR-PROFIT SUBSIDIARIES RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF THEIR ASSETS AND LIABILITIES, ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS, FOR TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION CRITERIA. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. COMMONSPIRIT'S TAXABLE ENTITIES DID NOT HAVE ANY MATERIAL UNRECOGNIZED INCOME TAX BENEFITS AS OF JUNE 30, 2025 AND 2024. COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. GALA 522000 398300 123700 5500 102021 26850 87764 522000 398300 123700 5500 102021 26850 87764 222135 -98435 1 THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OHIO 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310537486 501(C)(3) 1890366 0 HOSPITAL PROGRAMS GOOD SAMARITAN HOSPITAL FREE CLINIC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 273893817 501(C)(3) 1107137 0 GENERAL SUPPORT GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311778403 501(C)(3) 453478 0 GENERAL SUPPORT TRIHEALTH PHYSICIAN INSTITUTE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311074519 501(C)(3) 203831 0 GENERAL SUPPORT BETHESDA HOSPITAL INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 310537122 501(C)(3) 95257 0 GENERAL SUPPORT TRIHEALTH INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311438846 501(C)(3) 12701 0 HOSPITAL PROGRAMS TRIHEALTH PHYSICIAN ENTERPRISE CORP 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 311383365 501(C)(3) 8672 0 GENERAL SUPPORT 7 0 EDUCATION GRANTS 16 36427 EMERGENCY ASSISTANCE FUND - PATIENT 4 2100 PART I, LINE 2: ALL GRANTS GO INTO A TEMPORARILY RESTRICTED FUND. EACH FUND IS CREATED FOR A SPECIFIC PURPOSE AND IS MONITORED BY THE STAFF OF THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. THE FILING ORGANIZATION ALSO COMPLETED EVALUATIONS FOR MOST GRANTEES. 0 1 0 0 0 0 0 0 0 MARK CLEMENT CEO-TRIHEALTH 0 1651024 0 769875 0 137174 0 49708 0 25976 0 2633757 0 0 ANDREW SWALLOW PRES.-FOUNDATION (START 1/25) 0 282039 0 80684 0 12362 0 46984 0 36755 0 458824 0 0 MARY RAFFERTY PRES.-FOUNDATION (END 1/25) 0 257300 0 65380 0 8062 0 51229 0 12842 0 394813 0 0 KELLY ROWLAND DIRECTOR OF DEVELOPMENT 0 167560 0 18735 0 10883 0 16064 0 29516 0 242758 0 0 KELLY VANCE MANAGER 0 95936 0 9702 0 200 0 6522 0 39816 0 152176 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. NONE OF THE 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. PART I, LINE 3: TRIHEALTH, INC., A RELATED ORGANIZATION OF THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. WHO PAID THE INDIVIDUAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE FILING ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: * COMPENSATION COMMITTEE; * INDEPENDENT COMPENSATION CONSULTANT; * COMPENSATION SURVEY OR STUDY; AND * APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, QUESTION 4A: THE REPORTABLE INDIVIDUALS OF THE ORGANIZATION ARE PAID BY TRIHEALH, INC., AN ORGANIZATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(A) AS AN ORGANIZATION DESCRIBED IN IRC 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 PAY ARE CONDITIONED UPON SIGNING A SEPERATION AND RELEASE AGREEMENT. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC. DURING THE 2024 CALENDAR YEAR. X 4 87537 FAIR MARKET VALUE 0 0 1 1 PART I, COLUMN (B): NUMBERS SHOWN REFLECT THE NUMBER OF CONTRIBUTIONS RECEIVED DURING THE TAX YEAR. PART I, LINE 32B: WHEN THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. ("FOUNDATION") RECEIVES SECURITIES AS A NON-CASH CONTRIBUTION, THEY ARE GIVEN TO NORTHERN TRUST, WHO THEN SELLS THEM AND DEPOSITS THE FUNDS FOR THE FOUNDATION. FORM 990, PART III, LINE 1 THE ORGANIZATION'S MISSION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH BY BRINGING IT NEW LIFE, ENERGY AND VIABILITY IN THE 21ST CENTURY. FIDELITY TO THE GOSPEL URGES US TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS WE MOVE TOWARD THE CREATION OF HEALTHIER COMMUNITIES. FORM 990, PART III, LINE 4A THE GOOD SAMARITAN FOUNDATION OF CINCINNATI, INC. ("FOUNDATION") WAS FOUNDED IN 1986 AND IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE ("IRS") AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION ("IRC SEC.") 501(A) AS AN ORGANIZATION DESCRIBED IN IRC SEC. 501(C)(3). IT IS ENTRUSTED TO RECEIVE ALL CHARITABLE GIFTS TO THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO ("HOSPITAL") AND THE GOOD SAMARITAN COLLEGE OF NURSING AND HEALTH SCIENCE ("COLLEGE") TO STEWARD THOSE FUNDS PRUDENTLY, AND TO ENSURE THAT THEY ARE USED ACCORDING TO THE DESIRES OF DONORS. BOTH HOSPITAL AND COLLEGE ARE RECOGNIZED BY THE IRS AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SEC. 501(A) AS ORGANIZATIONS DESCRIBED IN IRC SEC. 501(C)(3). WITH RESPECT TO THE HOSPITAL, IT OPERATES EXCLUSIVELY TO SECURE AND STEWARD PHILANTHROPIC GIFTS WHICH WILL SUSTAIN THE LEVEL OF PERSONAL, COMPASSIONATE CARE FOR WHICH IT IS RENOWNED. A GIFT TO THE FOUNDATION ENABLES THE HOSPITAL TO CONTINUE REACHING OUT TO THE COMMUNITY WITH INNOVATIVE HEALTH EDUCATION AND WELLNESS PROGRAMS THAT HELP PEOPLE HELP THEMSELVES BY MAINTAINING BETTER HEALTH. THE FOUNDATION'S STAFF AND BOARD OF TRUSTEES, THE MAJORITY OF WHICH ARE INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY, RAISE FUNDS THROUGH SPECIAL EVENTS, ANNUAL GIVING, MAJOR GIFTS, PLANNED GIVING, CORPORATE/FOUNDATION GRANTS AND CAPITAL CAMPAIGNS TO HELP FUND MANY AREAS OF THE HOSPITAL, SUCH AS, COMMUNITY PROGRAMS, MEDICAL/NURSING EDUCATION, MEDICAL/NURSING RESEARCH, CAPITAL NEEDS, DEPARTMENTAL SUPPORT, AND PROGRAM SUPPORT. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. SHALL BE THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO ARTICLE II, SECTION 2.2 OF THE CODE OF REGULATIONS OF THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC., THE SOLE MEMBER OF THE CORPORATION SHALL APPOINT THE BOARD OF TRUSTEES OF THE CORPORATION NO LATER THAN SEPTEMBER 30 OF EACH YEAR. FORM 990, PART VI, SECTION A, LINE 7B THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO MUST APPROVE AMENDMENTS TO THE FILING ORGANIZATION'S REGULATIONS AND THOSE MATTERS RESERVED BY OHIO LAW. 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 CHANGES ARE NOT RE-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 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. FORM 990, PART VI, SECTION C, LINE 19 THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC.'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION, THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC.'S FINANCIAL STATEMENTS ARE INCLUDED IN THE CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINITIATIVES.ORG OR AT HTTP://WWW.DACBOND.COM. FORM 990, PART VII, SECTION A - AVERAGE HOURS PER WEEK: THE OFFICERS AND DIRECTORS FOR THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. THAT SHOW AT LEAST 60 HOURS PER WEEK, EXCLUDING THE FILING ORGANIZATION'S PRESIDENT/CEO, 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 I, LINE 6 DURING THE TAX YEAR, THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. WAS ASSISTED BY 269 VOLUNTEERS ASSISTING IN VARIOUS FUNDRAISING ACTIVITIES AND EVENTS TO BENEFIT THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO. FORM 990, PART VI, LINE 1 PURSUANT TO ARTICLE V, SECTION 5.1 OF THE CODE OF REGULATIONS ("CODE") OF THE GOOD SAMARITAN HOSPITAL FOUNDATION, INC., THE EXECUTIVE COMMITTEE SHALL BE APPOINTED BY VOTE OF THE BOARD. PURSUANT TO ARTICLE V, SECTION 5.2(A) OF THE CODE, THE EXECUTIVE COMMITTEE SHALL CONSIST OF THREE (3) OR MORE OF THE TRUSTEES, INCLUDING THE CHAIR, THE PRESIDENT AND THE CHIEF EXECUTIVE OFFICER AND OTHER REPRESENTATIVES OF THE BOARD AS DEEMED NECESSARY. THE CHAIR SHALL SERVE AS THE CHAIR OF THE EXECUTIVE COMMITTEE. MEMBERS OF THE EXECUTIVE COMMITTEE (OTHER THAN THE CHAIR AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER) SHALL SERVE AT THE PLEASURE OF THE BOARD AND MAY BE REMOVED WITH OR WITHOUT CAUSE AT ANY TIME BY VOTE OF THE BOARD. TWO CONSECUTIVE UNEXCUSED ABSENCES SHALL BE GROUNDS FOR REMOVAL FROM THE EXECUTIVE COMMITTEE. PURSUANT TO ARTICLE V, SECTION 5.2(B) OF THE CODE, THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD BY STATUTE. PURSUANT TO ARTICLE V, SECTION 5.2(C) OF THE CODE, THE PRESENCE OF A MAJORITY OF VOTING MEMBERS OF THE EXECUTIVE COMMITTEE THEN SERVING SHALL CONSTITUTE A QUORUM FOR ANY MEETING OF THE EXECUTIVE COMMITTEE. THE ACT OF A MAJORITY OF THE TRUSTEES PRESENT AT A MEETING AT WHICH A QUORUM IS PRESENT IS THE ACT OF THE EXECUTIVE COMMITTEE. ANY ACTION WHICH MAY BE AUTHORIZED OR TAKEN AT AN EXECUTIVE COMMITTEE MEETING MAY BE AUTHORIZED OR TAKEN WITHOUT A MEETING WITH THE WRITTEN APPROVAL OF ALL THE MEMBERS OF THE EXECUTIVE COMMITTEE ENTITLED TO VOTE THEREON. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF THE GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI, INC. ARE INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CATHOLIC HEALTH INITIATIVES ("CHI"), A RELATED ORGANIZATION. CHI 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. DURING THE TAX YEAR, THERE WAS NOT A CHANGE IN THE PROCESS OF AUDIT OVERSIGHT AND/OR SELECTION OF AN INDEPENDENT AUDITOR BY CHI. ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA NE 68154 470765154 HOSPITAL NE 501(C)(3) 3 ACH 0 ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA NE 68154 470757164 HOSPITAL NE 501(C)(3) 3 CHI NEBRASKA 0 ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA NE 68124 470484764 HOSPITAL NE 501(C)(3) 3 CHI NEBRASKA 0 ALEGENT HEALTH - COMMUNITY MEMORIAL HOSPITAL OF MO VALLEY IA 631 N 8TH ST MISSOURI VALLEY IA 51555 420776568 HOSPITAL IA 501(C)(3) 3 CHI NEBRASKA 0 ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA NE 68122 470376615 HOSPITAL NE 501(C)(3) 3 CHI NEBRASKA 0 ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER NE 68661 470399853 HOSPITAL NE 501(C)(3) 3 CHI NEBRASKA 0 ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING IA 50841 420782518 HOSPITAL IA 501(C)(3) 3 CHI NEBRASKA 0 ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS MN 56345 411351177 LTERM CARE MN 501(C)(3) 10 CSH 0 APPLETREE COURT 601 OAK ST BRECKENRIDGE MN 56520 411850500 SENIOR LIVING MN 501(C)(3) 10 SFH 0 ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE CA 93420 203256066 FUNDRAISING FOUNDATION CA 501(C)(3) 12A DH 0 BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD CA 93301 951802779 HOSPITAL CA 501(C)(3) 3 DCC 0 BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS TX 77384 274499340 PHYSICIANS TX 501(C)(3) 12A SLHS 0 BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON TX 77030 760458535 PHYSICIANS TX 501(C)(3) 3 BSLHV 0 BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON 1201 9TH AVE SEATTLE WA 98101 910653422 RESEARCH WA 501(C)(3) 4 VWFH 0 BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 232187242 INACTIVE PA 501(C)(3) 12A CSH 0 BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN TX 77802 742759890 HOSPITAL TX 501(C)(3) 3 SLH-CO 0 BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN TX 77802 742913931 REHABILITATION TX 501(C)(3) 10 SJSC 0 CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES CA 90015 954000909 FUNDRAISING FOUNDATION CA 501(C)(3) 12A DCC 0 CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON ND 58421 450227311 HOSPITAL ND 501(C)(3) 3 CSH 0 CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 840405257 HOSPITAL CO 501(C)(3) 3 CSH 0 CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 9100 EAST MINERAL AVE CENTENNIAL CO 80112 840902211 FUNDRAISING FOUNDATION CO 501(C)(3) 7 CHIC 0 CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS CO 80920 270930004 FUNDRAISING FOUNDATION CO 501(C)(3) 12A CSH 0 CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 460992796 TELEHEALTH CO 501(C)(3) 12A CSH 0 CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG OR 97471 263946191 SURGERY CENTER OR 501(C)(3) 10 CS OR 0 CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD CA 93311 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