2026-05-13T09:53:34-05:00 2025-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2024-07-01 310537122 BETHESDA HOSPITAL INC BETH 5135696575 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 MARK CLEMENT 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 1163902333 0 X WWW.TRIHEALTH.COM X 1896 OH TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. 13 10 4351 650 2321771 0 5625882 5890409 958627678 1065922505 -51610299 32133684 4695898 6076438 917339159 1110023036 161641 470653 0 0 362329779 390371969 0 0 0 489338302 555786401 851829722 946629023 65509437 163394013 1346275157 1369784065 689604560 669068481 656670597 700715584 X TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE. THIS IS ACCOMPLISHED BY PROVIDING A FULL RANGE OF HEALTH RELATED SERVICES INCLUDING PREVENTION, WELLNESS AND EDUCATION. 0 0 811584576 470653 1067291885 SEE SCHEDULE O 811584576 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 342 0 1 4351 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 1 0 X MICHAEL CROFTON - VP FINANCE 5135696577 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI OH 45202 SR SALLY DUFFY SECRETARY 1.00 3.00 X X 0 0 0 RALPH MICHAEL VICE CHAIR 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-TRIHEALTH 25.00 35.00 X X 0 2558073 75684 PHILLIP CASTELLINI TRUSTEE (END 6/25) 1.00 3.00 X 0 0 0 KATHY KELLY CHAIR 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 KEN PATTON DO MED STAFF PRESIDENT-BETHESDA 1.00 3.00 X 46700 0 0 KASEY ROHLING MD MED STAFF PRESIDENT-GOOD SAM 1.00 3.00 X 0 45000 0 MICHAEL CROFTON TREASURER (7/24-6/25) 25.00 35.00 X 0 524900 82006 STEVE GRACEY ASST SECRETARY/SVP LEGAL-TRIHEALTH 25.00 35.00 X 0 759998 89778 JOHN WARD SVP-BETHESDA REGION 55.00 5.00 X 0 881518 87697 HELEN KOSELKA MD CHIEF MEDICAL OFFICER-TRIHEALTH 25.00 35.00 X 0 922577 91581 TERRI HANLON-BREMER CHIEF OPERATING OFFICER-TRIHEALTH 25.00 35.00 X 0 1100300 70366 JEREMIAH KIRKLAND PRES. & COO-BUTLER 30.00 30.00 X 0 586769 109018 JOHN HUTSON MD PRES. & COO-BETHESDA 60.00 0.00 X 0 555678 71369 DAVID ATKINSON CHIEF PEOPLE OFFICER-TRIHEALTH 25.00 35.00 X 0 568240 52890 CYNTHIA ADAMS PHD RN CHIEF NURSING EXEC (START 10/24) 25.00 35.00 X 0 163737 4260 MARIA ASHDOWN INTERIM CNE (7/24-10/24) 30.00 30.00 X 0 388840 92036 RICHARD OKRAGLY MD PHYSICIAN 60.00 0.00 X 275111 0 60452 ROBERT KUNKEL MD PHYSICIAN 60.00 0.00 X 251417 0 51175 SCOTT WOODS MD PHYSICIAN 60.00 0.00 X 271931 0 53175 MICHAEL WEBB MD PHYSICIAN 60.00 0.00 X 241405 0 45097 JOHNATHAN SORSCHER MD PHYSICIAN 60.00 0.00 X 237790 0 54426 ANDREW DEVOE FORMER OFFICER 0.00 0.00 X 0 239052 32905 WILL GRONEMAN FORMER KEY EMPLOYEE 0.00 60.00 X 0 489322 80124 DAVID COOK FORMER KEY EMPLOYEE 0.00 0.00 X 0 428584 0 JENNY SKINNER FORMER KEY EMPLOYEE 0.00 0.00 X 0 503066 51443 SUSAN MACY FORMER KEY EMPLOYEE 0.00 0.00 X 0 353849 6353 MICHAEL EVERETT FORMER KEY EMPLOYEE 0.00 0.00 X 0 293392 0 JERRI IRBY FORMER KEY EMPLOYEE 0.00 0.00 X 0 429998 0 1324354 11792893 1261835 538 1 1 0 PREFERRED LAB PARTNERS LLC 1 MEDICAL VILLAGE DRIVE SUITE B EDGEWOOD KY 41017 LABORATORY 19591675 COMMONSPIRIT HEALTH 444 W LAKE ST STE 2500 CHICAGO IL 60606 CLINICAL MAINTENANCE 8181096 SEVEN HILLS ANESTHESIA 4030 SMITH ROAD SUITE 325 CINCINNATI OH 45209 ANESTHESIA 7712208 AMERICAN NURSING CARE 6281 TRI-RIDGE BLVD LOVELAND OH 45140 STAFFING 2705480 BEACON ORTHOPEDICS & SPORTS MEDICINE 500 E BUSINESS WAY CINCINNATI OH 45241 REHABILITATION 2295275 69 5705935 89217 95257 5890409 PATIENT REVENUE 621990 877041514 875315424 1726090 PHARMACY 621990 136634524 136634524 JOA REVENUE SHARE 621990 33544021 33544021 AFFILIATED ORG. RENTAL 532000 16934228 16934228 MEDICAL RESEARCH 541700 647765 647765 1120453 524772 595681 1065922505 11748487 11748487 1244674 0 1244674 1244674 1244674 74247827 16667 53879297 0 20368530 16667 20385197 20385197 CAFETERIA 621990 3462384 3462384 VALUE BASED INCENTIVES 621990 573014 573014 LAB SERVICES 621990 270174 270174 526192 526192 4831764 1110023036 911401362 2321771 190409494 470653 470653 3909253 3909253 1381341 1381341 298502560 244214589 54287971 16256850 12259918 3996932 47872790 32000449 15872341 22449175 17454300 4994875 20722341 20722341 695760 1984 693776 378460 378460 9531 732 8799 1021512 1021512 46683004 34816102 11866902 3765446 98294 3667152 13879453 8533890 5345563 14421592 1789639 12631953 22848170 20221013 2627157 475886 192476 283410 269284 195194 74090 21828509 21701514 126995 51189188 41317319 9871869 4347353 3118091 1229262 MEDICAL/DIETARY SUPPLY 310537234 310316159 221075 OHIO HOSPITAL FEE 25940958 25940958 EQUIPMENT & REPAIRS 15039803 15039803 DUES & SUBSCRIPTIONS 485937 485937 1246980 693221 553759 946629023 811584576 135044447 0 26393 27879 102276742 118705549 21128433 23759933 172251 1402156 1025112394 519825015 516159946 505287379 329616136 318901131 56052451 47507772 240004489 272346548 18748772 14999018 62089544 66846700 1346275157 1369784065 68070282 74890956 0 133543 545162017 539972075 17924662 14522244 58447599 39549663 689604560 669068481 X 625341669 670200879 31328928 30514705 656670597 700715584 1346275157 1369784065 X 163394013 2940091 -122289117 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9531 9531 0 PART II-B, LINE 1: DURING THE TAX YEAR, BETHESDA HOSPITAL, INC. ("HOSPITAL") PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS, A PORTION ($732) OF WHICH RELATED TO LOBBYING ACTIVITIES. IN ADDITION, TRIHEALTH, INC., A RELATED ORGANIZATION OF HOSPITAL, WHICH PROVIDES ADMINISTRATIVE SUPPORT SERVICES TO HOSPITAL, PAID ANNUAL MEMBERSHIP DUES TO VARIOUS NATIONAL, STATE AND LOCAL ORGANIZATIONS A PORTION OF WHICH RELATED TO LOBBYING ACTIVITIES. A PORTION OF THE AFOREMENTIONED ADMINISTRATIVE SERVICES ARE ALLOCATED TO HOSPITAL AND $8,799 OF THE AMOUNT SHOWN ON LINE 1I REPRESENTS HOSPITAL'S SHARE OF THESE LOBBYING EXPENSES. 4926878 130 170093 142707 4954394 4221247 125 713352 7846 4926878 4431716 3025 -213494 4221247 5556021 12907 -242245 894967 4431716 3742157 1000130 813734 5556021 0.91785 0.08215 0 1 1 5342850 5342850 674602348 276300195 398302153 3278001 2240215 1037786 307138988 236060970 71078018 34750207 5223635 29526572 505287379 INVESTMENT IN JOINT VENTURES 272346548 C 272346548 THIRD PARTY SETTLEMENTS 5089392 MALPRACTICE INSURANCE/WORKERS COMP LIABILITY 2778000 DUE TO RELATED ORGANIZATIONS 31682271 39549663 X PART V, LINE 4: INVESTMENT PROCEEDS FROM ENDOWMENT FUNDS ARE USED TO SUPPORT BETHESDA HOSPITAL, INC. PROGRAMS. PART X, LINE 2: 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, 2025 OR 2024. 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, 2025 OR 2024. 1 1 X 1 X 1 X 1 1 0 1 1 10476941 12413656 0 0.00000 116201959 75268348 40933611 0.04320 126678900 87682004 40933611 0.04320 15577234 13730912 1846322 0.00200 15139153 3532693 11606460 0.01230 43234 0 43234 0.00000 2903098 0 2903098 0.00310 0 0 33662719 17263605 16399114 0.01740 160341619 104945609 57332725 0.06060 87682 0 87682 0.00010 87682 87682 0.00010 0 55034089 0 145210553 182121184 -36910631 X 1 1 2 1 BETHESDA NORTH HOSPITAL 10500 MONTGOMERY ROAD CINCINNATI OH 45242 WWW.TRIHEALTH.COM 1024 X X X X X 2 BETHESDA BUTLER HOSPITAL 3125 HAMILTON-MASON ROAD HAMILTON OH 45011 WWW.TRIHEALTH.COM 1457 X X X BETHESDA NORTH HOSPITAL 1 0 0 1 X X X X X X X X X 24 1 1 1 1 X SEE SEC C. SUPPLEMENTAL INFO FOR PT V, SEC B FOR URL. X 1 24 1 SEE SEC C. SUPPLEMENTAL INFO FOR PT V, SEC B FOR URL. 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 BETHESDA BUTLER HOSPITAL 2 0 0 1 X X X X X X X X X 24 1 1 1 1 X SEE SEC C. SUPPLEMENTAL INFO FOR PT V, SEC B FOR URL. X 1 24 1 SEE SEC C. SUPPLEMENTAL INFO FOR PT V, SEC B FOR URL. 0 1 X 150.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X HTTP://WWW.TRIHEALTH.COM/TOOLS/PAY-YOUR-BILL/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 5: THE HEALTH COLLABORATIVE ("THC") CONTRACTED WITH THE HEALTH POLICY INSTITUTE OF OHIO ("HPIO") TO DEVELOP THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"). THE ANALYSIS WAS GUIDED BY A SET OF RESEARCH QUESTIONS, AND CONSISTED OF: SECONDARY, QUANTITATIVE DATA COMPILATION AND ANALYSIS ADDITIONAL PRIMARY AND SECONDARY COMMUNITY DATA ANALYSIS COMMUNITY ENGAGEMENTDEVELOPMENT OF THE REGIONAL CHNA WAS INFORMED BY THE ADVISORY COMMITTEE AS WELL AS THE PUBLIC HEALTH AND SPECIAL POPULATIONS TASK FORCES. ADVISORY COMMITTEE AND TASK FORCE MEMBERS WERE ENGAGED IN THE PROCESS BECAUSE OF THEIR CLOSE TIES WITH THE COMMUNITIES THEY LIVE IN AND SERVE. THEY WERE A VALUABLE SOURCE OF DATA AND INFORMATION THROUGHOUT THE ASSESSMENT PROCESS. COMMUNITY ENGAGEMENT WAS BROUGHT TO THE FOREFRONT OF THE REGIONAL CHNA PROCESS BY BUILDING THE ASSESSMENT AND TELLING THE COMMUNITY STORY, COMING TO CONSENSUS AROUND SHARED REGIONAL PRIORITIES, AND LAUNCHING A COMMUNITY PARTNERSHIP NETWORK TO BUILD INFRASTRUCTURE FOR ONGOING, BI-DIRECTIONAL COMMUNICATION. HPIO AND THC PROVIDED REGULAR UPDATES TO BOTH THE ADVISORY COMMITTEE AND TASK FORCES, INCLUDING MONTHLY MEETINGS WITH THE ADVISORY COMMITTEE AND SIX MEETINGS WITH THE TASK FORCES.APPENDIX B, OF THE REPORTING ORGANIZATION'S STANDALONE CHNA, CONTAINS A LIST OF THE ORGANIZATIONS WHICH PARTICIPATED AS A MEMBER OF THE ADVISORY COMMITTEE AND TASK FORCES.DEFINING COMMUNITY ENGAGEMENT FOR THE REGIONAL CHNA, ENGAGEMENT WITH COMMUNITY BEGAN WITH CLEARLY DEFINING THE COMMUNITY AND THEN ESTABLISHING INTENTIONAL, THOUGHTFUL, AND CO-CREATED WAYS TO ENGAGE WITH PARTNERS AND BUILD TRUST. FACILITATED BY THC, COMMUNITY IS DEFINED AS THE 18-COUNTY REGION OF SOUTHWEST OHIO, NORTHERN KENTUCKY, AND SOUTHEAST INDIANA, AND INCLUSIVE OF HEALTH SYSTEMS AND HOSPITALS, PUBLIC HEALTH DEPARTMENTS THAT SERVE THOSE JURISDICTIONS, AND ALL COMMUNITY-BASED ORGANIZATIONS SERVING COMMUNITY MEMBERS. THROUGH SPECIFIC ACTIVITIES BUILT FOR A VARIETY OF AUDIENCES WITHIN THIS COMMUNITY, THC ENGAGED PARTNERS THROUGHOUT ALL PHASES OF THE COLLECTIVE HEALTH AGENDA CYCLE (INCLUDING THE REGIONAL CHNA) WITH CONVENING, STAKEHOLDER LISTENING SESSIONS, ONE- ON-ONE MEETINGS, AND IN ALIGNMENT WITH PRINCIPLES OF COMMUNITY BASED PARTICIPATORY RESEARCH. BUILDING THE ASSESSMENT AND TELLING THE COMMUNITY STORY TO MINIMIZE THE BURDEN ON COMMUNITY MEMBERS WHO REPORT BEING OVER-SURVEYED AND ASSESSED, THE ADVISORY COMMITTEE DECIDED TO LEVERAGE RECENT, EXISTING SOURCES OF PRIMARY AND SECONDARY COMMUNITY DATA, RATHER THAN COLLECTING NEW PRIMARY DATA. ADVISORY COMMITTEE AND TASK FORCE MEMBERS WERE INVITED TO SHARE ANY DATA THEY HAD COLLECTED TO BE INCLUDED IN THE REGIONAL CHNA, WITH A FOCUS ON SOURCES THAT FILLED DATA GAPS. SEVEN ADDITIONAL SOURCES OF COMMUNITY DATA WERE IDENTIFIED AND INCLUDED IN THE REGIONAL CHNA. COMING TO CONSENSUS AROUND SHARED REGIONAL PRIORITIES THROUGHOUT THE REGIONAL CHNA PROCESS, THC EMPHASIZED THE SHARED VALUES AND PRINCIPLES OF COLLECTIVE ACTION FOR THE ADVISORY COMMITTEE AND TASK FORCE MEMBERS. THIS INVITED ALIGNMENT FROM PARTNERS ON THE SIGNIFICANT HEALTH NEEDS, POTENTIAL PRIORITIES, AND FINAL PRIORITIES. TO INFORM THE PRIORITIZATION PROCESS, HPIO DEVELOPED A PRE-PRIORITIZATION SURVEY TO BE COMPLETED BY HOSPITALS, LOCAL HEALTH DEPARTMENTS, AND OTHER COMMUNITY PARTNERS. OF THE 47 PARTNERS WHO RESPONDED, THE LARGEST PROPORTION REPRESENTED COMMUNITY- BASED ORGANIZATIONS (28%), HIGHLIGHTING THE INCLUSION OF COMMUNITY VOICES THROUGH THE PRIORITIZATION PROCESS. LAUNCHING A COMMUNITY PARTNERSHIP NETWORK THE HEALTH COLLABORATIVE DEVELOPED THE COMMUNITY PARTNERSHIP NETWORK ("CPN") TO BUILD ONGOING COMMUNITY ENGAGEMENT INTO THE WORK OF THE REGIONAL CHNA AND COLLECTIVE HEALTH AGENDA. THE CPN WAS CREATED BASED ON FEEDBACK THC RECEIVED FROM PARTNERS. THE CPN WILL CREATE AN OPPORTUNITY FOR MORE REGULAR COMMUNITY ENGAGEMENT, TO CENTER COMMUNITY VOICE AND EQUITY IN THE REGIONAL CHNA, PROVIDE SPACE FOR BIDIRECTIONAL COMMUNICATION BETWEEN HEALTH SYSTEMS AND THE COMMUNITY, AND REDUCE "NEW" DATA COLLECTION (E.G., FOCUS GROUPS AND COMMUNITY HEALTH NEEDS SURVEYS). THE PURPOSE OF THE CPN IS TO LEVERAGE EXISTING COMMUNITY MEETINGS, MOMENTUM, AND ASSETS TO STRENGTHEN CONNECTIONS BETWEEN PARTNERS, INCLUDING THE COMMUNITY, AND ADVANCE SHARED GOALS FOR COMMUNITY HEALTH.REGIONAL CHNA ADVISORY STRUCTURETHE ADVISORY STRUCTURE FOR THE REGIONAL CHNA WAS BUILT USING THE MOBILIZING ACTION THROUGH PLANNING AND PARTNERSHIPS 2.0 (MAPP) CIRCLE OF INVOLVEMENT FRAMEWORK.THE CORE CIRCLE (CORE TEAM) MET REGULARLY, HOSTED AND FACILITATED MEETINGS, WERE RESPONSIBLE FOR DELIVERABLES, AND MANAGED DAY-TO-DAY OPERATIONS OF THE PROJECT. THE CORE TEAM CONSISTED OF THC, HPIO AND BUTLER COUNTY GENERAL HEALTH DISTRICT.THE CIRCLE OF ENGAGEMENT (ADVISORY COMMITTEE AND TASK FORCES) KEPT THE CORE CIRCLE ACCOUNTABLE FOR PROGRESS, PROVIDED EXPERTISE ON EACH STEP OF THE REGIONAL CHNA INCLUDING DATA COLLECTION AND ANALYSIS, REVIEWED RESULTS AND REPORT DRAFTS, AND APPROVED THE FINAL REGIONAL CHNA REPORT. ACROSS THE 45 PARTICIPATING ORGANIZATIONS IN THE ADVISORY COMMITTEE AND TASK FORCES, DIVERSE POPULATIONS WERE REPRESENTED THAT INCLUDE MEDICALLY UNDERSERVED PEOPLE, BLACK AND AFRICAN AMERICAN RESIDENTS, IMMIGRANTS AND REFUGEES, MOTHERS AND BABIES, HISPANIC/LATINO RESIDENTS, PEOPLE EXPERIENCING HOMELESSNESS, PEOPLE EXPERIENCING MENTAL HEALTH CHALLENGES, PEOPLE EXPERIENCING FOOD INSECURITY, PEOPLE WITH DISABILITIES, AND OTHER MARGINALIZED POPULATIONS.THE CIRCLE OF CHAMPIONS AND THE CIRCLE OF INFORMATION AND AWARENESS PROVIDED HIGH-LEVEL REVIEW AND OVERSIGHT OF THE WORK ON BEHALF OF THEIR ORGANIZATIONS. FINALLY, THE CIRCLE OF POSSIBILITY REPRESENTS ALL THE COMMUNITY ORGANIZATIONS AND COMMUNITY MEMBERS WHO CAN BE INCLUDED IN ACTIONABLE STRATEGIES FOR IMPLEMENTATION OF THE COLLECTIVE HEALTH AGENDA AND COMMUNITY HEALTH IMPROVEMENT PLANS. BETHESDA BUTLER HOSPITAL PART V, SECTION B, LINE 5: THE HEALTH COLLABORATIVE ("THC") CONTRACTED WITH THE HEALTH POLICY INSTITUTE OF OHIO ("HPIO") TO DEVELOP THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA"). THE ANALYSIS WAS GUIDED BY A SET OF RESEARCH QUESTIONS, AND CONSISTED OF: SECONDARY, QUANTITATIVE DATA COMPILATION AND ANALYSIS ADDITIONAL PRIMARY AND SECONDARY COMMUNITY DATA ANALYSIS COMMUNITY ENGAGEMENTDEVELOPMENT OF THE REGIONAL CHNA WAS INFORMED BY THE ADVISORY COMMITTEE AS WELL AS THE PUBLIC HEALTH AND SPECIAL POPULATIONS TASK FORCES. ADVISORY COMMITTEE AND TASK FORCE MEMBERS WERE ENGAGED IN THE PROCESS BECAUSE OF THEIR CLOSE TIES WITH THE COMMUNITIES THEY LIVE IN AND SERVE. THEY WERE A VALUABLE SOURCE OF DATA AND INFORMATION THROUGHOUT THE ASSESSMENT PROCESS. COMMUNITY ENGAGEMENT WAS BROUGHT TO THE FOREFRONT OF THE REGIONAL CHNA PROCESS BY BUILDING THE ASSESSMENT AND TELLING THE COMMUNITY STORY, COMING TO CONSENSUS AROUND SHARED REGIONAL PRIORITIES, AND LAUNCHING A COMMUNITY PARTNERSHIP NETWORK TO BUILD INFRASTRUCTURE FOR ONGOING, BI-DIRECTIONAL COMMUNICATION. HPIO AND THC PROVIDED REGULAR UPDATES TO BOTH THE ADVISORY COMMITTEE AND TASK FORCES, INCLUDING MONTHLY MEETINGS WITH THE ADVISORY COMMITTEE AND SIX MEETINGS WITH THE TASK FORCES.APPENDIX B, OF THE REPORTING ORGANIZATION'S STANDALONE CHNA, CONTAINS A LIST OF THE ORGANIZATIONS WHICH PARTICIPATED AS A MEMBER OF THE ADVISORY COMMITTEE AND TASK FORCES.DEFINING COMMUNITY ENGAGEMENT FOR THE REGIONAL CHNA, ENGAGEMENT WITH COMMUNITY BEGAN WITH CLEARLY DEFINING THE COMMUNITY AND THEN ESTABLISHING INTENTIONAL, THOUGHTFUL, AND CO-CREATED WAYS TO ENGAGE WITH PARTNERS AND BUILD TRUST. FACILITATED BY THC, COMMUNITY IS DEFINED AS THE 18-COUNTY REGION OF SOUTHWEST OHIO, NORTHERN KENTUCKY, AND SOUTHEAST INDIANA, AND INCLUSIVE OF HEALTH SYSTEMS AND HOSPITALS, PUBLIC HEALTH DEPARTMENTS THAT SERVE THOSE JURISDICTIONS, AND ALL COMMUNITY-BASED ORGANIZATIONS SERVING COMMUNITY MEMBERS. THROUGH SPECIFIC ACTIVITIES BUILT FOR A VARIETY OF AUDIENCES WITHIN THIS COMMUNITY, THC ENGAGED PARTNERS THROUGHOUT ALL PHASES OF THE COLLECTIVE HEALTH AGENDA CYCLE (INCLUDING THE REGIONAL CHNA) WITH CONVENING, STAKEHOLDER LISTENING SESSIONS, ONE- ON-ONE MEETINGS, AND IN ALIGNMENT WITH PRINCIPLES OF COMMUNITY BASED PARTICIPATORY RESEARCH. BUILDING THE ASSESSMENT AND TELLING THE COMMUNITY STORY TO MINIMIZE THE BURDEN ON COMMUNITY MEMBERS WHO REPORT BEING OVER-SURVEYED AND ASSESSED, THE ADVISORY COMMITTEE DECIDED TO LEVERAGE RECENT, EXISTING SOURCES OF PRIMARY AND SECONDARY COMMUNITY DATA, RATHER THAN COLLECTING NEW PRIMARY DATA. ADVISORY COMMITTEE AND TASK FORCE MEMBERS WERE INVITED TO SHARE ANY DATA THEY HAD COLLECTED TO BE INCLUDED IN THE REGIONAL CHNA, WITH A FOCUS ON SOURCES THAT FILLED DATA GAPS. SEVEN ADDITIONAL SOURCES OF COMMUNITY DATA WERE IDENTIFIED AND INCLUDED IN THE REGIONAL CHNA. COMING TO CONSENSUS AROUND SHARED REGIONAL PRIORITIES THROUGHOUT THE REGIONAL CHNA PROCESS, THC EMPHASIZED THE SHARED VALUES AND PRINCIPLES OF COLLECTIVE ACTION FOR THE ADVISORY COMMITTEE AND TASK FORCE MEMBERS. THIS INVITED ALIGNMENT FROM PARTNERS ON THE SIGNIFICANT HEALTH NEEDS, POTENTIAL PRIORITIES, AND FINAL PRIORITIES. TO INFORM THE PRIORITIZATION PROCESS, HPIO DEVELOPED A PRE-PRIORITIZATION SURVEY TO BE COMPLETED BY HOSPITALS, LOCAL HEALTH DEPARTMENTS, AND OTHER COMMUNITY PARTNERS. OF THE 47 PARTNERS WHO RESPONDED, THE LARGEST PROPORTION REPRESENTED COMMUNITY- BASED ORGANIZATIONS (28%), HIGHLIGHTING THE INCLUSION OF COMMUNITY VOICES THROUGH THE PRIORITIZATION PROCESS. LAUNCHING A COMMUNITY PARTNERSHIP NETWORK THE HEALTH COLLABORATIVE DEVELOPED THE COMMUNITY PARTNERSHIP NETWORK ("CPN") TO BUILD ONGOING COMMUNITY ENGAGEMENT INTO THE WORK OF THE REGIONAL CHNA AND COLLECTIVE HEALTH AGENDA. THE CPN WAS CREATED BASED ON FEEDBACK THC RECEIVED FROM PARTNERS. THE CPN WILL CREATE AN OPPORTUNITY FOR MORE REGULAR COMMUNITY ENGAGEMENT, TO CENTER COMMUNITY VOICE AND EQUITY IN THE REGIONAL CHNA, PROVIDE SPACE FOR BIDIRECTIONAL COMMUNICATION BETWEEN HEALTH SYSTEMS AND THE COMMUNITY, AND REDUCE "NEW" DATA COLLECTION (E.G., FOCUS GROUPS AND COMMUNITY HEALTH NEEDS SURVEYS). THE PURPOSE OF THE CPN IS TO LEVERAGE EXISTING COMMUNITY MEETINGS, MOMENTUM, AND ASSETS TO STRENGTHEN CONNECTIONS BETWEEN PARTNERS, INCLUDING THE COMMUNITY, AND ADVANCE SHARED GOALS FOR COMMUNITY HEALTH.REGIONAL CHNA ADVISORY STRUCTURETHE ADVISORY STRUCTURE FOR THE REGIONAL CHNA WAS BUILT USING THE MOBILIZING ACTION THROUGH PLANNING AND PARTNERSHIPS 2.0 (MAPP) CIRCLE OF INVOLVEMENT FRAMEWORK.THE CORE CIRCLE (CORE TEAM) MET REGULARLY, HOSTED AND FACILITATED MEETINGS, WERE RESPONSIBLE FOR DELIVERABLES, AND MANAGED DAY-TO-DAY OPERATIONS OF THE PROJECT. THE CORE TEAM CONSISTED OF THC, HPIO AND BUTLER COUNTY GENERAL HEALTH DISTRICT.THE CIRCLE OF ENGAGEMENT (ADVISORY COMMITTEE AND TASK FORCES) KEPT THE CORE CIRCLE ACCOUNTABLE FOR PROGRESS, PROVIDED EXPERTISE ON EACH STEP OF THE REGIONAL CHNA INCLUDING DATA COLLECTION AND ANALYSIS, REVIEWED RESULTS AND REPORT DRAFTS, AND APPROVED THE FINAL REGIONAL CHNA REPORT. ACROSS THE 45 PARTICIPATING ORGANIZATIONS IN THE ADVISORY COMMITTEE AND TASK FORCES, DIVERSE POPULATIONS WERE REPRESENTED THAT INCLUDE MEDICALLY UNDERSERVED PEOPLE, BLACK AND AFRICAN AMERICAN RESIDENTS, IMMIGRANTS AND REFUGEES, MOTHERS AND BABIES, HISPANIC/LATINO RESIDENTS, PEOPLE EXPERIENCING HOMELESSNESS, PEOPLE EXPERIENCING MENTAL HEALTH CHALLENGES, PEOPLE EXPERIENCING FOOD INSECURITY, PEOPLE WITH DISABILITIES, AND OTHER MARGINALIZED POPULATIONS.THE CIRCLE OF CHAMPIONS AND THE CIRCLE OF INFORMATION AND AWARENESS PROVIDED HIGH-LEVEL REVIEW AND OVERSIGHT OF THE WORK ON BEHALF OF THEIR ORGANIZATIONS. FINALLY, THE CIRCLE OF POSSIBILITY REPRESENTS ALL THE COMMUNITY ORGANIZATIONS AND COMMUNITY MEMBERS WHO CAN BE INCLUDED IN ACTIONABLE STRATEGIES FOR IMPLEMENTATION OF THE COLLECTIVE HEALTH AGENDA AND COMMUNITY HEALTH IMPROVEMENT PLANS. BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 6A: * CHRIST HOSPITAL* CINCINNATI CHILDREN'S HOSPITAL* ADAMS COUNTY REGIONAL MEDICAL CENTER,* MARGARET MARY HEALTH, * LINDNER CENTER OF HOPE* MERCY HEALTH CINCINNATI* TRIHEALTH * UC HEALTH BETHESDA BUTLER HOSPITAL PART V, SECTION B, LINE 6A: * CHRIST HOSPITAL* CINCINNATI CHILDREN'S HOSPITAL* ADAMS COUNTY REGIONAL MEDICAL CENTER,* MARGARET MARY HEALTH, * LINDNER CENTER OF HOPE* MERCY HEALTH CINCINNATI* TRIHEALTH * UC HEALTH BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 6B: * THE HEALTH COLLABORATIVE* BUTLER COUNTY GENERAL HEALTH DISTRICT AND SOUTHWEST ASSOCIATION OF OHIO HEALTH COMMISSIONERS* CINCINNATI HEALTH DEPARTMENT* CLERMONT COUNTY PUBLIC HEALTH* CLINTON COUNTY HEALTH DISTRICT* FRANKLIN COUNTY HEALTH DEPARTMENT, INDIANA * HAMILTON COUNTY PUBLIC HEALTH* NORWOOD CITY BOARD OF HEALTH* RIPLEY COUNTY HEALTH DEPARTMENT, INDIANA * CITY SPRINGDALE HEALTH DEPARTMENT* CENTER FOR CLOSING THE HEALTH GAP * HAMILTON COUNTY HUMAN SERVICES CHAMBER * UNITED WAY OF GREATER CINCINNATI * URBAN LEAGUE OF GREATER SOUTHWESTERN OHIO * BI3* INTERACT FOR HEALTH * THE HEALTHCARE CONNECTION * HEALTHSOURCE OF OHIO * CARESOURCE* ALL-IN CINCINNATI * BLACK WOMEN CULTIVATING CHANGE * CINCINNATI COMPASS * CLERMONT COUNTY BOARD OF DEVELOPMENTAL DISABILITIES * COMMUNITY BUILDERS * CRADLE CINCINNATI * FOODBANK OF DAYTON * FREESTORE FOODBANK * GREATER CINCINNATI BEHAVIORAL HEALTH SERVICES * GREATER CINCINNATI REGIONAL FOOD POLICY COUNCIL * HEALTHCARE ACCESS NOW * HOUSING OPPORTUNITIES MADE EQUAL (HOME) * NAMI SOUTHWEST OHIO * REFUGEE CONNECT * SANTA MARIA COMMUNITY SERVICES * SHARED HARVEST FOOD BANK * SU CASA * WARREN COUNTY HEALTH DISTRICT BETHESDA BUTLER HOSPITAL PART V, SECTION B, LINE 6B: * THE HEALTH COLLABORATIVE* BUTLER COUNTY GENERAL HEALTH DISTRICT AND SOUTHWEST ASSOCIATION OF OHIO HEALTH COMMISSIONERS* CINCINNATI HEALTH DEPARTMENT* CLERMONT COUNTY PUBLIC HEALTH* CLINTON COUNTY HEALTH DISTRICT* FRANKLIN COUNTY HEALTH DEPARTMENT, INDIANA * HAMILTON COUNTY PUBLIC HEALTH* NORWOOD CITY BOARD OF HEALTH* RIPLEY COUNTY HEALTH DEPARTMENT, INDIANA * CITY SPRINGDALE HEALTH DEPARTMENT* CENTER FOR CLOSING THE HEALTH GAP * HAMILTON COUNTY HUMAN SERVICES CHAMBER * UNITED WAY OF GREATER CINCINNATI * URBAN LEAGUE OF GREATER SOUTHWESTERN OHIO * BI3* INTERACT FOR HEALTH * THE HEALTHCARE CONNECTION * HEALTHSOURCE OF OHIO * CARESOURCE* ALL-IN CINCINNATI * BLACK WOMEN CULTIVATING CHANGE * CINCINNATI COMPASS * CLERMONT COUNTY BOARD OF DEVELOPMENTAL DISABILITIES * COMMUNITY BUILDERS * CRADLE CINCINNATI * FOODBANK OF DAYTON * FREESTORE FOODBANK * GREATER CINCINNATI BEHAVIORAL HEALTH SERVICES * GREATER CINCINNATI REGIONAL FOOD POLICY COUNCIL * HEALTHCARE ACCESS NOW * HOUSING OPPORTUNITIES MADE EQUAL (HOME) * NAMI SOUTHWEST OHIO * REFUGEE CONNECT * SANTA MARIA COMMUNITY SERVICES * SHARED HARVEST FOOD BANK * SU CASA * WARREN COUNTY HEALTH DISTRICT BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 7D: COPY AVAILABLE WITHOUT CHARGE.PLEASE CONTACT TRIHEALTH MISSION AND CULTURE BY EITHER TELEPHONE (513-569-6248), E-MAIL (FRANK_NATION@TRIHEALTH.COM) OR MAIL (625 EDEN PARK DRIVE, 9TH FLOOR, CINCINNATI, OHIO 45202). BETHESDA BUTLER HOSPITAL PART V, SECTION B, LINE 7D: COPY AVAILABLE WITHOUT CHARGE.PLEASE CONTACT TRIHEALTH MISSION AND CULTURE BY EITHER TELEPHONE (513-569-6248), E-MAIL (FRANK_NATION@TRIHEALTH.COM) OR MAIL (625 EDEN PARK DRIVE, 9TH FLOOR, CINCINNATI, OHIO 45202). BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 11: 1. SUBSTANCE ABUSE/MENTAL HEALTH-GIVEN THE HIGH PREVALENCE OF DEPRESSION, ANXIETY, & SUBSTANCE ABUSE IN THIS AREA, & THE FACT THAT CURRENT WORK IS NOT COMPLETED & THERE ARE MANY COMMUNITY PARTNERS THAT ARE ENGAGING ALONG WITH TRIHEALTH, THIS ISSUE REMAINS ONE OF THE TOP PRIORITY COMMUNITY NEEDS. THE GOAL IS TO IMPROVE EARLY IDENTIFICATION & TREATMENT, AS WELL AS EDUCATION, TO THOSE IN OUR COMMUNITY WHO NEED THE RIGHT CARE, IN THE RIGHT SETTING, AT THE RIGHT TIME REGARDING THIS ISSUE TO IMPROVE HEALTH OUTCOMES. THE STRATEGY OR PROGRAMS NEEDED TO ACHIEVE THIS GOAL IS AS FOLLOWS:*TREATMENT COORDINATORS-PROVIDE RN/SOCIAL WORKER WITH SPECIFIC SUBSTANCE USE TRAINING AND/OR CERTIFICATION AT INPATIENT SERVICES & EMERGENCY DEPARTMENT LOCATIONS TO ENGAGE, ASSESS, & PROVIDE APPOINTMENTS TO TREATMENT WITHIN 24-48 HOURS AFTER DISCHARGE. *OUTPATIENT ALCOHOL & TREATMENT PROGRAM-OFFER SUPPORT & TREATMENT TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, IN A STRUCTURED, OUTPATIENT SETTING. *INTEGRATED BEHAVIORAL HEALTH MODEL-DEVELOP A BEHAVIORAL HEALTH CARE MODEL TO PROACTIVELY IDENTIFY PATIENT NEEDS USING A COMPREHENSIVE BEHAVIORAL HEALTH ASSESSMENT & PROVIDE TREATMENT AS INDICATED. *BEHAVIORAL HEALTH INTAKE PROGRAM-REFER PATIENTS FROM THE EMERGENCY DEPARTMENT TO THE APPROPRIATE TREATMENT SETTING & LOCATION. THE PLAN IS TO ADDRESS THESE INITIATIVES BY PROVIDING REGISTERED NURSES, PHYSICIANS, COMMUNITY HEALTH EDUCATORS, PHILANTHROPIC CASH GRANTS, OUTREACH COMMUNICATION & PROGRAM MANAGEMENT SUPPORT. IT WILL DO SO IN PARTNERSHIP WITH BI3, ADDICTION SERVICES COUNCIL, BRIGHTVIEW, TALBERT HOUSE, NAMI OF SOUTHWEST OHIO, URBAN HEALTH PROJECT, CENTER FOR ADDICTION TREATMENT, BETHESDA FOUNDATION. 2. MATERNAL/CHILD HEALTH-GIVEN THE HIGH PREVALENCE IN CERTAIN GEOGRAPHIC AREAS, THE FACT THAT CURRENT WORK IS BEING EFFECTIVE & IS NOT COMPLETED & THERE ARE MANY COMMUNITY PARTNERS THAT ARE ENGAGING ALONG WITH TRIHEALTH. THE GOAL IS TO REDUCE INFANT MORTALITY RATES IN OUR SERVICE AREA, SPECIFICALLY WITH THE UNDERSERVED, AS WELL AS IMPROVE OUTCOMES FOR MATERNAL HEALTH WITH EMPHASIS ON EDUCATION, CLINICAL CARE, HEALTH DISPARITIES & COMMUNITY OUTREACH. THE STRATEGY OR PROGRAMS NEEDED TO ACHIEVE THIS GOAL IS AS FOLLOWS:*OB GYN CENTER-CENTER WILL PROVIDE OB/GYN SERVICES TO ALL, WITH SPECIAL ATTENTION TO HEALTH DISPARITIES AND THE UNDERSERVED, IMPROVING INFANT MORTALITY OUTCOMES & WOMEN'S HEALTH. *WOMAN CENTERED MEDICAL HOME MODEL-PROGRAM WILL PROVIDE A COMPLEX NETWORK OF CARE, DELIVERED BY DEDICATED CASE MANAGERS, SOCIAL WORKERS, LACTATION CONSULTANTS, BEHAVIORAL HEALTH CONSULTANTS, COMMUNITY HEALTH PROGRAM, FINANCIAL COUNSELORS & LEGAL AID CONSULTANTS TO PROVIDE EXCELLENT CARE WHILE ADDRESSING SOCIAL DETERMINANTS OF HEALTH. *HOPE PROGRAM-PROGRAM WILL PROVIDE PATIENT-CENTERED CARE TO CHEMICALLY DEPENDENT PREGNANT WOMEN IMPROVING BIRTH OUTCOMES & MATERNAL SUBSTANCE-FREE OUTCOMES.*PERINATAL OUTREACH- MAINTAINS SEVERAL KEY COMMUNITY PARTNERSHIPS THAT FOSTER COLLABORATION AROUND SOCIAL DETERMINANTS OF CARE TO RECEIVE REFERRALS TO BETHESDA NORTH FOR OB CARE.THE PLAN IS TO ADDRESS THESE INITIATIVES BY PROVIDING RNS, DEDICATED CASE MANAGER, LACTATION EDUCATOR, BEHAVIORAL HEALTH SOCIAL WORKER, DIETICIANS, GENETIC COUNSELORS & ASSISTANCE WITH TRANSPORTATION, FOOD PANTRY, HOME FURNISHINGS AND BABY ITEMS. IT WILL DO SO IN PARTNERSHIP WITH CRADLE CINCINNATI, FIRST STEP HOME, URBAN HEALTH PROJECT, MARCH OF DIMES, TALBERT HOUSE FATHERHOOD PROJECT, SWEET CHEEKS DIAPER BANK, START STRONG, THINK FIRST FOR YOUR BABY, HEALTHY BEGINNINGS, HEALTHY MOMS & BABES, GS FREE CLINIC, EVERY CHILD SUCCEEDS, CRIBS FOR KIDS, CHILDBIRTH EDUCATION ASSOCIATION. 3. CHRONIC CONDITIONS-HEART DISEASE, DIABETES, HYPERTENSION AND OTHER HEALTH CONDITIONS RESULTING FROM POSTPONED SCREENINGS, ACCESS TO CARE & HEALTH EDUCATION ARE AFFECTING THE COMMUNITY DISPROPORTIONATELY. THE GOAL IS TO ADDRESS & IMPROVE SPECIFIC CHRONIC HEALTH CONDITIONS THAT ARE IMPACTED BY DISPARITIES THROUGH IMPROVED EDUCATION, DATA COLLECTION, ASSESSMENTS, INTERVENTIONS, CULTURALLY COMPETENT CARE & CARE MANAGEMENT. THE STRATEGY OR PROGRAMS NEEDED TO ACHIEVE THIS GOAL IS AS FOLLOWS:*HEALTH DISPARITIES DATA COLLECTION-EXPAND PROGRAM OF COLLECTING HEALTH DISPARITY DATA REGARDING CHRONIC CONDITIONS TO ASSESS SOCIAL DETERMINANTS OF HEALTH TO ASSIST WITH INTERVENTIONS & TRACK OUTCOMES. *COORDINATE EXISTING/NEW CHRONIC HEALTH PROGRAMS WITH AN EMPHASIS ON HEALTH DISPARITIES - THROUGH TRIHEALTH'S CENTER FOR HEALTH EQUITY, COORDINATE AND ASSIMILATE CURRENT/FUTURE PROGRAMS THAT ADDRESS CHRONIC CONDITIONS IN THE AREAS OF CRITICAL NEEDS BASED ON ZIP CODES, ETHNICITY, GENDER & OTHER SOCIAL DETERMINANTS OF HEALTH.*TRIHEALTH OUTREACH PROGRAMS-IMPROVE COORDINATION OF PROGRAMS IN ORDER TO MAKE THEM AVAILABLE DIRECTLY TO THE UNDERSERVED COMMUNITY WITH CONNECTION TO TRIHEALTH & COMMUNITY ORGANIZATIONS. PROGRAM COORDINATION INCLUDES BUT ISN'T LIMITED TO MOBILE MAMMOGRAPHY, FREE HEALTH SCREENINGS, SENIOR CARE, THINKFIRST EDUCATION, PHARMACY ASSISTANCE FOOD PROGRAMS AND LEGAL AID, ADVOCACY, HOUSING REPAIRS AND EMPLOYEE RESOURCE GROUPS (ERG).TRIHEALTH WILL DO SO IN PARTNERSHIP WITH BI3, NAMI, MEHARRY MEDICAL COLLEGE, AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, LEGAL AID OF GREATER CINCINNATI, RIDE CINCINNATI, HEALTH COLLABORATIVE, SVDP CHARITABLE PHARMACY, INTERACT FOR HEALTH, PEOPLE WORKING COLLABORATIVELY, SHARED HARVEST FOODBANK GREATER CINCINNATI FOUNDATION, UNITED WAY, BETHESDA FOUNDATION & OTHER VARIOUS COMMUNITY ORGANIZATIONS.4. FOOD ACCESS AND INSECURITY-GIVEN THE HIGH PREVALENCE OF LIMITED FOOD ACCESS & INSECURITY IN THE REGION, IT IS A CRITICAL SOCIAL DETERMINATE OF HEALTH THAT CONTRIBUTES & IMPACTS PEOPLE'S PHYSICAL & MENTAL WELL-BEING. THE GOAL IS TO IMPROVE ACCESS TO FOOD & RESOURCES FOR THE UNDERSERVED POPULATIONS WITH EMPHASIS ON EDUCATION, ASSESSMENT, COLLABORATION, FOOD DISTRIBUTION & INTEGRATION WITH CLINICAL CARE. THE STRATEGY OR PROGRAMS NEEDED TO ACHIEVE THIS GOAL IS AS FOLLOWS:*TRIHEALTH FOOD PANTRIES-PROGRAM THAT PROVIDES SCREENINGS, EDUCATION, FOOD, PERSONAL HYGIENE ITEMS & COMMUNITY RESOURCE INFORMATION FOR UNDERSERVED PATIENTS WHO ARE IN NEED THAT ENHANCES HEALTH & MENTAL WELLBEING WHICH IMPACTS CHRONIC CONDITIONS AND HEALTH EQUITY. *PARTNERSHIPS WITH THE COMMUNITY-ACTIVE PARTNERSHIPS WITH ORGANIZATIONS, SUCH AS FREESTORE FOODBANK, SHARED HARVEST, HOSEA HOUSE, LAST MILE RESCUE, & OTHERS WHO CONTRIBUTE TO THE COMMUNITY WITH FOOD FOR HOMELESS, STUDENTS, MOBILE MARKETS TO ADDRESSES FOOD DISPARITIES IN THE UNDERSERVED COMMUNITIES.*TEAM MEMBER ENGAGEMENT FOOD DRIVES-TRIHEALTH TEAM MEMBER INITIATED FOOD DRIVES TO SUPPORT HOSPITAL & COMMUNITY PARTNER PROGRAMS TO ADDRESS FOOD ACCESS AND INSECURITIES. THE PLAN IS TO PROVIDE THE FOLLOWING TO THE COMMUNITY: FACILITY SPACE, PHYSICIANS, NURSES, TEAM MEMBERS, COMMUNITY RELATIONS DIRECTOR AND COORDINATOR. IT WILL DO SO IN PARTNERSHIP WITH FREESTORE FOOD BANK, SHARED HARVEST, LAST MILE RESCUE, HOSEA HOUSE, GREATER CINCINNATI REGIONAL FOOD POLICY COUNCIL, HEALTH COLLABORATIVE, INTERACT FOR HEALTH.IN ITS IMPLEMENTATION PLAN, BETHESDA HOSPITAL PROVIDED A LIST OF COMMUNITY RESOURCES AND OTHER TRIHEALTH SYSTEM PROGRAMS AVAILABLE TO HELP ADDRESS THESE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IT SERVES. HOWEVER, DUE TO SOFTWARE CONSTRAINTS, THEY ARE NOT IDENTIFIED HERE. THIS LIST CAN BE FOUND ON PAGES 11-13 OF THE PLAN FOUND AT THE FOLLOWING URL (HTTPS://WWW.TRIHEALTH.COM/ABOUT-TRIHEALTH/COMMUNITY/HEALTH-NEEDS-ASSESSMENT).PLEASE NOTE THAT ALL OF THE ABOVE NEEDS BEING ADDRESSED ARE IN LINE WITH THE STATE HEALTH IMPROVEMENT PLAN (SHIP) 2020-2022. BETHESDA BUTLER HOSPITAL PART V, SECTION B, LINE 11: 1. SUBSTANCE ABUSE/MENTAL HEALTH-GIVEN THE HIGH PREVALENCE OF DEPRESSION, ANXIETY, & SUBSTANCE ABUSE IN THIS AREA, & THE FACT THAT CURRENT WORK IS NOT COMPLETED & THERE ARE MANY COMMUNITY PARTNERS THAT ARE ENGAGING ALONG WITH TRIHEALTH, THIS ISSUE REMAINS ONE OF THE TOP PRIORITY COMMUNITY NEEDS. THE GOAL IS TO IMPROVE EARLY IDENTIFICATION & TREATMENT, AS WELL AS EDUCATION, TO THOSE IN OUR COMMUNITY WHO NEED THE RIGHT CARE, IN THE RIGHT SETTING, AT THE RIGHT TIME REGARDING THIS ISSUE TO IMPROVE HEALTH OUTCOMES. THE STRATEGY OR PROGRAMS NEEDED TO ACHIEVE THIS GOAL IS AS FOLLOWS:*TREATMENT COORDINATORS-PROVIDE RN/SOCIAL WORKER WITH SPECIFIC SUBSTANCE USE TRAINING AND/OR CERTIFICATION AT INPATIENT SERVICES & EMERGENCY DEPARTMENT LOCATIONS TO ENGAGE, ASSESS, & PROVIDE APPOINTMENTS TO TREATMENT WITHIN 24-48 HOURS AFTER DISCHARGE. *OUTPATIENT ALCOHOL & TREATMENT PROGRAM-OFFER SUPPORT & TREATMENT TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, IN A STRUCTURED, OUTPATIENT SETTING. *INTEGRATED BEHAVIORAL HEALTH MODEL-DEVELOP A BEHAVIORAL HEALTH CARE MODEL TO PROACTIVELY IDENTIFY PATIENT NEEDS USING A COMPREHENSIVE BEHAVIORAL HEALTH ASSESSMENT & PROVIDE TREATMENT AS INDICATED. *BEHAVIORAL HEALTH INTAKE PROGRAM-REFER PATIENTS FROM THE EMERGENCY DEPARTMENT TO THE APPROPRIATE TREATMENT SETTING & LOCATION. THE PLAN IS TO ADDRESS THESE INITIATIVES BY PROVIDING REGISTERED NURSES, PHYSICIANS, COMMUNITY HEALTH EDUCATORS, PHILANTHROPIC CASH GRANTS, OUTREACH COMMUNICATION & PROGRAM MANAGEMENT SUPPORT. IT WILL DO SO IN PARTNERSHIP WITH BI3, ADDICTION SERVICES COUNCIL, BRIGHTVIEW, TALBERT HOUSE, NAMI OF SOUTHWEST OHIO, URBAN HEALTH PROJECT, CENTER FOR ADDICTION TREATMENT, BETHESDA FOUNDATION. 2. CHRONIC CONDITIONS-HEART DISEASE, DIABETES, HYPERTENSION AND OTHER HEALTH CONDITIONS RESULTING FROM POSTPONED SCREENINGS, ACCESS TO CARE & HEALTH EDUCATION ARE AFFECTING THE COMMUNITY DISPROPORTIONATELY. THE GOAL IS TO ADDRESS & IMPROVE SPECIFIC CHRONIC HEALTH CONDITIONS THAT ARE IMPACTED BY DISPARITIES THROUGH IMPROVED EDUCATION, DATA COLLECTION, ASSESSMENTS, INTERVENTIONS, CULTURALLY COMPETENT CARE & CARE MANAGEMENT. THE STRATEGY OR PROGRAMS NEEDED TO ACHIEVE THIS GOAL IS AS FOLLOWS:*HEALTH DISPARITIES DATA COLLECTION-EXPAND PROGRAM OF COLLECTING HEALTH DISPARITY DATA REGARDING CHRONIC CONDITIONS TO ASSESS SOCIAL DETERMINANTS OF HEALTH TO ASSIST WITH INTERVENTIONS & TRACK OUTCOMES. *COORDINATE EXISTING/NEW CHRONIC HEALTH PROGRAMS WITH AN EMPHASIS ON HEALTH DISPARITIES - THROUGH TRIHEALTH'S CENTER FOR HEALTH EQUITY, COORDINATE AND ASSIMILATE CURRENT/FUTURE PROGRAMS THAT ADDRESS CHRONIC CONDITIONS IN THE AREAS OF CRITICAL NEEDS BASED ON ZIP CODES, ETHNICITY, GENDER & OTHER SOCIAL DETERMINANTS OF HEALTH.*TRIHEALTH OUTREACH PROGRAMS-IMPROVE COORDINATION OF PROGRAMS IN ORDER TO MAKE THEM AVAILABLE DIRECTLY TO THE UNDERSERVED COMMUNITY WITH CONNECTION TO TRIHEALTH & COMMUNITY ORGANIZATIONS. PROGRAM COORDINATION INCLUDES BUT ISN'T LIMITED TO MOBILE MAMMOGRAPHY, FREE HEALTH SCREENINGS, SENIOR CARE, THINKFIRST EDUCATION, PHARMACY ASSISTANCE FOOD PROGRAMS AND LEGAL AID, ADVOCACY, HOUSING REPAIR AND EMPLOYEE RESOURSE GROUP (ERG).TRIHEALTH WILL DO SO IN PARTNERSHIP WITH BI3, NAMI, MEHARRY MEDICAL COLLEGE, AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, LEGAL AID OF GREATER CINCINNATI, RIDE CINCINNATI, HEALTH COLLABORATIVE, SVDP CHARITABLE PHARMACY, INTERACT FOR HEALTH, PEOPLE WORKING COLLABORATIVELY, SHARED HARVEST FOODBANK GREATER CINCINNATI FOUNDATION, UNITED WAY, BETHESDA FOUNDATION & OTHER VARIOUS COMMUNITY ORGANIZATIONS.3. FOOD ACCESS AND INSECURITY-GIVEN THE HIGH PREVALENCE OF LIMITED FOOD ACCESS & INSECURITY IN THE REGION, IT IS A CRITICAL SOCIAL DETERMINATE OF HEALTH THAT CONTRIBUTES & IMPACTS PEOPLE'S PHYSICAL & MENTAL WELL-BEING. THE GOAL IS TO IMPROVE ACCESS TO FOOD & RESOURCES FOR THE UNDERSERVED POPULATIONS WITH EMPHASIS ON EDUCATION, ASSESSMENT, COLLABORATION, FOOD DISTRIBUTION & INTEGRATION WITH CLINICAL CARE. THE STRATEGY OR PROGRAMS NEEDED TO ACHIEVE THIS GOAL IS AS FOLLOWS:*TRIHEALTH FOOD PANTRIES-PROGRAM THAT PROVIDES SCREENINGS, EDUCATION, FOOD, PERSONAL HYGIENE ITEMS & COMMUNITY RESOURCE INFORMATION FOR UNDERSERVED PATIENTS WHO ARE IN NEED THAT ENHANCES HEALTH & MENTAL WELLBEING WHICH IMPACTS CHRONIC CONDITIONS AND HEALTH EQUITY. *PARTNERSHIPS WITH THE COMMUNITY-ACTIVE PARTNERSHIPS WITH ORGANIZATIONS, SUCH AS FREESTORE FOODBANK, SHARED HARVEST, HOSEA HOUSE, LAST MILE RESCUE, BETHESDA FOUNDATION & OTHERS WHO CONTRIBUTE TO THE COMMUNITY WITH FOOD FOR HOMELESS, STUDENTS, MOBILE MARKETS TO ADDRESSES FOOD DISPARITIES IN THE UNDERSERVED COMMUNITIES.*TEAM MEMBER ENGAGEMENT FOOD DRIVES-TRIHEALTH TEAM MEMBER INITIATED FOOD DRIVES TO SUPPORT HOSPITAL & COMMUNITY PARTNER PROGRAMS TO ADDRESS FOOD ACCESS AND INSECURITIES. THE PLAN IS TO PROVIDE THE FOLLOWING TO THE COMMUNITY: FACILITY SPACE, PHYSICIANS, NURSES, TEAM MEMBERS, COMMUNITY RELATIONS DIRECTOR AND COORDINATOR. IT WILL DO SO IN PARTNERSHIP WITH FREESTORE FOOD BANK, SHARED HARVEST, LAST MILE RESCUE, HOSEA HOUSE, GREATER CINCINNATI REGIONAL FOOD POLICY COUNCIL, HEALTH COLLABORATIVE, INTERACT FOR HEALTH.IN ITS IMPLEMENTATION PLAN, BETHESDA BUTLER HOSPITAL PROVIDED A LIST OF COMMUNITY RESOURCES AND OTHER TRIHEALTH SYSTEM PROGRAMS AVAILABLE TO HELP ADDRESS THESE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IT SERVES. HOWEVER, DUE TO SOFTWARE CONSTRAINTS, THEY ARE NOT IDENTIFIED HERE. THIS LIST CAN BE FOUND ON PAGES 9-11 OF THE PLAN FOUND AT THE FOLLOWING URL (HTTPS://WWW.TRIHEALTH.COM/ABOUT-TRIHEALTH/COMMUNITY/HEALTH-NEEDS-ASSESSMENT).PLEASE NOTE THAT ALL OF THE ABOVE NEEDS BEING ADDRESSED ARE IN LINE WITH THE STATE HEALTH IMPROVEMENT PLAN (SHIP) 2020-2022. BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 13B: SEE PART VI RESPONSE TO PART I, LINE 3C. BETHESDA BUTLER HOSPITAL PART V, SECTION B, LINE 13B: SEE PART VI RESPONSE TO PART I, LINE 3C. BETHESDA NORTH HOSPITAL PART V, SECTION B, LINE 13H: SEE PART VI RESPONSE TO PART I, LINE 3C. BETHESDA BUTLER HOSPITAL PART V, SECTION B, LINE 13H: SEE PART VI RESPONSE TO PART I, LINE 3C. PART V, SECTION B, LINES 7A AND 10A: HTTPS://WWW.TRIHEALTH.COM/ABOUT-TRIHEALTH/FULFILLING-OUR-MISSION-AND-VALUES/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 18 1 - BETHESDA MEDICAL CENTER-ARROW SPRINGS 100 ARROW SPRINGS BLVD LEBANON OH 45036 24-HOUR EMERGENCY ROOM AND COMPREHENSIVE OUTPATIENT SERVICES 2 - BETHESDA OBGYN CENTER RESIDENT CLINIC 10495 MONTGOMERY ROAD CINCINNATI OH 45242 WOMEN'S HEALTH 3 - TRIHEALTH SLEEP MEDICINE 10475 MONTGOMERY ROAD CINCINNATI OH 45242 SLEEP CENTER 4 - B NORTH MINIMALLY INVASIVE SURGERY CTR 10506 MONTGOMERY ROAD CINCINNATI OH 45242 OUTPATIENT SURGICAL CENTER 5 - BETHESDA HAND REHABILITATION 10700 MONTGOMERY ROAD CINCINNATI OH 45242 PHYSICAL THERAPY 6 - BETHESDA LOVELAND PHYSICAL THERAPY 10675 LOVELAND-MADERIA ROAD LOVELAND OH 45140 PHYSICAL THERAPY 7 - BETHESDA FAMILY PRACTICE CENTER 1775 LEXINGTON AVE CINCINNATI OH 45212 FAMILY MEDICINE CLINIC 8 - BETHESDA ALCOHOLDRUG TREATMENT 4410 CARVER WOODS DRIVE CINCINNATI OH 45242 OUTPATIENT ALCOHOL AND DRUG TREATMENT 9 - BETHESDA BUTLER PHYSICAL THERAPY 3055 HAMILTON-MASON ROAD HAMILTON OH 45011 PHYSICAL THERAPY 10 - BETHESDA BUTLER IMAGING CENTER 3075 HAMILTON-MASON ROAD HAMILTON OH 45011 MEDICAL IMAGING 11 - TRIHEALTH SLEEP MEDICINE 3055 HAMILTON-MASON ROAD HAMILTON OH 45011 SLEEP MEDICINE CENTER 12 - BETHESDA SURGERY CENTER 10615 MONTGOMERY ROAD 300 CINCINNATI OH 45242 OUTPATIENT SURGICAL CENTER 13 - BETHESDA MONTGOMERY CARDIAC TESTING 10525 MONTGOMERY ROAD CINCINNATI OH 45242 OUTPATIENT CARDIAC TESTING 14 - BETHESDA MONTGOMERY SLEEP CENTER 10535 MONTGOMERY ROAD CINCINNATI OH 45242 SLEEP CENTER 15 - BETHESDA MRI KENWOOD 8311 MOTGOMERY ROAD CINCINNATI OH 45236 MEDICAL IMAGING 16 - TRIHEALTH KENWOOD 8240 NORTHCREEK DRIVE CINCINNATI OH 45236 INTEGRATED OUTPATIENT CENTER 17 - THOMAS COMPREHENSIVE CARE CENTER 10506A MONTGOMERY RD CINCINNATI OH 45242 SPECIALTY SERVICES 18 - TRIHEALTH PHARMACY SOLUTIONS 4623 WESLEY AVE SUITE N CINCINNATI OH 45212 SPECIALTY PHARMACY PART I, LINE 3C: BETHESDA HOSPITAL, INC. UTILIZES THE FEDERAL POVERTY GUIDELINES ("FPG") IN DETERMINING CHARITY CARE ELIGIBILITY. SEE THE RESPONSES TO PART I, LINES 3A AND 3B.AN INDIVIDUAL'S INCOME UNDER FPG IS A SIGNIFICANT FACTOR IN DETERMINING ELIGIBILITY FOR CHARITY CARE. ADDITIONALLY, AN INDIVIDUAL'S INCOME IN RELATION TO HIS/HER MEDICAL EXPENSES IS ALSO TAKEN INTO ACCOUNT AND SUCH A PATIENT MAY BE EXTENDED DISCOUNTED OR FREE CARE BASED UPON THE FACTS AND CIRCUMSTANCES. PART I, LINE 6A: IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH TO CREATE AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION. THE COMMUNITY BENEFIT PROVIDED BY BETHESDA HOSPITAL, INC. IS TRACKED ON A STANDALONE BASIS; HOWEVER, ITS COMMUNITY BENEFIT IS REPORTED IN A REPORT PREPARED BY TRIHEALTH IN COMBINATION WITH ITS RELATED HOSPITALS - THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND MCCULLOUGH-HYDE MEMORIAL HOSPITAL. PART I, LINE 7: FOR THE AMOUNTS REPORTED AT COST, IN PART I, LINE 7, BETHESDA HOSPITAL, INC. UTILIZED WORKSHEET 2 - RATIO OF PATIENT CARE COST-TO-CHARGES, WHICH WAS PROVIDED IN THE INSTRUCTIONS TO SCHEDULE H, TO CALCULATE THE COST-TO-CHARGE RATIO. PART I, LINE 7G: THE SUBSIDIZED HEALTH SERVICES COMMUNITY BENEFIT AMOUNT REPORTED IN PART I, LINE 7(G) DOES NOT INCLUDE COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LN 7 COL(F): BAD DEBT EXPENSE IS NOT INCLUDED ON FORM 990, PART IX, LINE 25. IT IS PRESENTED ON FORM 990, PART VIII, LINE 2 AS A DEDUCTION FROM PATIENT SERVICE REVENUE WHICH CORRESPONDS TO ITS FINANCIAL STATEMENT PRESENTATION. SEE RESPONSE TO PART III, LINE 4. THEREFORE, NO ADJUSTMENT TO TOTAL EXPENSES SHOWN ON FORM 990, PART IX, LINE 25 IS NECESSARY. PART II, COMMUNITY BUILDING ACTIVITIES: BETHESDA HOSPITAL, INC. PROVIDED CASH DONATIONS THROUGH TRIHEALTH TO VARIOUS CHARITABLE ORGANIZATIONS WITHIN THE COMMUNITY TO ADDRESS HOMELESSNESS, TO INCREASE EDUCATIONAL OPPORTUNITIES AND TO BUILD AN ECONOMIC INFRASTRUCTURE.IN ADDITION, DURING THE TAX YEAR, BETHESDA HOSPITAL, INC. HELD A SERVE DAY WHERE TEAM MEMBERS ASSISTED LOCAL ORGANIZATIONS WITH VARIOUS COMMUNITY SERVICE PROJECTS. PART III, LINE 2: SEE PART VI RESPONSE TO PART III, LINE 4. PART III, LINE 3: SEE PART VI RESPONSE TO PART III, LINE 4. PART III, LINE 4: BETHESDA HOSPITAL, INC.'S FINANCIAL STATEMENTS ARE AUDITED AS PART OF THE TRIHEALTH AUDIT REPORT.PLEASE NOTE THAT UNDER ACCOUNTING STANDARDS UPDATE NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), WHICH THE TRIHEALTH SYSTEM ADOPTED DURING THE TAX YEAR 2019 (FISCAL YEAR ENDED JUNE 30, 2020), BAD DEBT IS CONSIDERED AN "IMPLICIT PRICE CONCESSION AND IS NOT DISTINGUISHED FROM A CONTRACTUAL ADJUSTMENT UNDER GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) AND THEREFORE THERE IS NO LONGER A SPECIFIC DISCLOSURE FOR BAD DEBT IN THE CURRENT YEAR AUDIT REPORT.SEE PATIENT SERVICE REVENUE (PART OF FOOTNOTE B - PAGES 19-22) FOR ADDITIONAL DETAIL REGARDING THE ABOVE-MENTIONED STANDARD AS WELL AS HOW THE TRIHEALTH SYSTEM ACCOUNTS FOR PATIENT SERVICE REVENUE.AS FOR THE AMOUNT OF BAD DEBT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S CHARITY CARE POLICY, BETHESDA HOSPITAL, INC. DOES NOT REPORT ACTUAL BAD DEBT EXPENSE AS COMMUNITY BENEFIT. IF UPON FURTHER RESEARCH, IT IS ULTIMATELY DETERMINED THAT A PORTION OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS WHO WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE UNDER TRIHEALTH'S CHARITY CARE POLICY, THOSE COSTS WOULD BE RECLASSIFIED, AS APPROPRIATE, TO COMMUNITY BENEFIT AT THAT TIME.PLEASE NOTE THAT BAD DEBT EXPENSE IS NOT DETERMINED UNTIL AFTER ALL DISCOUNTS AND ANY ASSOCIATED PAYMENTS ARE TAKEN INTO ACCOUNT. IF ANY PAYMENTS ARE RECEIVED AFTER A PATIENT ACCOUNT IS DETERMINED TO BE BAD DEBT, THE ACCOUNT WILL BE ADJUSTED ACCORDINGLY AT THAT TIME. PART III, LINE 8: BETHESDA HOSPITAL, INC. USES THE "STEPDOWN METHODOLOGY" IN DETERMINING THE MEDICARE ALLOWABLE COSTS REPORTED ON THE MEDICARE COST REPORT. THIS METHOD OF COST FINDING PROVIDES FOR THE ALLOCATION OF THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS WHICH UTILIZE SUCH SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. BETHESDA HOSPITAL, INC. DID NOT REPORT ANY MEDICARE SHORTFALL AS COMMUNITY BENEFIT IN PART III, LINE 7 OF THIS SCHEDULE. PART III, LINE 9B: AS OF THE FILING OF THIS RETURN, BETHESDA HOSPITAL, INC., AS PART OF TRIHEALTH, INC., MAINTAINS A WRITTEN DEBT COLLECTION POLICY. TRIHEALTH, INC., WHO PERFORMS THE BILLING SERVICES FOR ALL AFFILIATED HOSPITALS, WILL NOT INITIATE COLLECTION PRACTICES ON PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. BEFORE COLLECTION ACTIONS ARE TAKEN, TRIHEALTH, INC. WILL MAKE REASONABLE EFFORTS, GENERALLY AS EARLY IN THE BILLING PROCESS AS POSSIBLE, TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. AFTER SUCH EFFORTS HAVE BEEN MADE AND A BALANCE REMAINS THAT IS THE RESPONSIBILITY OF THE PATIENT OR GUARANTOR, TRIHEALTH, INC. MAY PURSUE, IN ITS SOLE DISCRETION, WHATEVER ACTIONS IT MAY BE ENTITLED TO TAKE UNDER LAW. PART VI, LINE 2: IN 1896, BETHESDA HOSPITAL, INC. ("BETHESDA") BEGAN AS A HOME VISITING MINISTRY OF THE METHODIST DEACONESSES TO SERVE THE HEALTH NEEDS OF THE GERMAN IMMIGRANTS LIVING IN CINCINNATI. NOW THAT MINISTRY, ONCE LED BY DEACONESS LOUISE GOLDER AND HER BROTHER REV. CHRISTIAN GOLDER, HAS GROWN INTO SEVERAL HEALTH SERVICES FOR GREATER CINCINNATI. IN 1995, BETHESDA, INC. AND GOOD SAMARITAN HOSPITAL FORMED A PARTNERSHIP TO CREATE A LOCAL HEALTH SYSTEM: TRIHEALTH, INC. ("TRIHEALTH"). THE MISSION OF TRIHEALTH IS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY THROUGH A FULL RANGE OF HEALTH RELATED SERVICES-PREVENTION, WELLNESS AND EDUCATION AND THUS EXEMPLIFY THE FOUNDING SPIRIT OF THE BETHESDA DEACONESSES.EVERY THREE (3) YEARS, BETHESDA PARTICIPATES IN THE GREATER CINCINNATI TRI-STATE REGION REGIONAL CHNA TO EVALUATE THE HEALTH AND WELL-BEING OF THE AREAS 18-COUNTIES AND IDENTIFY OPPORTUNITIES FOR COLLECTIVE ACTION. THE REGIONAL CHNA IS A RESOURCE THAT CAN BE USED BY PARTNERS ACROSS SECTORS AND POLICYMAKERS TO INCREASE ACCESS TO DATA, GUIDE HEALTH IMPROVEMENT, AND ADVANCE EQUITY. THE MOST RECENT REGIONAL CHNA IS AVAILABLE AT HTTPS://HEALTHCOLLAB.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/.BETHESDA CAREFULLY CONSIDERED THE HEALTH NEEDS IDENTIFIED IN THE REGIONAL CHNA FOR THE COMMUNITIES SERVED BY BETHESDA. IN ADDITION TO THE REGIONAL CHNA PROCESS, CURRENT DATA AND INPUT FROM LOCAL LEADERS, PHYSICIANS AND COMMUNITY ADVOCATES WERE SOLICITED TO DETERMINE THE SIGNIFICANT HEALTH NEEDS FOR THE BETHESDA COMMUNITY SERVED THROUGH COMMUNITY ROUNDTABLE MEETINGS AND SURVEYS. THE MOST RECENT CHNA WAS COMPLETED IN 2025 AND A COPY OF THE REPORT AS WELL AS THE ASSOCIATED IMPLEMENTATION PLAN IS AVAILABLE ON THE TRIHEALTH WEBSITE. SEE SCHEDULE H, PART V, LINE 7A FOR THE URL. PART VI, LINE 3: TRIHEALTH, INC. PERFORMS THE BILLING SERVICES FOR ALL AFFILIATED HOSPITALS INCLUDING BETHESDA HOSPITAL, INC. BROCHURES/APPLICATIONS, PROVIDED IN MULTIPLE LANGUAGES, ARE VISIBLE AND AVAILABLE IN THE REGISTRATION AND ADMITTING AREAS OF ALL TRIHEALTH AFFILIATED HOSPITALS. IN ADDITION, THE APPLICATION IS PRINTED ON THE REVERSE SIDE OF A PATIENT'S BILL WITH INSTRUCTIONS ON HOW TO COMPLETE THE APPLICATION AS WELL AS HOW TO RETURN IT. FINANCIAL COUNSELORS ASSIST PATIENTS IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. FINALLY, TRIHEALTH INC.'S WEBSITE CONTAINS INFORMATION REGARDING ITS CHARITY CARE AND FINANCIAL ASSISTANCE PROGRAMS WITH DIRECTIONS ON HOW TO CONTACT THE APPROPRIATE PERSONNEL TO INITIATE AN APPLICATION OR ASK QUESTIONS ABOUT THE PROCESS. PART VI, LINE 4: WITH BETHESDA NORTH HOSPITAL LOCATED IN MONTGOMERY, OHIO, A SUBURB OF CINCINNATI, AND BETHESDA BUTLER HOSPITAL LOCATED NEAR HAMILTON, OHIO, BETHESDA HOSPITAL, INC. AND THE TRIHEALTH SYSTEM SERVE PRIMARILY HAMILTON, BUTLER, WARREN AND CLERMONT COUNTIES IN OHIO AS WELL AS SOME PERSONS FROM INDIANA AND KENTUCKY. BETHESDA NORTH HOSPITALHAMILTON COUNTY IS THE MOST POPULATED COUNTY IN THE REGION AND IS HOME TO THE LARGEST CITY, CINCINNATI. THE ESTIMATED POPULATION OF THE COUNTY IS 827,000 WITH APPROXIMATELY 13% IN POVERTY AND APPROXIMATELY 14% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. HAMILTON COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $68,500 WITH 93% OF THE POPULATION HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (44% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 4.5%. APPROXIMATELY 17% OF THE POPULATION IS 65 YEARS AND OLDER, 62% IS WHITE, 23% IS AFRICAN-AMERICAN, 5% IS HISPANIC, 3% ASIAN AND 7% OTHER.CLERMONT COUNTY IS A LARGE COUNTY WHICH WAS ONCE MOSTLY RURAL BUT HAS BECOME MORE SUBURBAN AND IS ONE OF OHIO'S APPALACHIAN COUNTIES. THE ESTIMATED POPULATION OF THE COUNTY IS 212,000 WITH APPROXIMATELY 9% IN POVERTY AND APPROXIMATELY 14% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. CLERMONT COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $81,000 WITH 93% OF THE POPULATION HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (32% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 4.5%. APPROXIMATELY 19% OF THE POPULATION IS 65 YEARS AND OLDER, 91% IS WHITE, 1% IS AFRICAN-AMERICAN, 2% IS HISPANIC, 1% ASIAN AND 5% OTHER.WARREN COUNTY IS ONE OF THE FASTEST GROWING COUNTIES IN OHIO, BOTH IN RESIDENTIAL AND COMMERCIAL GROWTH. THE ESTIMATED POPULATION OF THE COUNTY IS 252,000 WITH APPROXIMATELY 6% IN POVERTY AND APPROXIMATELY 19% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. WARREN COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $107,500 WITH 95% OF THE POPULATION HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (48% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 4%. APPROXIMATELY 16% OF THE POPULATION IS 65 YEARS AND OLDER, 81% IS WHITE, 6% ASIAN, 3% IS AFRICAN-AMERICAN, 4% IS HISPANIC, AND 6% OTHER.BETHESDA BUTLERBUTLER COUNTY IS ONE OF THE MOST POPULATED COUNTIES IN THE REGION AND INCLUDES THE CITIES OF HAMILTON, MIDDLETOWN AND OXFORD. THE ESTIMATED POPULATION OF THE COUNTY IS 393,000 WITH APPROXIMATELY 12% IN POVERTY AND APPROXIMATELY 17% OF THE PEOPLE UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. BUTLER COUNTY HAS A MEDIAN INCOME OF APPROXIMATELY $80,000 WITH 91% OF THE POPULATION HAVING A HIGH SCHOOL DIPLOMA OR HIGHER (32% BACHELOR'S DEGREE OR HIGHER) AND AN UNEMPLOYMENT RATE OF ABOUT 4.5%. APPROXIMATELY 17% OF THE POPULATION IS 65 YEARS AND OLDER, 75% IS WHITE, 9% IS AFRICAN-AMERICAN, 7% IS HISPANIC, 4% ASIAN AND 5% OTHER. PART VI, LINE 5: BETHESDA HOSPITAL, INC. IS COMPRISED OF VARIOUS MEDICAL SERVICES INCLUDING BETHESDA NORTH HOSPITAL ("NORTH"), BETHESDA MEDICAL CENTER AT ARROW SPRINGS ("ARROW SPRINGS") AND BETHESDA BUTLER HOSPITAL ("HOSPITAL"). ITS BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY REPRESENTATIVES. NORTH IS A 458-BED ACUTE TERTIARY TEACHING HOSPITAL. NORTH PROVIDES A 24-HOUR EMERGENCY DEPARTMENT, INTENSIVE CARE UNITS AND A LEVEL II SPECIAL CARE NURSERY. SERVICES ARE OPEN TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY. IN ADDITION, NORTH HAS AN OPEN MEDICAL STAFF AND A HISTORY OF TRAINING AND EDUCATING MEDICAL RESIDENTS AND HEALTH CARE PROFESSIONALS. FINALLY IN CONCERT WITH THE HATTON INSTITUTE AT THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO, AN AFFILIATED HOSPITAL, NORTH CONDUCTS MEDICAL AND SCIENTIFIC RESEARCH PROGRAMS INCLUDING STUDIES THAT ARE NOT COMMERCIALLY SPONSORED. NORTH PARTICIPATES IN MEDICARE AND MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAMS, AND HAS AN ACTIVE CHARITY CARE PROGRAM.ARROW SPRINGS COMPRISES A FULLY STAFFED 24-HOUR EMERGENCY DEPARTMENT, PRIMARY CARE AND SPECIALIST PHYSICIANS, DIAGNOSTIC SERVICES, OCCUPATIONAL MEDICINE, PHYSICAL THERAPY AND A PHARMACY. IT PROVIDES THE SAME HIGH-QUALITY, PATIENT-CENTERED CARE AND SERVICES THAT IS PROVIDED BY NORTH. BUTLER IS AN OVER 50-BED SURGICAL HOSPITAL LOCATED NEAR HAMILTON, OHIO. IT PROVIDES EVERYTHING FROM SURGERY, CARDIOLOGY AND IMAGING TO PHYSICAL THERAPY AND SLEEP STUDIES. WITH EIGHT OPERATING ROOMS, THREE ENDOSCOPY SUITES, TWO PROCEDURE ROOMS AND A FULL-SERVICE 24-HOUR EMERGENCY DEPARTMENT, THE HOSPITAL IS COMPLEMENTED BY ADDITIONAL SERVICES AND PHYSICIAN OFFICES FOR PRIMARY CARE, PEDIATRICS AND SPECIALTY CARE ON CAMPUS.THE BETHESDA HOSPITAL, INC. SERVICES DESCRIBED ABOVE, AND OTHERS NOT LISTED, PROMOTE COMMUNITY HEALTH IN ACUTE ILLNESS, IN MANAGEMENT OF CHRONIC DISEASE, AND IN EDUCATION AND PREVENTION MEASURES WHICH SEEK TO REDUCE THE BURDENS ON THE GOVERNMENT.BETHESDA HOSPITAL, INC. SERVES ALMOST 660,000 PEOPLE ANNUALLY. THIS INCLUDES ALMOST 28,000 ADMISSIONS, APPROXIMATELY 106,000 EMERGENCY ROOM VISITS, MORE THAN 520,000 OUTPATIENT VISITS, AND ALMOST 4,300 NEW BABIES EACH YEAR.SEE RESPONSE TO PART VI, LINE 2 FOR ADDITIONAL INFORMATION. PART VI, LINE 6: IN 1995, THE GOOD SAMARITAN HOSPITAL OF CINCINNATI, OHIO AND BETHESDA HOSPITAL, INC. FORMED A PARTNERSHIP CALLED TRIHEALTH IN ORDER TO CREATE AN INTEGRATED HEALTH DELIVERY SYSTEM WHOSE MISSION IS TO IMPROVE THE HEALTH OF THE PEOPLE THEY SERVE, WITH AN EMPHASIS ON PREVENTION, WELLNESS AND EDUCATION.THROUGH FIVE (5) HOSPITALS, THIRTEEN (13) AMBULATORY LOCATIONS AND OVER 125 SITES OF CARE (EMPLOYING OVER 700 PHYSICIANS INCLUDING RESIDENTS), TRIHEALTH PROVIDES A WIDE RANGE OF CLINICAL, EDUCATIONAL, PREVENTIVE AND SOCIAL PROGRAMS. TRIHEALTH'S NON-HOSPITAL SERVICES INCLUDE PHYSICIAN PRACTICE MANAGEMENT, FITNESS CENTERS AND FITNESS CENTER MANAGEMENT, OCCUPATIONAL HEALTH CENTERS, HOME HEALTH AND HOSPICE CARE.HTTPS://WWW.TRIHEALTH.COM/ABOUT-TRIHEALTH/ 1 CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER 3333 BURNET AVE CINCINNATI OH 45229 310833936 501(C)(3) 237500 0 CRADLE CINCINNATI PARTNERSHIP FUNDING HEALTHY MOMS & BABES INC 2270 BANNING ROAD NO 200 CINCINNATI OH 45239 311155292 501(C)(3) 47842 0 GENERAL SUPPORT AMERICAN HEART ASSOCIATION INC 7272 GREENVILLE AVE DALLAS TX 75231 135613797 501(C)(3) 28500 0 SPONSORSHIP CINCINNATI ARTS ASSOCIATION 650 WALNUT STREET CINCINNATI OH 45202 311310256 501(C)(3) 19000 0 GENERAL SUPPORT CINCINNATI ZOO AND BOTANICAL GARDENS 3400 VINE ST CINCINNATI OH 45220 310537171 501(C)(3) 16625 0 SPONSORSHIP CANCERFREE KIDS 615 ELSINORE PLACE SUITE 777 CINCINNATI OH 45202 300087852 501(C)(3) 14250 0 GENERAL SUPPORT FREESTORE FOODBANK 3401 ROSENTHAL WAY CINCINNATI OH 45202 311243534 501(C)(3) 11875 0 CLINIC PANTRY DONATION CINCINNATI MUSEUM CENTER 1301 WESTERN AVE CINCINNATI OH 45203 311212634 501(C)(3) 9500 0 GENERAL SUPPORT FRIAR'S CLUB INC 4300 VINE STREET CINCINNATI OH 45217 310537485 501(C)(3) 9500 0 GENERAL SUPPORT PEOPLE WORKING COOPERATIVELY INC 4612 PADDOCK ROAD CINCINNATI OH 45229 310859104 501(C)(3) 6497 0 HOME MODIFICATION SUPPORT 10 0 PART I, LINE 2: BETHESDA HOSPITAL, INC. ("HOSPITAL") PROVIDES GRANTS TO OTHER ORGANIZATIONS DIRECTLY ON A VERY LIMITED BASIS. IN THOSE INSTANCES, THE DEPARTMENT GRANTING THE FUNDS IS RESPONSIBLE FOR OBTAINING AND STORING ALL NECESSARY INFORMATION FROM THE OTHER ORGANIZATION RELATIVE TO HOW THE FUNDS WILL BE SPENT. GENERALLY, GRANTS ARE PROVIDED, ON BEHALF OF HOSPITAL THROUGH TRIHEALTH, INC. ("TRIHEALTH"), A SUPPORTING ORGANIZATION OF HOSPITAL, WHICH PROVIDES ADMINISTRATIVE SUPPORT SERVICES TO HOSPITAL. AS SUCH, TRIHEALTH IS RESPONSIBLE FOR MONITORING THE USE OF HOW THE FUNDS WILL BE SPENT. 1 1 0 0 0 0 0 0 0 MARK CLEMENT PRESIDENT/CEO-TRIHEALTH 0 1651024 0 769875 0 137174 0 49708 0 25976 0 2633757 0 0 TERRI HANLON-BREMER CHIEF OPERATING OFFICER-TRIHEALTH 0 807387 0 260773 0 32140 0 53324 0 17042 0 1170666 0 0 HELEN KOSELKA MD CHIEF MEDICAL OFFICER-TRIHEALTH 0 707156 0 197328 0 18093 0 49708 0 41873 0 1014158 0 0 JOHN WARD SVP-BETHESDA REGION 0 652260 0 186317 0 42941 0 53324 0 34373 0 969215 0 0 STEVE GRACEY ASST SECRETARY/SVP LEGAL-TRIHEALTH 0 593047 0 163198 0 3753 0 48110 0 41668 0 849776 0 0 JEREMIAH KIRKLAND PRES. & COO-BUTLER 0 446240 0 109265 0 31264 0 69785 0 39233 0 695787 0 0 JOHN HUTSON MD PRES. & COO-BETHESDA 0 423517 0 104647 0 27514 0 30324 0 41045 0 627047 0 0 DAVID ATKINSON CHIEF PEOPLE OFFICER-TRIHEALTH 0 464748 0 101198 0 2294 0 23408 0 29482 0 621130 0 0 MICHAEL CROFTON TREASURER (7/24-6/25) 0 342253 0 176187 0 6460 0 54214 0 27792 0 606906 0 0 WILL GRONEMAN FORMER KEY EMPLOYEE 0 370247 0 105237 0 13838 0 53324 0 26800 0 569446 0 0 JENNY SKINNER FORMER KEY EMPLOYEE 0 257015 0 136874 0 109177 0 35075 0 16368 0 554509 0 0 MARIA ASHDOWN INTERIM CNE (7/24-10/24) 0 269240 0 101674 0 17926 0 61923 0 30113 0 480876 0 0 JERRI IRBY FORMER KEY EMPLOYEE 0 0 0 0 0 429998 0 0 0 0 0 429998 0 0 DAVID COOK FORMER KEY EMPLOYEE 0 0 0 0 0 428584 0 0 0 0 0 428584 0 428584 SUSAN MACY FORMER KEY EMPLOYEE 0 38656 0 0 0 315193 0 3123 0 3230 0 360202 0 0 RICHARD OKRAGLY MD PHYSICIAN 264304 0 0 0 10807 0 20231 0 40221 0 335563 0 0 0 SCOTT WOODS MD PHYSICIAN 257957 0 0 0 13974 0 17530 0 35645 0 325106 0 0 0 ROBERT KUNKEL MD PHYSICIAN 230883 0 0 0 20534 0 20337 0 30838 0 302592 0 0 0 MICHAEL EVERETT FORMER KEY EMPLOYEE 0 0 0 0 0 293392 0 0 0 0 0 293392 0 0 JOHNATHAN SORSCHER MD PHYSICIAN 234519 0 0 0 3271 0 41976 0 12450 0 292216 0 0 0 MICHAEL WEBB MD PHYSICIAN 236671 0 0 0 4734 0 19774 0 25323 0 286502 0 0 0 ANDREW DEVOE FORMER OFFICER 0 129459 0 0 0 109593 0 18521 0 14384 0 271957 0 0 CYNTHIA ADAMS PHD RN CHIEF NURSING EXEC (START 10/24) 0 63110 0 100000 0 627 0 2307 0 1953 0 167997 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. DURING THE 2024 CALENDAR YEAR, THE FOLLOWING 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. * DAVID COOK - $428,584 PART I, LINE 3: TRIHEALTH, INC., A RELATED ORGANIZATION OF BETHESDA HOSPITAL, INC., 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 HOSPITAL, INC. 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 2024 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: JERRI IRBY - $429,998 MICHAEL EVERETT - $293,392 SUSAN MACY - $270,020 A COUNTY OF HAMILTON OHIO (LINE A) 316000063 407272V59 2017-04-12 316011223 BUILDINGS AND STRUCTURES 0 0 0 B COUNTY OF HAMILTON OHIO (LINE B) 316000063 000000000 2020-05-14 148454656 BUILDINGS, STRUCTURES & REFUND OF TAXABLE & TAX-EXEMPT BONDS ISSUED 9/29/15 0 0 0 C COUNTY OF HAMILTON OHIO (LINE C) 316000063 4072722B8 2021-05-27 100000000 BUILDINGS, STRUCTURES, EQUIPMENT, REFUND OF TAX-EXEMPT BONDS ISSUED 4/19/17 0 0 0 A 4520000 318770658 3974594 314505586 290478 2020 0 0 1 1 B 156607411 1811516 117857464 36938431 2025 1 1 0 1 C 7800000 100853929 1011750 16940159 82902020 2025 1 0 0 1 A 0 1 1 1 0 0.01510 0.00000 0.01510 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 0 0.01970 0.00000 0.01970 0 0 1 A 0 0 0 1 0 0 0 1 1 B 0 0 0 1 0 0 0 1 1 C 0 1 0 0 1 0 0 1 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: COUNTY OF HAMILTON, OHIO (LINE A) DATE THE REBATE COMPUTATION WAS PERFORMED: 04/12/2022 ISSUER NAME: COUNTY OF HAMILTON, OHIO (LINE B) DATE THE REBATE COMPUTATION WAS PERFORMED: 05/21/2025 PART II, LINE 3, COLUMN A, COLUMN B AND COLUMN C TOTAL PROCEEDS SHOWN ARE NOT IDENTICAL TO THE ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO THE INVESTMENT EARNINGS. PART II, LINE 11, COLUMN A THE REMAINING UNSPENT FUNDS WAS DEPOSITED TO THE CREDIT OF THE BOND FUNDS AND APPLIED AS A CREDIT AGAINST BASIC RENT WITH RESPECT TO PRINCIPAL ON THE BONDS PURSUANT TO SECTION 2.24 OF THE SUBLEASE. PART II, LINE 11, COLUMN B THE AMOUNT SHOWN HERE CONSISTS OF $36,646,925 SPENT TO RETIRE PRINCIPAL AND INTEREST OF PRIOR BONDS, PLUS $291,506 FOR A SWAP TERMINATION FEE PAID WITH RESPECT TO THE RETIRED TAX-EXEMPT DEBT. THE REFUNDING CONSISTED OF PRIOR TAX-EXEMPT BONDS ($9,324,915) AND PRIOR TAXABLE BONDS ($27,322,010) OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL, A RELATED IRC SECTION 501(C)(3) ORGANIZATION OF BETHESDA HOSPITAL, INC. PART IV, LINE 6, COLUMN A AND COLUMN B SUCH AMOUNT WAS APPROPRIATELY YIELD RESTRICTED. PART IV, LINE 6, COLUMN C SUCH AMOUNT WILL BE APPROPRIATELY YIELD RESTRICTED, USING YIELD REDUCTION PAYMENTS IF NECESSARY. FORM 990, PART III, LINE 4 IN 1896, METHODIST EPISCOPAL CHURCH MINISTER DR. CHRISTIAN GOLDER FOUNDED THE GERMAN METHODIST DEACONESS ASSOCIATION IN CINCINNATI. THIS WAS THE BEGINNING OF BETHESDA HOSPITAL, INC. ("BETHESDA HOSPITAL") AND A HERITAGE OF CARING FOR PEOPLE FIRST WAS ESTABLISHED AND IS STILL CENTRAL, AS THE GREAT CARE WE PROVIDE GROWS EVEN BETTER. IN 1915, THE NAME BETHESDA IS FIRST USED TO REFLECT THE GROWING AWARENESS OF THE HOSPITAL'S IMPORTANCE IN SERVING THE MANY DIFFERENT PEOPLE WHO CAME THERE TO HEAL AND BE HEALED. THE FIRST BUILDING WAS A SMALL HOUSE IN MT. AUBURN. FROM THERE THE DEACONESSES WENT OUT INTO THE COMMUNITY BY FOOT AND TROLLEY TO MINISTER SPIRITUALLY AND PHYSICALLY TO ALL WHO NEEDED HELP. AS A RESULT OF THE OVERWHELMING NEEDS THEY ENCOUNTERED, A SMALL 20-BED HOSPITAL WAS PURCHASED IN 1898 ON THE CORNER OF READING ROAD AND OAK STREET. IN TWO SHORT YEARS, BETHESDA HOSPITAL'S HERITAGE HAD TAKEN SHAPE. ULTIMATELY, THIS LOCATION BECAME KNOWN AS BETHESDA OAK HOSPITAL ("BETHESDA OAK") AND GREW SIGNIFICANTLY OVER TIME. BETHESDA OAK'S 15-ACRE COMPLEX WAS HOME TO 1.1 MILLION SQUARE FEET OF FACILITIES WITH 450 BEDS UNTIL IT WAS CLOSED IN EARLY 2000. IN 1970, BETHESDA HOSPITAL OPENED BETHESDA NORTH HOSPITAL IN MONTGOMERY, OHIO AS THE FIRST COMMUNITY SATELLITE HOSPITAL IN GREATER CINCINNATI. TODAY, IT IS AMONG THE LARGEST ACUTE AND TERTIARY CARE HOSPITALS IN THE CINCINNATI REGION. IT OFFERS A COMPREHENSIVE RANGE OF SERVICES INCLUDING MATERNITY SERVICES AND A 24-HOUR EMERGENCY ROOM TO RESIDENTS OF NORTHERN CINCINNATI AND WARREN, BUTLER AND CLERMONT COUNTIES. OVER THE YEARS, THIS HOSPITAL CAMPUS HAS BEEN EXPANDED MANY TIMES TO MEET THE NEEDS OF THE COMMUNITY. ADDITIONS INCLUDE THE HAROLD AND EUGENIA THOMAS COMPREHENSIVE CARE CENTER, WHICH OPENED IN 2020, PROVIDING CANCER, IMAGING AND CARDIOVASCULAR SERVICES, INCLUDING THE MARY JO CROPPER FAMILY CENTER FOR BREAST CARE, ALL UNDER ONE ROOF AS WELL AS OTHER OUTPATIENT SERVICES AND A 300,000 SQUARE FOOT SEVEN-STORY PATIENT TOWER WHICH OPENED IN 2007 THAT ADDED 127 PRIVATE ROOMS AND A NEW CRITICAL CARE UNIT. IT CURRENTLY HAS APPROXIMATELY 360 ADULT AND 60 NEWBORN BEDS CURRENTLY IN USE. IN 2012, BETHESDA HOSPITAL PURCHASED THE BUTLER COUNTY MEDICAL CENTER, LOCATED NEAR HAMILTON, OHIO WHICH INCLUDED A 10-BED SURGICAL HOSPITAL WITH EIGHT OPERATING ROOMS, THREE ENDOSCOPY SUITES AND TWO PROCEDURE ROOMS AND QUICKLY OPENED A 15-BED EMERGENCY DEPARTMENT IN 2013. IN 2016, BETHESDA HOSPITAL COMPLETED A 53,512-SQUARE-FOOT EXPANSION TO THE FACILITY WHICH ADDED 32 NEW INPATIENT ROOMS, SIX NEW INTENSIVE CARE ROOMS AND FORTIFIED THE STRUCTURE FOR POSSIBLE FUTURE THIRD-FLOOR EXPANSION. THE CAMPUS HOUSES A CANCER INSTITUTE, INFUSION SERVICES, CARDIAC DIAGNOSTIC SERVICES, HEART INSTITUTE, DIGESTIVE INSTITUTE, SLEEP CENTER AND ORTHOPEDIC AND PHYSICAL THERAPY INSTITUTE. IN ADDITION TO THE HOSPITALS, BETHESDA HOSPITAL MAINTAINS MULTIPLE OUTPATIENT FACILITIES WHICH BRINGS EVEN MORE PHYSICIANS AND ADDITIONAL CLINICAL CARE TO THE COMMUNITY AND THE FACILITIES ARE DIGITALLY CONNECTED WITH THE HOSPITALS ALLOWING FOR IMMEDIATE CONSULT AND RECORD-SHARING. THE RESULT IS QUICKER, MORE ACCURATE PATIENT CARE. DURING THE YEAR, BETHESDA HOSPITAL'S INPATIENT VOLUME CONSISTED OF 27,854 ADMISSIONS CULMINATING IN 120,975 PATIENT DAYS WITH AN AVERAGE LENGTH OF STAY OF 5.10 DAYS. OBSTETRICS SERVICES TOTALED 4,296 BIRTHS WHILE BETHESDA HOSPITAL HAD A TOTAL OF 6,164 OBSERVATION DAYS OF SERVICE. THE EMERGENCY ROOM SAW 105,982 VISITS CONSISTING OF 87,779 OUTPATIENT AND 18,203 INPATIENT. FINALLY, NON-EMERGENCY OUTPATIENT VISITS TOTALED 521,644. NEARLY 62% OF BETHESDA HOSPITAL PATIENTS ARE COVERED BY EITHER MEDICARE OR MEDICAID WITH THE REMAINING BEING COMMERCIAL OR SELF-PAY. FOR ADDITIONAL INFORMATION, PLEASE SEE SCHEDULE H. FORM 990, PART VI, SECTION A, LINE 6 BETHESDA HOSPITAL, INC. HAS TWO CORPORATE MEMBERS - BETHESDA, INC. (VOTING MEMBER) AND TRIHEALTH, INC. (NON-VOTING MEMBER). FORM 990, PART VI, SECTION A, LINE 7A BETHESDA, INC. HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF BETHESDA HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B BETHESDA, INC. MUST APPROVE CERTAIN FINANCIAL TRANSACTIONS, AMENDMENTS TO BETHESDA HOSPITAL, INC.'S GOVERNING DOCUMENTS 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 AFTER REVIEW BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD, ALONG WITH THE COMMITTEE'S SUMMARY OF THE FORM 990. 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 BETHESDA HOSPITAL, INC.'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CONTRIBUTED CAPITAL TO PARENT -6,000,000. LOSS ON UNCONSOLIDATED ORGANIZATIONS -115,648,072. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS HELD AT FOUNDATION -778,044. NET SPECIAL FUNDS ACTIVITY -36,180. ADJUSTMENT TO TRUE UP INVESTMENT IN TRIHEALTH, INC. 173,179. FORM 990, PART I, LINE 6 DURING THE TAX YEAR, BETHESDA HOSPITAL, INC. WAS ASSISTED BY 650 VOLUNTEERS WHO DONATED APPROXIMATELY 73,450 HOURS. FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF TRUSTEES OF BETHESDA HOSPITAL, INC. ("THE CORPORATION"), ESTABLISHED AN EXECUTIVE COMMITTEE WHICH MAY EXERCISE SUCH POWER AND AUTHORITY OF THE BOARD OF TRUSTEES IN INTERVALS BETWEEN MEETINGS OF THE BOARD AS AUTHORIZED BY THE BOARD. THE EXECUTIVE COMMITTEE IS COMPOSED OF THE BOARD CHAIR, THE BOARD VICE CHAIR, THE PRESIDENT & CEO, THE SECRETARY AND TWO OTHER BOARD MEMBERS ALL IN ACCORDANCE WITH THE NETWORK AFFILIATION AGREEMENT. FORM 990, PART XII, LINE 2C THE FINANCIAL STATEMENTS OF BETHESDA HOSPITAL, INC. ("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 VI, SECTION B, LINE 16B DURING THE YEAR, BETHESDA HOSPITAL, INC. PARTICIPATED IN A JOINT VENTURE WITH ONE OR MORE TAXABLE PERSONS AND/OR ORGANIZATIONS. AS OF THE END OF THE FISCAL YEAR, BETHESDA HOSPITAL, INC. HAD NOT ADOPTED A WRITTEN POLICY OR PROCEDURE THAT REQUIRES THE ORGANIZATION TO NEGOTIATE, IN ITS TRANSACTIONS AND ARRANGEMENTS WITH OTHER MEMBERS OF THE VENTURE OR ARRANGEMENT, SUCH TERMS AND SAFEGUARDS AS ARE ADEQUATE TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. HOWEVER, ALL JOINT VENTURES, WHEN ENTERED INTO, HAVE OUTSIDE LEGAL COUNSEL REVIEW OF THE OPERATING AGREEMENT OR OTHER ORGANIZATIONAL DOCUMENTS TO ENSURE THAT THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED PRIOR TO THE COMMENCEMENT OF THE JOINT VENTURE. ONCE THE JOINT VENTURE COMMENCES, BETHESDA HOSPITAL, INC. PERSONNEL MONITORS ITS ACTIVITIES TO ENSURE THE ORGANIZATION'S EXEMPT STATUS IS PROTECTED. FORM 990, PART VII, SECTION A - AVERAGE HOURS PER WEEK THE OFFICERS AND DIRECTORS FOR 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) FOR 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. 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