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Nonprofiteer
← TRIHEALTH HOSPITAL INC

Form 990 for tax year 2022

Filed by TRIHEALTH HOSPITAL INC.

Totals

Total revenue
$3,218,185
Total expenses
$14,701,436
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$3,218,185
Investment income
$0
Other revenue
$0
Total assets, end of year
$129,782,569
Total liabilities, end of year
$297,889
Net assets or fund balances, end of year
$129,484,680
Program services expenses (Part IX)
$3,596,547
Management and general expenses
$11,104,889
Fundraising expenses
$0
Program service expenses (Part III)
$3,596,547

Program services were 24.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: PATIENT SERVICES

    total $3,218,185 · related or exempt $3,218,185

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $1,026,078 · program services $1,026,078

  • 8 · Pension plan contributions

    total $30,345 · program services $30,345

  • 9 · Other employee benefits

    total $151,544 · program services $151,544

  • 10 · Payroll taxes

    total $71,108 · program services $71,108

  • 11g · Fees: other

    total $87,885 · program services $87,885

  • 13 · Office expenses

    total $102,597 · program services $102,597

  • 14 · Information technology

    total $654 · program services $654

  • 16 · Occupancy

    total $450,476 · program services $450,476

  • 22 · Depreciation, depletion and amortization

    total $621,690 · program services $621,690

  • 24a · Other expenses: IMPAIRMENT OF GOODWILL

    total $11,063,885 · management and general $11,063,885

  • 24b · Other expenses: MEDICAL/DIETARY SUPPLY

    total $943,952 · program services $943,952

  • 24c · Other expenses: EQUIPMENT

    total $104,935 · program services $104,935

  • 24d · Other expenses: OVERHEAD ALLOCATION

    total $41,004 · management and general $41,004

  • 24e · All other expenses

    total $5,283 · program services $5,283

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $599 · end of year $599

  • 4 · Accounts receivable

    beginning of year $234,280 · end of year $376,544

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $20,821

  • 10a · Land, buildings and equipment: cost or other basis

    $17,097,798

  • 10b · Land, buildings and equipment: accumulated depreciation

    $14,737,801

  • 10c · Land, buildings and equipment, net

    beginning of year $2,981,686 · end of year $2,359,997

  • 14 · Intangible assets

    beginning of year $77,447,196 · end of year $66,383,311

  • 15 · Other assets

    beginning of year $62,407,218 · end of year $60,641,297

  • 17 · Accounts payable and accrued expenses

    beginning of year $445,124 · end of year $127,951

  • 25 · Other liabilities

    beginning of year $1,657,924 · end of year $169,938

  • 27 · Net assets without donor restrictions

    beginning of year $140,967,931 · end of year $129,484,680

Mission and programs · 2022

Mission

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.

Activities or mission (Part I)

TO IMPROVE THE HEALTH STATUS OF THE PEOPLE WE SERVE.

  • TRIHEALTH HOSPITAL, INC. OPERATES AN OUTPATIENT SURGERY CENTER WHICH PROVIDES THE COMMUNITY ACCESS TO A VARIETY OF PROCEDURES INCLUDING GENERAL SURGERY, ENDOSCOPY, ORTHOPEDICS, HAND SURGERY, EAR, NOSE AND THROAT, FACIAL PLASTICS, PODIATRY AND VEIN SURGERIES. THE 13,000-SQUARE-FOOT SURGERY CENTER HAS FOUR OPERATING ROOMS, TWO ENDOSCOPY ROOMS AND A LABORATORY.THE SURGERY CENTER IS CONNECTED TO TWO MEDICAL OFFICE BUILDINGS WITH ALL THREE BUILDINGS CREATING A 73,000-SQUARE-FOOT INTEGRATED PHYSICIAN OFFICE AND MEDICAL COMPLEX.

    Expenses $3,596,547 · Revenue $3,218,185

As filed on the 2022 return.

Listed in Part VII

  • Sr Sally Duffy

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Ralph Michael

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Robert Collins MD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Mark Clement

    PRESIDENT/CEO

    Total calculated
    $2,317,728
    From this org
    $0
    From related orgs
    $2,238,265
    Other
    $79,463
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,519,500 related
    Bonus
    $0 + $527,124 related
    Other
    $0 + $191,641 related
    Deferred
    $0 + $55,675 related
    Nontaxable benefits
    $0 + $23,788 related
    Filer's total
    $0 + $2,317,728 related
  • Phillip Castellini

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Kathy Kelly

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Theodore Torbeck

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Philip Foster

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Quint Studer

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Rance Duke

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Cynthia Booth

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Kristin Coppage MD

    MED STAFF PRESIDENT-GOOD SAM

    Total calculated
    $1,037,948
    From this org
    $0
    From related orgs
    $940,721
    Other
    $97,227
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $886,848 related
    Bonus
    $0 + $6,251 related
    Other
    $0 + $47,622 related
    Deferred
    $0 + $60,135 related
    Nontaxable benefits
    $0 + $37,092 related
    Filer's total
    $0 + $1,037,948 related
  • Lorraine Stephens MD

    MED STAFF PRESIDENT-BETHESDA

    Total calculated
    $318,015
    From this org
    $0
    From related orgs
    $244,008
    Other
    $74,007
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $186,842 related
    Bonus
    $0 + $6,037 related
    Other
    $0 + $51,129 related
    Deferred
    $0 + $36,849 related
    Nontaxable benefits
    $0 + $37,158 related
    Filer's total
    $0 + $318,015 related
  • Andrew Devoe

    ASST TREASURER/CFO

    Total calculated
    $1,379,857
    From this org
    $0
    From related orgs
    $1,284,173
    Other
    $95,684
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $738,138 related
    Bonus
    $0 + $488,508 related
    Other
    $0 + $57,527 related
    Deferred
    $0 + $58,175 related
    Nontaxable benefits
    $0 + $37,509 related
    Filer's total
    $0 + $1,379,857 related
  • Steve Gracey

    ASST SECRETARY/SVP LEGAL

    Total calculated
    $760,046
    From this org
    $0
    From related orgs
    $675,796
    Other
    $84,250
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $500,083 related
    Bonus
    $0 + $140,225 related
    Other
    $0 + $35,488 related
    Deferred
    $0 + $47,484 related
    Nontaxable benefits
    $0 + $36,766 related
    Filer's total
    $0 + $760,046 related
  • David Cook

    CHIEF HR OFFICER (END 9/22)

    Total calculated
    $729,695
    From this org
    $0
    From related orgs
    $592,888
    Other
    $136,807
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $369,091 related
    Bonus
    $0 + $124,174 related
    Other
    $0 + $99,623 related
    Deferred
    $0 + $117,733 related
    Nontaxable benefits
    $0 + $19,074 related
    Filer's total
    $0 + $729,695 related
  • Jenny Skinner

    CNE-TRIHEALTH

    Total calculated
    $623,010
    From this org
    $0
    From related orgs
    $555,853
    Other
    $67,157
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $411,320 related
    Bonus
    $0 + $106,058 related
    Other
    $0 + $38,475 related
    Deferred
    $0 + $43,403 related
    Nontaxable benefits
    $0 + $23,754 related
    Filer's total
    $0 + $623,010 related
  • Marla Silliman

    SVP-GOOD SAM REGION

    Total calculated
    $898,401
    From this org
    $0
    From related orgs
    $828,602
    Other
    $69,799
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $598,682 related
    Bonus
    $0 + $152,579 related
    Other
    $0 + $77,341 related
    Deferred
    $0 + $58,175 related
    Nontaxable benefits
    $0 + $11,624 related
    Filer's total
    $0 + $898,401 related
  • Steve Mombach

    SVP - AMBULATORY SERVICES

    Total calculated
    $739,728
    From this org
    $0
    From related orgs
    $659,020
    Other
    $80,708
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $489,316 related
    Bonus
    $0 + $137,068 related
    Other
    $0 + $32,636 related
    Deferred
    $0 + $56,790 related
    Nontaxable benefits
    $0 + $23,918 related
    Filer's total
    $0 + $739,728 related
  • Helen Koselka MD

    CHIEF MEDICAL OFFICER

    Total calculated
    $871,023
    From this org
    $0
    From related orgs
    $770,817
    Other
    $100,206
    Hours/week
    1 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $575,564 related
    Bonus
    $0 + $148,657 related
    Other
    $0 + $46,596 related
    Deferred
    $0 + $62,752 related
    Nontaxable benefits
    $0 + $37,454 related
    Filer's total
    $0 + $871,023 related
  • Will Groneman

    FORMER KEY EMPLOYEE

    Total calculated
    $486,400
    From this org
    $0
    From related orgs
    $408,837
    Other
    $77,563
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $251,279 related
    Bonus
    $0
    Other
    $0 + $157,558 related
    Deferred
    $0 + $54,235 related
    Nontaxable benefits
    $0 + $23,328 related
    Filer's total
    $0 + $486,400 related
  • Gail Donovan

    FORMER KEY EMPLOYEE

    Total calculated
    $582,038
    From this org
    $0
    From related orgs
    $582,038
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $582,038 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $582,038 related
  • Kevin Joseph MD

    FORMER KEY EMPLOYEE

    Total calculated
    $706,754
    From this org
    $0
    From related orgs
    $660,175
    Other
    $46,579
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $28,084 related
    Bonus
    $0
    Other
    $0 + $632,091 related
    Deferred
    $0 + $37,234 related
    Nontaxable benefits
    $0 + $9,345 related
    Filer's total
    $0 + $706,754 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
TRIHEALTH, INC., A RELATED ORGANIZATION OF TRIHEALTH 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, 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. 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.: GAIL DONOVAN - $582,038 WILL GRONEMAN - $55,510
PART I, LINE 4A:
THE REPORTABLE INDIVIDUALS OF TRIHEALTH HOSPITAL, INC., WITH THE EXCEPTION OF A FEW, 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 POLICY, MAY BE ADDED TO THE SEVERANCE PACKAGE AND THE AMOUNT OF NOTICE PAY WILL BE DETERMINED BY HUMAN RESOURCES IN ACCORDANCE WITH TRIHEALTH POLICY. PAYMENTS OF SEVERANCE ARE CONDITIONED UPON SIGNING A SEPARATION AND RELEASE AGREEMENT. DURING THE 2022 CALENDAR YEAR, THE FOLLOWING REPORTABLE INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM TRIHEALTH, INC.: KEVIN JOSEPH, MD - $572,594 WILL GRONEMAN - $89,632

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • HEALTHCARE SOLUTIONS NETWORK LLC

    PHYSICIAN HOSPITAL ORGANIZATION · OH

  • PREFERRED LAB PARTNERS LLC

    LABORATORY SERVICES · KY

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • TRIHEALTH PHYSICIANS OF INDIANA INC

    C · PHYSICIAN PRACTICES · OH · controlled entity

  • TRIHEALTH PHYSICIAN SOLUTIONS INC

    C · CLAIMS ADMINISTRATION · OH · controlled entity

  • TRIHEALTH CIPHO INC

    C · PHYSICIAN HEALTH ORGANIZATION · OH · controlled entity

  • PREMIERE MEDICAL OWNERS ASSOCIATION

    C · CONDO ASSOCIATION · OH · controlled entity

  • SERVE INSURANCE LTD

    C · ALTERNATIVE RISK FINANCING · CJ · controlled entity

Provenance

Return type
form_990
Tax year
2022
Filed
13 May 2024
IRS schema version
2022v5.0
Source object
202421349349303767

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