{"success":true,"data":{"_id":341842025,"filings":[{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"A community partner dedicated to the excellence in serving the health needs of the Tri-State area.","primary_activities":"Trinity Health System comprises the most complete health care option in Eastern Ohio. The hospital includes Trinity East and Trinity West which has combined capacity of over 500 beds. Trinity East offers a variety of services including Skilled Care, Long-Term Care, Inpatient Physical Rehabilitation and behavioral Medicine Services (Mental Health & Addiction Recovery). Trinity West is a full service acute care facility offering 24 hour emergency care, kidney dialysis, lithotripsy, endoscopy and related services, surgery and medical surgical inpatient units and all other diagnostic departments. The goal of Trinity Skilled Care Center is to provide services which in turn allow the patients to regain independence in daily living and return them to their highest level of well being. The Trinity Skilled Care Center, a hospital-based skilled and long term care nursing facility, is fully certified for 50 beds and was developed to meet the needs of patients who require additional skilled care beyond the acute phase of illness or injury. In 2010, Trinity Skilled Care Center had 435 admissions and 15,980 patient days. The Skilled Care Center also has an ongoing activity program. Patients are encouraged to participate in these enjoyable activities as a group or individually. The atmosphere is informal and relaxing to aid in the emotional well being of each patient. Discharge planning begins on admission to Trinity Skilled Care Center. Individualized goals are established with the patient, the patient's family and a highly qualified team of professionals. This team includes: the attending physician, nurse, social services, dietician, physical therapist, occupational therapist and speech therapist. This process assures the continuity of care upon discharge. Trinity's Rehabilitation Center provides an integrated and interdisciplinary team approach to help patients who have physical impairments. Programs are available for patients with strokes and other neurological disorders, arthritis, amputations, joint replacements and other orthopedic problems, brain injury, and spinal cord injury. The Center has 20 private rooms, each specially designed for rehabilitation. Patients also utilize a home-like apartment to regain skills such as cooking, bathing and dressing. Physical Therapy, Occupational Therapy and Speech-Language Pathology areas have state-of-the-art equipment, and the therapists are highly trained rehabilitation specialists. A van is available for community outings and home visits. These trips provide opportunities for patients to practice their skills in their community, home and work place when appropriate. With a team approach to treatment, a personalized rehabilitation program is designed to meet the unique needs and goals of each patient. The team consists of the patient, his/her family, physicians, rehabilitation nurses, physical therapists, occupational therapists, speech language pathologists, psychologists, social workers, therapeutic recreational specialists, dieticians, respiratory therapists, case coordinators and vocational counselors. Through a positive, personalized and interdisciplinary approach, the team helps patients regain physical, emotional, social and verbal skills In 2010, the Rehab Center had 271 admissiions and 3,471 patient days. The Renal Unit provides hemodialysis treatments to both acute and chronic population of patients with kidney disease. This procedure oriented department is staff with registered nurses and technicians who complete training in providing hemodialysis treatments. The department works very closely with the Biomedical Department in providing a safe enviroment for the patients. In 2010, the Renal Unit had over 500 chronic outpatients and over 400 chronic inpatients. The Women's Health & Birth Center is proud to offer total maternity care. Our specially qualified staff of dedicated nurses and physicians guides you and your family through a comprehensive education program and the childbirth experience. At the Women's Health & Birth Center you deliver your baby in a specially designed childbearing room for your entire hospital stay: admission procedures, labor, delivery, recovery. Your post-partum stay is in a speciually designed room that makes the family experience one you will always remember. Our private childbearing rooms are equipped for the entire birth experience. All forms of pain relief except general anesthesia may be provided in this room. The childbearing room also Cesarean deliveries are performed in the Women's Health & Birth Center in a modern, state of the art surgical suite, with labor and postpartum care provided in a Women's Health & Birth Center Suite. The surgical suite may also be used by those wishing a more traditional birth experience. Fathers are encouraged to stay at the hospital; sleeping accommodations are provided at no extra charge. At the Women's Health & Birth Center, rooming-in is flexible and designed to meet your individual needs. You and your family are partners with us in the care of your baby. If YOU want to rest or have time alone, we can care for your baby in our well-equipped nursery near your room. In the Women's Health & Birth Center, a specially trained perinatal nurse is assigned to each mother and baby to provide personal, individualized care. Extra time and teaching are integral parts of the attention we give all families. After discharge, we know that questions often arise and it is good to have someone with whom you can talk. But even more, we are interested in you and we want to provide as much care and assistance as we can during this special time in your life. Once home, a perinatal nurse from the Women's Health & Birth Center is available for consultation through telephone calls to all patients. Simply call at anytime of the day or night if you need assistance or information. In 2010, the Women's Health & Birth Center delivered 557 babies.\n\nTrinity Health System's Cancer Treatment capabilities grew substantially with the construction of the Tony Teramana Cancer Center. Opened in January, 2000, the Center houses one of the most powerful tools in cancer treatment; the Varian Clinic 21EX Linear Accelerator. This unit, termed the \"Gold Standard\" in Cancer treatment, was only one of four in the world when it was installed. The Center also utilizes a newly purchased Simulator which is directly linked to Trinity's CT Scanner. This feature allows Radiation Oncologists to perform treatment planning equal to major metropolitan health centers. The Tony Teramana Cancer Center also provides Chemotherapy and surgical consultation services for regional residents. The Chemotherapy Services at The Tony Teramana Cancer Center is provided with compassion, privacy and optimum results. In 2010, the Center saw 9,812 patients and performed 23,189 procedures. In line with Trinity Health System's values; Service, Reverence and Stewardship, The Tony Teramana Cancer Center can meet the needs of cancer patients through a holistic approach which includes compassion, concern, dignity and respect. This service is due largely to the generosity of the Tony Teramana Family, whose $1 million gift made this center a world-class cancer treatment facility. Trinity Health System's Cardiac Rehabilitation Program is designed to effect lifestyle change in patients enrolled. These changes are achieved through safe, physical conditioning, sound educational sessions, and group support, which emphasize the understanding of risk factors associated with heart disease. The program's goal is to enhance the quality of life for the patient. Age is not a factor. By participating lifestyle possible. Our specialy trained staff works with patients, their families, and physicians to develop a personalized program of health and wellness. The goals of the Cardiac Rehab program are increased understanding of heart disease, increased endurance, decreased heart rate and blood pressure, increased muscular fitness, reduced cholesterol/triglyceride levels, decreased body fat, better nutrition management and improved sense of well-being. An integral part of the overall program, education increases a patient's understanding of their illness and helps them to identify current habits that can negatively affect their cardiac condition. We cover issues like risk factor reduction, angina, heart attack, medication, dietary and exercise guidelines, smoking, and breathing and relaxation methods. Individuals enrolled in this phase are referred by their physician. After an assessment of condition is made, a patient is scheduled for exercise training with monitoring. Risk factors, diet, and lifestyle changes are also discussed. Convenient sessions are scheduled three times per week and last approximately one hour. Once the outpatient program is concluded, patients may continue this phase in order to insure their quality of life. Their ongoing participation in the program can offer them increased endurance, decreased heart rate and blood pressure, and increased muscular fitness. In 2010, the Cardiac Rehab program helped 437 outpatients and 1,396 maintenance patients. Trinity WorkCare is the Occupational Health Department of Trinity Health System and provides a comprehensive Occupational Health Service to the business community. Our program is designed to assist the client company decrease lost work time, medical expenses, insurance premiums and maintain compliance with company and government regulations. WorkCare services include medical surveillance, substance abuse testing, injury treatment and case management, physical therapy, wellness promotion and employee assistance program. In 2010, there were 8,264 visits to WorkCare. Outpatient occupational therapy at Trinity is provided both as an extension of services received as an inpatient or you can receive services as a new patient. We are staffed to provide expertise with all neurological and orthopedic disorders and specialize in the area of hand disorders. We provide exercise, modalities (paraffin, ultrasound, iontophoresis, fluidotherapy and E-stim), functional activities, splinting/bracing and ADL training. Physical therapy assesses your movement, strength and endurance and will help to restore quality of muscle tone, coordination, balance, strength, endurance, joint flexibility and functional mobility. Our department is fully equipped to allow for private treatment. Additionally a modern gym is utilized for your exercise needs. We provide specialized programs in exercise, functional activities and modalities. Our Speech Pathology Department is equipped to render a broad spectrum of diagnostic and rehabilitative services to children, adolescents and adults with disorders associated with decreased cognitive skills, aphasia, apraxia, dysarthria, voice and delayed speech and language. We also specialize in diagnostic and therapeutic interventions for patients with swallowing disorders. To support seniors through trying times, we proudly offer the Trinity Senior Program, a therapeutic program designed to meet the emotional and psychological needs of older adults. We see patients 55 years or older that are experiencing emotional difficulties such as depression, anxiety, grief, anger and other emotional issues. The sort term outpatient program includes support groups, occupational and recreational groups and health/medication education. Trinity Home Health is special home care for special people. The disciplines offered are skilled nursing care, physical therapy, occupational therapy, medical social services (Ohio) and home health aides. In 2010, the home health department did over 28,000 home visits.\n\nThe Emergency Services of Trinity Health System are available at Trinity Medical Center West. The ER has been remodeled and expanded to accommodate patients requiring treatment - it has doubled in size and now has twice as many treatment beds available and more physician, professional and support staff have been added to provide care. A dedicated x-ray room has been constructed adjacent to the ER and special treatment areas have been constructed for cardiac emergencies, trauma, pediatric emergencies, obstetrical emergencies, suturing and fractures. The ER is open 24 hours/7 days a week for all levels of emergency and urgent care. In 2010, we had 49,500 Emergency Room visits.","year":2010,"name":"TRINITY HOSPITAL HOLDING COMPANY","phone":"7402837000","website":"www.trinityhealth.com","type":"990","principal_officer":"Fred Brower","year_formation":1996,"state_legal_domicile":"OH","total_volunteers":75,"tax_period_begin":"2010-01-01T00:00:00","tax_period_end":"2010-12-31T00:00:00","address":"380 Summit Avenue, Steubenville, OH, 439522667, USA","city":"Steubenville","state":"OH","country":"USA","zip_code":"439522667"},"Governance":{"501c3 determination":true,"Number of voting members":22,"Number of independent voting members":19,"Number of employees total":1897,"Total Gross UBI":0,"Net unrelated business taxable income":0,"Number of employees":1897,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Family or business relationship":false,"Delegation of management duties":false,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":true,"Election of board members":true,"Decisions subject to approval":true,"Minutes of governing body":true,"Local chapters":true,"Form 990 provided to governing body":false,"Document retention policy":true,"Investment in joint venture":false,"Independent audit financial statements":true,"Consolidated audit financial statements":true,"Accountant compile or review":false,"Financial statements audited by independent accountant":true,"Audit committee":true,"Federal grant audit required":true,"Federal grant audit performed":true,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":true,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":187383075,"Contributions":{"value":743691,"Other contributions":63945,"Fundraising revenue":0,"Dues":0,"Campaigns":0,"Grant revenue":219537,"Related organizations":460209},"Program revenue":{"value":182144432,"Total revenue":{"value":181128364,"VARIOUS":181128364},"Total other revenue":1016068,"Unrelated business revenue":0},"Investment income":{"value":472221,"Investment income total":1581652,"Net investment gain":-1111314,"Income from invest bond proceeds":1883},"Other revenues":{"value":4022731,"Other total":3896797,"Royalties revenue":0,"Net rental income":0,"Net income from fundraising events":16786,"Net income from gaming":0,"Net income":109148}},"Expenses":{"value":181442980,"Grant expense":{"value":169675,"Grants to domestic orgs":69216,"Grants to domestic individuals":100459,"Foreign grants":0},"Total professional fundraising expense":{"value":0,"Fundraising professional":0},"Benefits paid to members":{"value":0,"Benefits paid to members Total":0},"Salaries":{"value":90428371,"Current officers":250560,"Disqualified persons":0,"Other salaries and wages":67553501,"Pension plan contributions":5255240,"Other employee benefits":12676802,"Payroll taxes":4692268},"Other expenses":{"value":90844934,"Management services":6388040,"Legal":158414,"Accounting":233378,"Lobbying services":0,"Investment management fees":184102,"Other services":363374,"Advertising":705559,"Office expenses":1680209,"Information technology":885354,"Royalties":0,"Occupancy":5115696,"Travel":222123,"Conferences and meetings":27365,"Interest":2026622,"Payments to affiliates":590103,"Depreciation and depletion":8271063,"Insurance":1514532,"Travel entertainment public officials":0,"Itemized Expenses":{"value":53927811,"VARIOUS":53927811},"All other expenses":8551189}},"Assets":{"value":171179695,"Non-interest bearing cash":31783,"Savings and temp cash investments":6655363,"Pledges and grants receivable":0,"Accounts receivable":19814655,"Receivables from officers":0,"Receivables from disqual persons":0,"Other net note and loans":851216,"Inventories for sale or use":2978134,"Prepaid expenses deferred charges":1753575,"Land, building, equipment":54444657,"Investments publicly traded":67085269,"Investments other":0,"Investments program related":0,"Intangible assets":1700000,"Other assets":15865043},"Liabilities":{"value":73952508,"Accounts payable, accrued":16596314,"Grants payable":0,"Deferred, revenue":0,"Tax exempt bond liabilities":42529501,"Escrow account liability":0,"Loans from officers, directors":0,"Secured mortgages and notes payable":0,"Unsecured notes loans payable":0,"Other liabilities":14826693},"Fund balance":{"value":97227187},"Form990Details":{"program_service_accomplishments":[{"description":"Trinity Health System comprises the most complete health care option in Eastern Ohio. The hospital includes Trinity East and Trinity West which has combined capacity of over 500 beds. Trinity East offers a variety of services including Skilled Care, Long-Term Care, Inpatient Physical Rehabilitation and behavioral Medicine Services (Mental Health & Addiction Recovery). Trinity West is a full service acute care facility offering 24 hour emergency care, kidney dialysis, lithotripsy, endoscopy and related services, surgery and medical surgical inpatient units and all other diagnostic departments. The goal of Trinity Skilled Care Center is to provide services which in turn allow the patients to regain independence in daily living and return them to their highest level of well being. The Trinity Skilled Care Center, a hospital-based skilled and long term care nursing facility, is fully certified for 50 beds and was developed to meet the needs of patients who require additional skilled care beyond the acute phase of illness or injury. In 2010, Trinity Skilled Care Center had 435 admissions and 15,980 patient days. The Skilled Care Center also has an ongoing activity program. Patients are encouraged to participate in these enjoyable activities as a group or individually. The atmosphere is informal and relaxing to aid in the emotional well being of each patient. Discharge planning begins on admission to Trinity Skilled Care Center. Individualized goals are established with the patient, the patient's family and a highly qualified team of professionals. This team includes: the attending physician, nurse, social services, dietician, physical therapist, occupational therapist and speech therapist. This process assures the continuity of care upon discharge. Trinity's Rehabilitation Center provides an integrated and interdisciplinary team approach to help patients who have physical impairments. Programs are available for patients with strokes and other neurological disorders, arthritis, amputations, joint replacements and other orthopedic problems, brain injury, and spinal cord injury. The Center has 20 private rooms, each specially designed for rehabilitation. Patients also utilize a home-like apartment to regain skills such as cooking, bathing and dressing. Physical Therapy, Occupational Therapy and Speech-Language Pathology areas have state-of-the-art equipment, and the therapists are highly trained rehabilitation specialists. A van is available for community outings and home visits. These trips provide opportunities for patients to practice their skills in their community, home and work place when appropriate. With a team approach to treatment, a personalized rehabilitation program is designed to meet the unique needs and goals of each patient. The team consists of the patient, his/her family, physicians, rehabilitation nurses, physical therapists, occupational therapists, speech language pathologists, psychologists, social workers, therapeutic recreational specialists, dieticians, respiratory therapists, case coordinators and vocational counselors. Through a positive, personalized and interdisciplinary approach, the team helps patients regain physical, emotional, social and verbal skills In 2010, the Rehab Center had 271 admissiions and 3,471 patient days. The Renal Unit provides hemodialysis treatments to both acute and chronic population of patients with kidney disease. This procedure oriented department is staff with registered nurses and technicians who complete training in providing hemodialysis treatments. The department works very closely with the Biomedical Department in providing a safe enviroment for the patients. In 2010, the Renal Unit had over 500 chronic outpatients and over 400 chronic inpatients. The Women's Health & Birth Center is proud to offer total maternity care. Our specially qualified staff of dedicated nurses and physicians guides you and your family through a comprehensive education program and the childbirth experience. At the Women's Health & Birth Center you deliver your baby in a specially designed childbearing room for your entire hospital stay: admission procedures, labor, delivery, recovery. Your post-partum stay is in a speciually designed room that makes the family experience one you will always remember. Our private childbearing rooms are equipped for the entire birth experience. All forms of pain relief except general anesthesia may be provided in this room. The childbearing room also Cesarean deliveries are performed in the Women's Health & Birth Center in a modern, state of the art surgical suite, with labor and postpartum care provided in a Women's Health & Birth Center Suite. The surgical suite may also be used by those wishing a more traditional birth experience. Fathers are encouraged to stay at the hospital; sleeping accommodations are provided at no extra charge. At the Women's Health & Birth Center, rooming-in is flexible and designed to meet your individual needs. You and your family are partners with us in the care of your baby. If YOU want to rest or have time alone, we can care for your baby in our well-equipped nursery near your room. In the Women's Health & Birth Center, a specially trained perinatal nurse is assigned to each mother and baby to provide personal, individualized care. Extra time and teaching are integral parts of the attention we give all families. After discharge, we know that questions often arise and it is good to have someone with whom you can talk. But even more, we are interested in you and we want to provide as much care and assistance as we can during this special time in your life. Once home, a perinatal nurse from the Women's Health & Birth Center is available for consultation through telephone calls to all patients. Simply call at anytime of the day or night if you need assistance or information. In 2010, the Women's Health & Birth Center delivered 557 babies.","expense":73051276,"grants":0,"revenue":188526504},{"description":"Trinity Health System's Cancer Treatment capabilities grew substantially with the construction of the Tony Teramana Cancer Center. Opened in January, 2000, the Center houses one of the most powerful tools in cancer treatment; the Varian Clinic 21EX Linear Accelerator. This unit, termed the \"Gold Standard\" in Cancer treatment, was only one of four in the world when it was installed. The Center also utilizes a newly purchased Simulator which is directly linked to Trinity's CT Scanner. This feature allows Radiation Oncologists to perform treatment planning equal to major metropolitan health centers. The Tony Teramana Cancer Center also provides Chemotherapy and surgical consultation services for regional residents. The Chemotherapy Services at The Tony Teramana Cancer Center is provided with compassion, privacy and optimum results. In 2010, the Center saw 9,812 patients and performed 23,189 procedures. In line with Trinity Health System's values; Service, Reverence and Stewardship, The Tony Teramana Cancer Center can meet the needs of cancer patients through a holistic approach which includes compassion, concern, dignity and respect. This service is due largely to the generosity of the Tony Teramana Family, whose $1 million gift made this center a world-class cancer treatment facility. Trinity Health System's Cardiac Rehabilitation Program is designed to effect lifestyle change in patients enrolled. These changes are achieved through safe, physical conditioning, sound educational sessions, and group support, which emphasize the understanding of risk factors associated with heart disease. The program's goal is to enhance the quality of life for the patient. Age is not a factor. By participating lifestyle possible. Our specialy trained staff works with patients, their families, and physicians to develop a personalized program of health and wellness. The goals of the Cardiac Rehab program are increased understanding of heart disease, increased endurance, decreased heart rate and blood pressure, increased muscular fitness, reduced cholesterol/triglyceride levels, decreased body fat, better nutrition management and improved sense of well-being. An integral part of the overall program, education increases a patient's understanding of their illness and helps them to identify current habits that can negatively affect their cardiac condition. We cover issues like risk factor reduction, angina, heart attack, medication, dietary and exercise guidelines, smoking, and breathing and relaxation methods. Individuals enrolled in this phase are referred by their physician. After an assessment of condition is made, a patient is scheduled for exercise training with monitoring. Risk factors, diet, and lifestyle changes are also discussed. Convenient sessions are scheduled three times per week and last approximately one hour. Once the outpatient program is concluded, patients may continue this phase in order to insure their quality of life. Their ongoing participation in the program can offer them increased endurance, decreased heart rate and blood pressure, and increased muscular fitness. In 2010, the Cardiac Rehab program helped 437 outpatients and 1,396 maintenance patients. Trinity WorkCare is the Occupational Health Department of Trinity Health System and provides a comprehensive Occupational Health Service to the business community. Our program is designed to assist the client company decrease lost work time, medical expenses, insurance premiums and maintain compliance with company and government regulations. WorkCare services include medical surveillance, substance abuse testing, injury treatment and case management, physical therapy, wellness promotion and employee assistance program. In 2010, there were 8,264 visits to WorkCare. Outpatient occupational therapy at Trinity is provided both as an extension of services received as an inpatient or you can receive services as a new patient. We are staffed to provide expertise with all neurological and orthopedic disorders and specialize in the area of hand disorders. We provide exercise, modalities (paraffin, ultrasound, iontophoresis, fluidotherapy and E-stim), functional activities, splinting/bracing and ADL training. Physical therapy assesses your movement, strength and endurance and will help to restore quality of muscle tone, coordination, balance, strength, endurance, joint flexibility and functional mobility. Our department is fully equipped to allow for private treatment. Additionally a modern gym is utilized for your exercise needs. We provide specialized programs in exercise, functional activities and modalities. Our Speech Pathology Department is equipped to render a broad spectrum of diagnostic and rehabilitative services to children, adolescents and adults with disorders associated with decreased cognitive skills, aphasia, apraxia, dysarthria, voice and delayed speech and language. We also specialize in diagnostic and therapeutic interventions for patients with swallowing disorders. To support seniors through trying times, we proudly offer the Trinity Senior Program, a therapeutic program designed to meet the emotional and psychological needs of older adults. We see patients 55 years or older that are experiencing emotional difficulties such as depression, anxiety, grief, anger and other emotional issues. The sort term outpatient program includes support groups, occupational and recreational groups and health/medication education. Trinity Home Health is special home care for special people. The disciplines offered are skilled nursing care, physical therapy, occupational therapy, medical social services (Ohio) and home health aides. In 2010, the home health department did over 28,000 home visits.","expense":81012735,"grants":0,"revenue":209072986},{"description":"The Emergency Services of Trinity Health System are available at Trinity Medical Center West. The ER has been remodeled and expanded to accommodate patients requiring treatment - it has doubled in size and now has twice as many treatment beds available and more physician, professional and support staff have been added to provide care. A dedicated x-ray room has been constructed adjacent to the ER and special treatment areas have been constructed for cardiac emergencies, trauma, pediatric emergencies, obstetrical emergencies, suturing and fractures. The ER is open 24 hours/7 days a week for all levels of emergency and urgent care. In 2010, we had 49,500 Emergency Room visits.","expense":4793928,"grants":0,"revenue":12371893}],"program_service_revenue_detail":[{"business_code":"621990","description":"Medicare payments","total_revenue":85198165,"related_or_exempt_function_income":85198165,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Blue Cross payments","total_revenue":26862212,"related_or_exempt_function_income":26862212,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Medicaid payments","total_revenue":13721521,"related_or_exempt_function_income":13721521,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Commercial Insurance payments","total_revenue":48106241,"related_or_exempt_function_income":48106241,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Self Pay / Other payments","total_revenue":7240225,"related_or_exempt_function_income":7240225,"unrelated_business_revenue":0,"exclusion_amount":0}],"functional_expense_allocations":{"current_officers_directors":{"program_services":0,"management_and_general":250560,"fundraising":0,"total":250560},"disqualified_persons":{"program_services":0,"management_and_general":0,"fundraising":0,"total":0},"other_salaries_and_wages":{"program_services":59218789,"management_and_general":8334712,"fundraising":0,"total":67553501},"pension_plan_contributions":{"program_services":4606851,"management_and_general":648389,"fundraising":0,"total":5255240},"other_employee_benefits":{"program_services":11112745,"management_and_general":1564057,"fundraising":0,"total":12676802},"payroll_taxes":{"program_services":4113339,"management_and_general":578929,"fundraising":0,"total":4692268},"management_fees":{"program_services":5599887,"management_and_general":788153,"fundraising":0,"total":6388040},"legal_fees":{"program_services":138869,"management_and_general":19545,"fundraising":0,"total":158414},"accounting_fees":{"program_services":204584,"management_and_general":28794,"fundraising":0,"total":233378},"lobbying_fees":{"program_services":0,"management_and_general":0,"fundraising":0,"total":0},"professional_fundraising_fees":{"fundraising":0,"total":0},"investment_management_fees":{"program_services":161388,"management_and_general":22714,"fundraising":0,"total":184102},"other_service_fees":{"program_services":318541,"management_and_general":44833,"fundraising":0,"total":363374},"advertising":{"program_services":618508,"management_and_general":87051,"fundraising":0,"total":705559},"office_expenses":{"program_services":1472906,"management_and_general":207303,"fundraising":0,"total":1680209},"information_technology":{"program_services":776120,"management_and_general":109234,"fundraising":0,"total":885354},"royalties":{"program_services":0,"management_and_general":0,"fundraising":0,"total":0},"occupancy":{"program_services":4484524,"management_and_general":631172,"fundraising":0,"total":5115696},"travel":{"program_services":194718,"management_and_general":27405,"fundraising":0,"total":222123},"conferences_meetings":{"program_services":23989,"management_and_general":3376,"fundraising":0,"total":27365},"interest":{"program_services":1776579,"management_and_general":250043,"fundraising":0,"total":2026622},"payments_to_affiliates":{"program_services":517296,"management_and_general":72807,"fundraising":0,"total":590103},"depreciation_depletion":{"program_services":7250584,"management_and_general":1020479,"fundraising":0,"total":8271063},"insurance":{"program_services":1327670,"management_and_general":186862,"fundraising":0,"total":1514532},"all_other_expenses":{"program_services":7496148,"management_and_general":1055041,"fundraising":0,"total":8551189}},"fundraising_and_gaming_summary":{"gross_income_fundraising_events":124991,"fundraising_direct_expenses":108205,"gross_income_gaming":0},"tax_and_disclosure_flags":{"activities_conducted_through_partnership":false,"foreign_financial_account":false,"backup_withholding_compliance":false,"employment_tax_returns_filed":true,"lobbying_activities":false,"deductible_non_cash_contributions":false,"deductible_contributions_of_art":false,"method_of_accounting_accrual":true,"schedule_o_part_vi":true,"schedule_o_part_xi":true},"principal_officer_detail":{"person_name":"Fred Brower","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952"},"audit_financial_statement_detail":{"financial_statement_attached":false,"accountant_compile_or_review":false,"audited_financial_statement_consolidated":true,"federal_grant_audit_required":true,"federal_grant_audit_performed":true},"related_party_due_diligence":{"officer_entity_with_business_relationship":true,"officer_mailing_address":false,"related_entity":true,"related_org_controlled_entity":false,"compensation_from_other_sources":false,"excess_benefit_transaction":false,"annual_disclosure_covered_persons":true},"grant_due_diligence":{"grants_to_organizations":true,"grants_to_individuals":true,"more_than_5000_to_organizations":false,"more_than_5000_to_individuals":false,"grants_payable_beginning_of_year":0,"grants_payable_end_of_year":0},"books_are_in_care_of":{"phone":"7402837000","business_name_line1":"Trinity Medical Center East","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"439522667"},"contractor_compensation":[{"business_name_line1":"ARUP Laboratories","compensation":812095,"services_description":"Lab Services","address_line1":"500 Chipeta Way","city":"Salt Lake City","state":"UT","zip":"84108","name":"ARUP Laboratories","address":"500 Chipeta Way, Salt Lake City, UT, 84108"},{"business_name_line1":"Washington Healthcare Strategies","compensation":632888,"services_description":"Anesthesia","address_line1":"702 Parkview Drive","city":"Gibsonia","state":"PA","zip":"15044","name":"Washington Healthcare Strategies","address":"702 Parkview Drive, Gibsonia, PA, 15044"},{"business_name_line1":"Biotronics Inc","compensation":410646,"services_description":"Cardiopulmonary and Infusion surgical services","address_line1":"1370 Beulah Riad","address_line2":"2nd Floor","city":"Pittsburgh","state":"PA","zip":"15235","name":"Biotronics Inc","address":"1370 Beulah Riad, 2nd Floor, Pittsburgh, PA, 15235"},{"business_name_line1":"Allegheny General Hospital","compensation":339181,"services_description":"Imaging Servcies","address_line1":"320 East North Avenue","city":"Pittsburgh","state":"PA","zip":"15212","name":"Allegheny General Hospital","address":"320 East North Avenue, Pittsburgh, PA, 15212"},{"business_name_line1":"Karlsberger Architecture","compensation":326635,"services_description":"Architects","address_line1":"PO Box 951402","city":"Cleveland","state":"OH","zip":"44193","name":"Karlsberger Architecture","address":"PO Box 951402, Cleveland, OH, 44193"}],"officers_directors_key_employees":[{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":9000,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member and Secretary","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member and Treasurer","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Board Member and Vice Chairman","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Board Member & Vice Chair","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"President and CEO","average_hours_per_week":40.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":360991,"other_compensation":85419,"individual_trustee_or_director":true,"officer":true},{"title":"CFO","average_hours_per_week":40.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":240312,"other_compensation":29036,"key_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":486560,"reportable_comp_from_related_orgs":0,"other_compensation":14622,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":1204519,"reportable_comp_from_related_orgs":0,"other_compensation":12968,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":743323,"reportable_comp_from_related_orgs":0,"other_compensation":12968,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":305103,"reportable_comp_from_related_orgs":0,"other_compensation":14622,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":297929,"reportable_comp_from_related_orgs":0,"other_compensation":10509,"highest_compensated_employee":true}]},"ScheduleA":{"public_charity_status":{"hospital_170b1_aiii":true}},"ScheduleB":{"attached":true,"required":true},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":743000,"contributions":0,"investment_earnings_or_losses":68173,"grants_or_scholarships":0,"other_expenditures":60682,"administrative_expenses":7491,"end_year_balance":743000},"current_year_minus1":{"beginning_year_balance":586000,"contributions":0,"investment_earnings_or_losses":203695,"grants_or_scholarships":0,"other_expenditures":39282,"administrative_expenses":7413,"end_year_balance":743000},"current_year_minus2":{"beginning_year_balance":838000,"contributions":0,"investment_earnings_or_losses":-209389,"grants_or_scholarships":0,"other_expenditures":33771,"administrative_expenses":8840,"end_year_balance":586000},"board_designated_eoy_percentage":0.0,"permanent_endowment_eoy_percentage":1.0,"term_endowment_eoy_percentage":0.0,"held_by_unrelated_organizations":false,"held_by_related_organizations":false},"land_buildings_equipment":{"land":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":703748,"book_value":703748},"buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":35683962,"book_value":7060544,"depreciation":28623418},"leasehold_improvements":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":0,"book_value":0,"depreciation":0},"equipment":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":144859706,"book_value":42652276,"depreciation":102207430},"other_land_buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":21089173,"book_value":4028089,"depreciation":17061084},"total_book_value":54444657},"other_assets":{"assets":[{"description":"Interest in net assets of the Foundation","book_value":14258155},{"description":"Due from Third Party Payors","book_value":929563},{"description":"Due ffrom affiliates","book_value":299491},{"description":"Other receivables","book_value":20517},{"description":"Accrued Interest","book_value":357317}],"total_book_value":15865043},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"Amounts due to affiliates","amount":1061301},{"description":"Retirement Benefit Payable","amount":13765392}],"total_liability":14826693},"net_assets_reconciliation":{"total_revenue":187383075,"total_expenses":181442980,"excess_or_deficit_for_year":5940095,"net_unrealized_gains_losses_on_investments":5601474,"donated_services_and_facilities":0,"investment_expenses":0,"prior_period_adjustments":0,"other_amount":4302676,"total_adjustments":9904150,"excess_or_deficit_per_financial_statements":15844245},"revenue_reconciliation":{"total_revenue_audited_financial_statements":194901141,"net_unrealized_gains_investments":5601474,"donated_services_and_use_facilities":0,"recoveries_prior_year_grants":0,"other_revenue":2499525,"revenue_not_reported":8100999,"revenue_subtotal":186800142,"investment_expenses_not_included":0,"other_revenues_not_included":582933,"revenue_not_reported_financial_statement":582933,"total_revenue_per_990":187383075},"expense_reconciliation":{"total_expenses_audited_financial_statements":181442980,"donated_services_use_facilities":0,"prior_year_adjustments":0,"losses_reported":0,"other_expenses_included":0,"expenses_not_reported":0,"expenses_subtotal":181442980,"investment_expenses_not_included":0,"other_expenses_not_included":0,"expenses_not_reported_financial_statement":0,"total_expenses_per_990":181442980},"supplemental_information":[{"identifier":"SchD_P05_S00_L04","form_and_line_reference":"Schedule D, Part V, Line 4","explanation":"Trinity Hospital Holding Company's endowment funds are maintained to provide a permanent source of income. The principal must be invested and kept intact. Only the income is used by the organization."},{"identifier":"SchD_P11_S00_L08","form_and_line_reference":"Schedule D, Part XI, Line 8","explanation":"Net gain on extinguishment of debt and related interest swap $1,902,959. Change in pension obligation (2,662,673). Change in value of interest rate swap 4,032,000. Change in unrestricted interest in Foundation 596,566. Change in temporarily interest in Foundation 556,172. Change in permanently interest in Foundation 3,584. Auxiliary activity (125,929)."},{"identifier":"SchD_P12_S00_L02d","form_and_line_reference":"Schedule D, Part XII, Line 2d","explanation":"Change in interest in Foundation, Net gain on extinguishment of debt and related interest rate swap."},{"identifier":"SchD_P12_S00_L04b","form_and_line_reference":"Schedule D, Part XII, Line 4b","explanation":"Auxiliary activities, donation from Foundation"}]},"ScheduleG":{"fundraising_events":{"event1":{"name":"Uniform Sale","gross_receipts":41951,"charitable_contributions":0,"gross_revenue":41951,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":36534},"event2":{"name":"Book Sale","gross_receipts":64392,"charitable_contributions":0,"gross_revenue":64392,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":55094},"other_events":{"gross_receipts":18648,"charitable_contributions":0,"gross_revenue":18648,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":16577,"event_count":5},"total":{"gross_receipts":124991,"charitable_contributions":0,"gross_revenue":124991,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":108205},"direct_expense_summary":108205,"net_income_summary":16786}},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_200":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":true,"bad_debt_expense":4584859,"bad_debt_expense_attributable_to_financial_assistance":153000,"reimbursed_by_medicare":57445305,"cost_of_care_reimbursed_by_medicare":59663612,"medicare_surplus_or_shortfall":-2218307,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"persons_served":0,"total_community_benefit_expense":4159682,"direct_offsetting_revenue":0,"net_community_benefit_expense":4159682,"total_expense_percentage":0.0229},"unreimbursed_medicaid":{"persons_served":36784,"total_community_benefit_expense":23102406,"direct_offsetting_revenue":16455440,"net_community_benefit_expense":6646966,"total_expense_percentage":0.0366},"unreimbursed_costs":{"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"total_financial_assistance":{"activities_or_programs":0,"persons_served":36784,"total_community_benefit_expense":27262088,"direct_offsetting_revenue":16455440,"net_community_benefit_expense":10806648,"total_expense_percentage":0.0595},"community_health_services":{"activities_or_programs":11,"persons_served":13322,"total_community_benefit_expense":479576,"direct_offsetting_revenue":57190,"net_community_benefit_expense":422386,"total_expense_percentage":0.0023},"health_professions_education":{"activities_or_programs":12,"persons_served":259,"total_community_benefit_expense":825027,"direct_offsetting_revenue":1950,"net_community_benefit_expense":823077,"total_expense_percentage":0.0045},"subsidized_health_services":{"activities_or_programs":4,"persons_served":21409,"total_community_benefit_expense":11267185,"direct_offsetting_revenue":8924266,"net_community_benefit_expense":2342919,"total_expense_percentage":0.0129},"research":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"cash_and_inkind_contributions":{"activities_or_programs":5,"persons_served":300,"total_community_benefit_expense":33998,"direct_offsetting_revenue":0,"net_community_benefit_expense":33998,"total_expense_percentage":0.0002},"total_other_benefits":{"activities_or_programs":32,"persons_served":35290,"total_community_benefit_expense":12605786,"direct_offsetting_revenue":8983406,"net_community_benefit_expense":3622380,"total_expense_percentage":0.0199},"total_community_benefits":{"activities_or_programs":32,"persons_served":72074,"total_community_benefit_expense":39867874,"direct_offsetting_revenue":25438846,"net_community_benefit_expense":14429028,"total_expense_percentage":0.0794}},"community_building":{"physical_improvements_and_housing":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"economic_development":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"community_support":{"activities_or_programs":1,"persons_served":29,"total_community_benefit_expense":46,"direct_offsetting_revenue":0,"net_community_benefit_expense":46,"total_expense_percentage":0.0},"environmental_improvements":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"leadership_development":{"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"coalition_building":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"health_improvement_advocacy":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"workforce_development":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"other_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"total_community_building_activities":{"activities_or_programs":1,"persons_served":29,"total_community_benefit_expense":46,"direct_offsetting_revenue":0,"net_community_benefit_expense":46,"total_expense_percentage":0.0}},"hospital_facility_count":2,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Trinity Medical Center West","address_line1":"4000 Johnson Road","city":"Steubenville","state":"OH","zip":"43952","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"Trinity Medical Center West","address":"4000 Johnson Road, Steubenville, OH, 43952"},{"facility_number":2,"business_name_line1":"Trinity Medical Center East","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","licensed_hospital":true,"general_medical_and_surgical":true,"name":"Trinity Medical Center East","address":"380 Summit Avenue, Steubenville, OH, 43952"}],"facility_policies":[{"business_name_line1":"Trinity Medical Center West","facility_number":1,"name":"Trinity Medical Center West"},{"business_name_line1":"Trinity Medical Center East","facility_number":2,"name":"Trinity Medical Center East"}],"supplemental_information":[{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"Line 7 was calculated on a cost to charge ratio."},{"form_and_line_reference":"Schedule H, Part I, Line 7, Column f","explanation":"n/a"},{"form_and_line_reference":"Schedule H, Part I, Line 7g","explanation":"In Schedule H, Part I, Line 7g, Trinity reported the OB Clinic. The costs reported associated with the clinic are fringe benefits, purchased services, supplies and indirect expenses."},{"form_and_line_reference":"Schedule H, Part II","explanation":"Trinity Health System is organized to promote the health of the community. Our mission is to be a community partner dedicated to excellence in serving the health needs of the Tri-State area. We pursue that mission through two respected hospitals, as well as in outpatient facilities, physicians' offices, community outreach sites and homes throughout the Tri-State area. We put our exceptional resources to work out in the community as well, through our primary care and specialty physician practices and our hospice, home care and outreach services."},{"form_and_line_reference":"Schedule H, Part III, Section A, Line 4","explanation":"The bad debt at cost number is derived using the applicable cost to charge ratio for the hospital. Total costs for the Hospital divided by the gross charges and the factor is applied to the gross bad debt number less recoveries of bad debt. Trinity does not have a specific footnote for bad debt expense. Trinity maintains an allowance for doubtful accounts to reserve for estimated losses based on length of time the account has been outstanding and historical collection experience. Trinity performs an evaluation of the collectability of net revenues recorded and records and allowance of doubtful accounts based on probability of collection."},{"form_and_line_reference":"Schedule H, Part III, Section B, Line 8","explanation":"The Medicare shortfall in the amount of $2,218,307 should be treated as a community benefit. Jefferson County, where Trinity Health System is located, has the highest proportion of elderly in the state of Ohio. As a result, the use of health care service and also Medicare is higher than the state average. Trinity accepts all patients regardless of their ability to pay and our 2010 charity care approximated $10,343,271. In providing this charity care to those patients where no payment is anticipated, this is seen as a community benefit."},{"form_and_line_reference":"Schedule H, Part III, Section C, Line 9b","explanation":"The Health System is committed to serve everyone, accepts all patients regardless of their ability to pay. A patient is classified as a charity patient by reference to certain established policies of the Health System. Essentially, these policies define charity services as those services for which no payment is anticipated. In assessing a patient's ability to pay, the Health System utilizes the generally recognized poverty income levels established by the federal government, but also includes certain cases where incurred charges are significant when compared to patient income and resources. The Health System's policy provides charity care to patients up to 200% of the federal poverty level. The hospital provides care to persons covered by governmental programs at below cost. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, the hospital recognized these amounts as charity care in meeting its mission to the entire community. In 2010, charity care approximated $10,343,271. To educate and inform our patients about their eligibility for assisstance under federal, state or local government programs or under our charity care policy, self-pay inpatients are interviewed by the organization's Financial Counselors. At this time, the charity is discussed and explained to the patient and they may request a charity application to complete. If a patient happens to be discharged without being interviewed, the first patient billing statement also states the Charity guidelines and they are given the opportunity to contact us for an application. For outpatient accounts, any balance billing after insurance also explains the charity guidelines to patients."},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"Trinity Health System, which consists of two hospitals - Trinity East and Trinity West, is a 500 bed health system located in Steubenville, Ohio. Trinity Health System is an extension of the missions and proud heritages of its co-sponsors, Tri State Health Services (reflecting the perspectives of the local community) and Franciscan Services Corporation (representing the perspectives of the health care ministry of the Sisters of St. Francis of Sylvania, Ohio). As a non-profit, charitable health care delivery system, Trinity Health System is dedicated to preserving the secular Community traditions and the Catholic traditions of it co-sponsors in the delivery of health care in the Greater Steubenville, Ohio region. The Sisters of St. Francis of Sylvania, Ohio sponsor their health and human services ministry through Franciscan Services Corporation. The organization, located in Ohio, Texas and Kentucky include six hospitals, eight long-term care facilities, four assisted living facilities, independent senior housing, a counseling center and a long-term domestic shelter. Trinity Health System is organized to promote the health of the community. Our mission is to be a community partner dedicated to excellence in serving the health needs of the Tri-State area. We pursue that mission through two respected hospitals, as well as in outpatient facilities, physicians' offices, community outreach sites and homes throughout the Tri-State area. We put our exceptional resources to work out in the community as well, through our primary care and specialty physician practices and our hospice, home care and outreach services. Our mission is the purpose of the organization. We are organized to identify and respond to community needs. We execute our mission under the authority of our board. Members include community representatives who reside in the organization's primary service area and are neither employees nor contractors of the organization, nor family members thereof. The board's mission also includes processes for determining and responding to health needs. Serving more than 188,000 patients in 2010, Trinity is a leading healthcare system in the valley. Our 1,700 employees and physicians utilize state-of-the-art facilities, advanced technologies and the latest procedures to accomplish our mission and to improve the health of the communities we serve. In conjunction with Tri-State Health Services, one of our sponsors, we provide a Mobile Medical Van that goes to various places in our community to educate the population about different topics and provide healthcare for the poor and other disadvantaged population. At each site the van visits, the following tests are available: free breathing test, free blood pressure, free blood test for AAT Deficiency (determines those at risk of developing those at risk of developing COPD). The Health System's primary service area encompasses a three county area in Ohio and West Virginia. The counties are Jefferson County, Ohio and Brooke and Hancock Counties, WV. Residents from these 3 counties provide for over 11,000 admissions to the System and account for 85% of the Hospital's admissions. Jefferson County is located on the Ohio and West Virginia borders along the Ohio River, approximately 40 miles west of Pittsburgh, PA. Jefferson County has experienced a declining population over the past 20 years and has the highest proportion of elderly in that state of Ohio. As a result, the use of health care services is higher than the state average."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"The Health System is committed to serve everyone regardless of their ability to pay. A patient is classified as a charity patient by reference to certain established policies of the Health System. Essentially, these policies define charity services as those services for which no payment is anticipated. In assessing a patient's ability to pay, the Health System utilizes the generally recognized poverty income levels established by the federal government, but also includes certain cases where incurred charges are significant when compared to patient income and resources. The Health System's policy provides charity care to patients up to 200% of the federal poverty level. The hospital provides care to persons covered by governmental programs at below cost. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, the hospital recognized these amounts as charity care in meeting its mission to the entire community. In 2010, charity care approximated $10,343,271. (Part I, line 7) To educate and inform our patients about their eligibility for assistance under federal, state, or local government programs or under our charity care policy, self-pay inpatients are interviewed by the organization's Financial Counselors. At this time, the charity is discussed and explained to the patient and they may request a charity application to complete. If a patient happens to be discharged without being interviewed, the first patient billing statement also states the Charity guidelines and they are given the opportunity to contact us for charity applications. For outpatient accounts, any balance billing after insurance also explains the charity guidelines to patients."},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"The Health System considers Jefferson County, Ohio and Brooke and Hancock, West Virginia, to be its primary service area, with the majority of business coming from Jefferson County residents (Jefferson County accounts for 66% of inpatient business). The population of Jefferson County has declined over the past 20 years and is projected to continue to decline in all age cohorts, recording a 3.5% decline for the period of 2000-2006 (the most recent publicly reported census data). The unemployment rate of the service area is well above both state and national averages, with the most recent data reported for the first quarter of 2009 for Jefferson County to be 10.5%. Brooke and Hancock counties report similar unemployment rates for the first quarter at 9.9% and 10.4%, respectively. A key challenge for the Health System is operating within an area that is experiencing significant population declines and a deteriorating economic climate. The Health System experiences significant out-migration, both directed by the Hospital as well as by patient/physician preference. Until 2006, out migration had been on a rise for primary service area residents who utilize Pennsylvania and Ohio hospitals. However, beginning in 2007, out migration from Trinity's primary service area to other hospitals in Ohio, Pennsylvania and west Virginia has declined. In 2007,(most recent public data available), we have seen reductions in out migration from our primary service area to Pennsylvania, Ohio and West Virginia hospitals of (10.1%), (4.8%) and (2.5%) respectively. We have also realized an increase in market share in Jefferson County from 2006 level of 65.68% to 2007 level of 66.27%. We have seen similar increases in Brooke and Hancock counties as well with the market share increasing from 2006 level of 20.99% to 2007 level of 21.46%. Overall, the data documents that we met our planning goal of improving the market share by 1 percentage point a year. Overall, the service area of the System has a lower average household income than the State of Ohio and a higher unemployment rate. Jefferson County is economically depressed with a per-capita income lower than State averages. All 3 counties in the System's immediate service area have a high proportion of the population at or below the poverty level. The economic conditions of the area have hindered the growth of the Hospital and more self-pay patients have taken advantage of the Hospital's services. Charity Care and Bad Debt accounts have increased each year for the last few years with levels in 2010 appearing to be 10% higher than the level in 2009. As recently unemployed residents lose their health benefits, we expect higher charity care levels. We are working on strategies to address this increase and have recently engaged an organization to focus solely on converting our uninsured population to Medical Assistance, as appropriate. The Payer mix at THS is heavily weighted to the governmental payers, with 56% of the 2010 YTD revenue generated from Medicare and 14% generated from the Medicaid program - and increase of 2% over the same period in 2009. With the 2 programs recording significant shortfalls between payment to hospitals and hospital costs, the economic challenges for THS are great. A competitor analysis identifies independent physician groups as the most significant threat to the System's market position. Area physician groups have established competing ancillary services, which have historically been profitable services for the Hospital. A long term acute care hospital owned by approximately 50 of our area physicians opened in the fall of 2009. It offers key ancillary services and other profitable treatment programs. Limiting the loss in revenue, maintaining competitive outpatient services and terminating services, in which we can no longer compete, has been a focus for 2010."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":69216,"reported_domestic_individual_grants":100459,"reported_domestic_org_grants_program_services":69216,"reported_domestic_individual_grants_program_services":100459,"no_grant_over_5000":true,"individual_grants":[{"type":"Employee medical education assistance","recipient_count":7,"cash":57363,"noncash":0,"noncash_description":"n/a","valuation_method":"FMV"},{"type":"Physician medical education assistance","recipient_count":1,"cash":43096,"noncash":0,"noncash_description":"n/a","valuation_method":"FMV"}],"total_domestic_grants":169675,"total_domestic_program_services":169675,"detail_individual_grants_total":100459,"detail_domestic_grants_total":100459,"supplemental_information":[{"identifier":"SchI_P01_S00_L02","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"Our policies for monitoring the use of grant funds in the United States is following the policies and procedures of the granting organization in regards to the distribution and reporting of grants."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"Our policies for monitoring the use of grant funds in the United States is following the policies and procedures of the granting organization in regards to the distribution and reporting of grants.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0,"reported_foreign_grants_program_services":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"Fred B Brower","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":7339,"compensation_based_on_related_orgs":311126,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":49171,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":36247,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":42526,"total_compensation_filing_org":85418,"total_compensation_related_orgs":360991,"name":"Fred B Brower"},{"person_name":"Elizabeth Allen","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":6117,"compensation_based_on_related_orgs":233376,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":16928,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":12108,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":819,"total_compensation_filing_org":29036,"total_compensation_related_orgs":240312,"name":"Elizabeth Allen"},{"person_name":"Kumar B Amin MD","base_compensation_filing_org":597411,"bonus_filing_org":607107,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":12968,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":1217486,"total_compensation_related_orgs":0,"name":"Kumar B Amin MD"},{"person_name":"Jeffrey F Shall MD","base_compensation_filing_org":610466,"bonus_filing_org":132857,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":12968,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":756291,"total_compensation_related_orgs":0,"name":"Jeffrey F Shall MD"},{"person_name":"Amjad Alkaed MD","base_compensation_filing_org":316279,"bonus_filing_org":170281,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":14622,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":501182,"total_compensation_related_orgs":0,"name":"Amjad Alkaed MD"},{"person_name":"Basel Termanini MD","base_compensation_filing_org":297929,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":10509,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":308438,"total_compensation_related_orgs":0,"name":"Basel Termanini MD"},{"person_name":"Mark Kissinger","base_compensation_filing_org":250516,"bonus_filing_org":54587,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":14622,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":319725,"total_compensation_related_orgs":0,"name":"Mark Kissinger"}],"supplemental_information":[{"identifier":"SchJ_P01_S00_L03","form_and_line_reference":"Schedule J, Part I, Line 3","explanation":"The organization bases the CEO's compensation on review from the compensation committee, a compensation survey and then approval from the Board."},{"identifier":"SchJ_P01_S00_L04","form_and_line_reference":"Schedule J, Part I, Line 4","explanation":"The President ($13,469) and Vice President ($4,680) of Human Resources participated in a supplemental retirement plan."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":346002729,"business_name_line1":"City of Steubenville Ohio","cusip_number":"860068BZ7","date_issued":"2010-08-12T00:00:00","issue_price":42796876,"purpose":"refinance 2007 bond issue","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"City of Steubenville Ohio"}],"bond_proceeds":[{"total_proceeds":42976876,"gross_proceeds_in_reserve_funds":0,"capitalized_interest":0,"issuance_costs_from_proceeds":609276,"credit_enhancement":0,"working_capital_expenditures":32387,"capital_expenditures":0,"other_spent_proceeds":34961794,"refunding_escrow":0,"amount_bond_defeased":0,"amount_retired":0,"amount_unspent":20445,"substantial_completion_year":2010,"current_refunding":true,"advance_refunding":false,"final_allocation_made":true,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":true,"management_contract":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}],"supplemental_information":[{"identifier":"SchK_P02_S00_L03","form_and_line_reference":"Schedule K, Part II, Line 3","explanation":"Proceeds of 2010 Issue = $43,930,000. Original issue discount = $1,133,124. 2010 proceeds = $42,976,876."}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"person_name":"Michael Barber","relationship":"Board Member of Trinity","description":"he owns National Colloid, a company which we purchase chemicals from","amount":129260,"sharing_of_revenues":false,"name":"Michael Barber"}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":341818681,"business_name_line1":"Trinity Health System","primary_activities":"support and management services","exempt_code_section":"501(c)3","public_charity_status":"11b","legal_domicile_state":"OH","direct_controlling_business_name_line1":"Tri-State Health Services & FSC","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","name":"Trinity Health System","address":"380 Summit Avenue, Steubenville, OH, 43952"},{"ein":341329423,"business_name_line1":"Trinity Health System Foundation","primary_activities":"charitable fundraising supporting Trinity Health System","exempt_code_section":"501(c)3","public_charity_status":"11a","legal_domicile_state":"OH","direct_controlling_business_name_line1":"Trinity Health System","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","name":"Trinity Health System Foundation","address":"380 Summit Avenue, Steubenville, OH, 43952"}],"taxable_corporations_and_trusts":[{"ein":341471026,"business_name_line1":"Trinity Management Services Organization","primary_activity":"mgmt serv,provide dr staff","ownership_percentage":0.0,"legal_domicile_state":"OH","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","type_of_entity":"C","name":"Trinity Management Services Organization","address":"380 Summit Avenue, Steubenville, OH, 43952"}],"transaction_flags":{"gift_grant_or_capital_contribution_from_other_org":true,"gift_grant_or_capital_contribution_to_other_org":false,"loans_or_guarantees_from_other_org":false,"loans_or_guarantees_to_other_org":false,"performance_of_services_by_other_orgs":false,"performance_of_services_for_other_orgs":false,"sharing_of_facilities":false,"sharing_of_paid_employees":false,"reimbursement_paid_by_other_org":false,"reimbursement_paid_to_other_org":true,"rental_of_facilities_from_other_orgs":false,"rental_of_facilities_to_other_orgs":false,"purchase_of_assets_from_other_org":false,"sale_of_assets_to_other_org":false,"exchange_of_assets":false,"receipt_of_interest_annuities_rents_royalties":false,"other_transfer_from_other_org":false,"other_transfer_to_other_org":false},"transactions":[{"business_name_line1":"Trinity Health System","amount_involved":4427618,"method_of_amount_determination":"FMV","transaction_type":"o","name":"Trinity Health System"},{"business_name_line1":"Trinity Management Services Organization","amount_involved":1763842,"method_of_amount_determination":"FMV","transaction_type":"o","name":"Trinity Management Services Organization"},{"business_name_line1":"Trinity Health System Foundation","amount_involved":457000,"method_of_amount_determination":"FMV","transaction_type":"c","name":"Trinity Health System Foundation"}]},"source_xml":"201113139349300416_public.xml"}],"Latest":{"Organization":{"Hours":[0],"Total Compensation":[0],"Direct compensation":[0],"Other compensation":[0]},"Basic":{"mission":"A community partner dedicated to the excellence in serving the health needs of the Tri-State area.","primary_activities":"Trinity Health System comprises the most complete health care option in Eastern Ohio. The hospital includes Trinity East and Trinity West which has combined capacity of over 500 beds. Trinity East offers a variety of services including Skilled Care, Long-Term Care, Inpatient Physical Rehabilitation and behavioral Medicine Services (Mental Health & Addiction Recovery). Trinity West is a full service acute care facility offering 24 hour emergency care, kidney dialysis, lithotripsy, endoscopy and related services, surgery and medical surgical inpatient units and all other diagnostic departments. The goal of Trinity Skilled Care Center is to provide services which in turn allow the patients to regain independence in daily living and return them to their highest level of well being. The Trinity Skilled Care Center, a hospital-based skilled and long term care nursing facility, is fully certified for 50 beds and was developed to meet the needs of patients who require additional skilled care beyond the acute phase of illness or injury. In 2010, Trinity Skilled Care Center had 435 admissions and 15,980 patient days. The Skilled Care Center also has an ongoing activity program. Patients are encouraged to participate in these enjoyable activities as a group or individually. The atmosphere is informal and relaxing to aid in the emotional well being of each patient. Discharge planning begins on admission to Trinity Skilled Care Center. Individualized goals are established with the patient, the patient's family and a highly qualified team of professionals. This team includes: the attending physician, nurse, social services, dietician, physical therapist, occupational therapist and speech therapist. This process assures the continuity of care upon discharge. Trinity's Rehabilitation Center provides an integrated and interdisciplinary team approach to help patients who have physical impairments. Programs are available for patients with strokes and other neurological disorders, arthritis, amputations, joint replacements and other orthopedic problems, brain injury, and spinal cord injury. The Center has 20 private rooms, each specially designed for rehabilitation. Patients also utilize a home-like apartment to regain skills such as cooking, bathing and dressing. Physical Therapy, Occupational Therapy and Speech-Language Pathology areas have state-of-the-art equipment, and the therapists are highly trained rehabilitation specialists. A van is available for community outings and home visits. These trips provide opportunities for patients to practice their skills in their community, home and work place when appropriate. With a team approach to treatment, a personalized rehabilitation program is designed to meet the unique needs and goals of each patient. The team consists of the patient, his/her family, physicians, rehabilitation nurses, physical therapists, occupational therapists, speech language pathologists, psychologists, social workers, therapeutic recreational specialists, dieticians, respiratory therapists, case coordinators and vocational counselors. Through a positive, personalized and interdisciplinary approach, the team helps patients regain physical, emotional, social and verbal skills In 2010, the Rehab Center had 271 admissiions and 3,471 patient days. The Renal Unit provides hemodialysis treatments to both acute and chronic population of patients with kidney disease. This procedure oriented department is staff with registered nurses and technicians who complete training in providing hemodialysis treatments. The department works very closely with the Biomedical Department in providing a safe enviroment for the patients. In 2010, the Renal Unit had over 500 chronic outpatients and over 400 chronic inpatients. The Women's Health & Birth Center is proud to offer total maternity care. Our specially qualified staff of dedicated nurses and physicians guides you and your family through a comprehensive education program and the childbirth experience. At the Women's Health & Birth Center you deliver your baby in a specially designed childbearing room for your entire hospital stay: admission procedures, labor, delivery, recovery. Your post-partum stay is in a speciually designed room that makes the family experience one you will always remember. Our private childbearing rooms are equipped for the entire birth experience. All forms of pain relief except general anesthesia may be provided in this room. The childbearing room also Cesarean deliveries are performed in the Women's Health & Birth Center in a modern, state of the art surgical suite, with labor and postpartum care provided in a Women's Health & Birth Center Suite. The surgical suite may also be used by those wishing a more traditional birth experience. Fathers are encouraged to stay at the hospital; sleeping accommodations are provided at no extra charge. At the Women's Health & Birth Center, rooming-in is flexible and designed to meet your individual needs. You and your family are partners with us in the care of your baby. If YOU want to rest or have time alone, we can care for your baby in our well-equipped nursery near your room. In the Women's Health & Birth Center, a specially trained perinatal nurse is assigned to each mother and baby to provide personal, individualized care. Extra time and teaching are integral parts of the attention we give all families. After discharge, we know that questions often arise and it is good to have someone with whom you can talk. But even more, we are interested in you and we want to provide as much care and assistance as we can during this special time in your life. Once home, a perinatal nurse from the Women's Health & Birth Center is available for consultation through telephone calls to all patients. Simply call at anytime of the day or night if you need assistance or information. In 2010, the Women's Health & Birth Center delivered 557 babies.\n\nTrinity Health System's Cancer Treatment capabilities grew substantially with the construction of the Tony Teramana Cancer Center. Opened in January, 2000, the Center houses one of the most powerful tools in cancer treatment; the Varian Clinic 21EX Linear Accelerator. This unit, termed the \"Gold Standard\" in Cancer treatment, was only one of four in the world when it was installed. The Center also utilizes a newly purchased Simulator which is directly linked to Trinity's CT Scanner. This feature allows Radiation Oncologists to perform treatment planning equal to major metropolitan health centers. The Tony Teramana Cancer Center also provides Chemotherapy and surgical consultation services for regional residents. The Chemotherapy Services at The Tony Teramana Cancer Center is provided with compassion, privacy and optimum results. In 2010, the Center saw 9,812 patients and performed 23,189 procedures. In line with Trinity Health System's values; Service, Reverence and Stewardship, The Tony Teramana Cancer Center can meet the needs of cancer patients through a holistic approach which includes compassion, concern, dignity and respect. This service is due largely to the generosity of the Tony Teramana Family, whose $1 million gift made this center a world-class cancer treatment facility. Trinity Health System's Cardiac Rehabilitation Program is designed to effect lifestyle change in patients enrolled. These changes are achieved through safe, physical conditioning, sound educational sessions, and group support, which emphasize the understanding of risk factors associated with heart disease. The program's goal is to enhance the quality of life for the patient. Age is not a factor. By participating lifestyle possible. Our specialy trained staff works with patients, their families, and physicians to develop a personalized program of health and wellness. The goals of the Cardiac Rehab program are increased understanding of heart disease, increased endurance, decreased heart rate and blood pressure, increased muscular fitness, reduced cholesterol/triglyceride levels, decreased body fat, better nutrition management and improved sense of well-being. An integral part of the overall program, education increases a patient's understanding of their illness and helps them to identify current habits that can negatively affect their cardiac condition. We cover issues like risk factor reduction, angina, heart attack, medication, dietary and exercise guidelines, smoking, and breathing and relaxation methods. Individuals enrolled in this phase are referred by their physician. After an assessment of condition is made, a patient is scheduled for exercise training with monitoring. Risk factors, diet, and lifestyle changes are also discussed. Convenient sessions are scheduled three times per week and last approximately one hour. Once the outpatient program is concluded, patients may continue this phase in order to insure their quality of life. Their ongoing participation in the program can offer them increased endurance, decreased heart rate and blood pressure, and increased muscular fitness. In 2010, the Cardiac Rehab program helped 437 outpatients and 1,396 maintenance patients. Trinity WorkCare is the Occupational Health Department of Trinity Health System and provides a comprehensive Occupational Health Service to the business community. Our program is designed to assist the client company decrease lost work time, medical expenses, insurance premiums and maintain compliance with company and government regulations. WorkCare services include medical surveillance, substance abuse testing, injury treatment and case management, physical therapy, wellness promotion and employee assistance program. In 2010, there were 8,264 visits to WorkCare. Outpatient occupational therapy at Trinity is provided both as an extension of services received as an inpatient or you can receive services as a new patient. We are staffed to provide expertise with all neurological and orthopedic disorders and specialize in the area of hand disorders. We provide exercise, modalities (paraffin, ultrasound, iontophoresis, fluidotherapy and E-stim), functional activities, splinting/bracing and ADL training. Physical therapy assesses your movement, strength and endurance and will help to restore quality of muscle tone, coordination, balance, strength, endurance, joint flexibility and functional mobility. Our department is fully equipped to allow for private treatment. Additionally a modern gym is utilized for your exercise needs. We provide specialized programs in exercise, functional activities and modalities. Our Speech Pathology Department is equipped to render a broad spectrum of diagnostic and rehabilitative services to children, adolescents and adults with disorders associated with decreased cognitive skills, aphasia, apraxia, dysarthria, voice and delayed speech and language. We also specialize in diagnostic and therapeutic interventions for patients with swallowing disorders. To support seniors through trying times, we proudly offer the Trinity Senior Program, a therapeutic program designed to meet the emotional and psychological needs of older adults. We see patients 55 years or older that are experiencing emotional difficulties such as depression, anxiety, grief, anger and other emotional issues. The sort term outpatient program includes support groups, occupational and recreational groups and health/medication education. Trinity Home Health is special home care for special people. The disciplines offered are skilled nursing care, physical therapy, occupational therapy, medical social services (Ohio) and home health aides. In 2010, the home health department did over 28,000 home visits.\n\nThe Emergency Services of Trinity Health System are available at Trinity Medical Center West. The ER has been remodeled and expanded to accommodate patients requiring treatment - it has doubled in size and now has twice as many treatment beds available and more physician, professional and support staff have been added to provide care. A dedicated x-ray room has been constructed adjacent to the ER and special treatment areas have been constructed for cardiac emergencies, trauma, pediatric emergencies, obstetrical emergencies, suturing and fractures. The ER is open 24 hours/7 days a week for all levels of emergency and urgent care. In 2010, we had 49,500 Emergency Room visits.","year":2010,"name":"TRINITY HOSPITAL HOLDING COMPANY","phone":"7402837000","website":"www.trinityhealth.com","type":"990","principal_officer":"Fred Brower","year_formation":1996,"state_legal_domicile":"OH","total_volunteers":75,"tax_period_begin":"2010-01-01T00:00:00","tax_period_end":"2010-12-31T00:00:00","address":"380 Summit Avenue, Steubenville, OH, 439522667, USA","city":"Steubenville","state":"OH","country":"USA","zip_code":"439522667"},"Governance":{"501c3 determination":true,"Number of voting members":22,"Number of independent voting members":19,"Number of employees total":1897,"Total Gross UBI":0,"Net unrelated business taxable income":0,"Number of employees":1897,"Prohibited tax shelter transactions":false,"Taxable party notification":false,"Family or business relationship":false,"Delegation of management duties":false,"Conflict of interest policy":true,"Whistle blower policy":true,"Compensation process for CEO":true,"Compensation process for other employees":true,"Changes to organizing documents":false,"Material diversion or misuse":false,"Members or stockholders":true,"Election of board members":true,"Decisions subject to approval":true,"Minutes of governing body":true,"Local chapters":true,"Form 990 provided to governing body":false,"Document retention policy":true,"Investment in joint venture":false,"Independent audit financial statements":true,"Consolidated audit financial statements":true,"Accountant compile or review":false,"Financial statements audited by independent accountant":true,"Audit committee":true,"Federal grant audit required":true,"Federal grant audit performed":true,"Political activities":false,"Donor advised funds":false,"Conservation easements":false,"Collections of art":false,"School":false,"Hospital":true,"Foreign activities":false,"Foreign office":false,"Gaming":false,"Fundraising activities":true,"Professional fundraising":false,"Loan to officer or DQP":false,"Grant to related person":false,"Business relationship through family member":false,"Business relationship with organization":false,"Transfers to exempt non-charitable organization":false},"Revenues":{"value":187383075,"Contributions":{"value":743691,"Other contributions":63945,"Fundraising revenue":0,"Dues":0,"Campaigns":0,"Grant revenue":219537,"Related organizations":460209},"Program revenue":{"value":182144432,"Total revenue":{"value":181128364,"VARIOUS":181128364},"Total other revenue":1016068,"Unrelated business revenue":0},"Investment income":{"value":472221,"Investment income total":1581652,"Net investment gain":-1111314,"Income from invest bond proceeds":1883},"Other revenues":{"value":4022731,"Other total":3896797,"Royalties revenue":0,"Net rental income":0,"Net income from fundraising events":16786,"Net income from gaming":0,"Net income":109148}},"Expenses":{"value":181442980,"Grant expense":{"value":169675,"Grants to domestic orgs":69216,"Grants to domestic individuals":100459,"Foreign grants":0},"Total professional fundraising expense":{"value":0,"Fundraising professional":0},"Benefits paid to members":{"value":0,"Benefits paid to members Total":0},"Salaries":{"value":90428371,"Current officers":250560,"Disqualified persons":0,"Other salaries and wages":67553501,"Pension plan contributions":5255240,"Other employee benefits":12676802,"Payroll taxes":4692268},"Other expenses":{"value":90844934,"Management services":6388040,"Legal":158414,"Accounting":233378,"Lobbying services":0,"Investment management fees":184102,"Other services":363374,"Advertising":705559,"Office expenses":1680209,"Information technology":885354,"Royalties":0,"Occupancy":5115696,"Travel":222123,"Conferences and meetings":27365,"Interest":2026622,"Payments to affiliates":590103,"Depreciation and depletion":8271063,"Insurance":1514532,"Travel entertainment public officials":0,"Itemized Expenses":{"value":53927811,"VARIOUS":53927811},"All other expenses":8551189}},"Assets":{"value":171179695,"Non-interest bearing cash":31783,"Savings and temp cash investments":6655363,"Pledges and grants receivable":0,"Accounts receivable":19814655,"Receivables from officers":0,"Receivables from disqual persons":0,"Other net note and loans":851216,"Inventories for sale or use":2978134,"Prepaid expenses deferred charges":1753575,"Land, building, equipment":54444657,"Investments publicly traded":67085269,"Investments other":0,"Investments program related":0,"Intangible assets":1700000,"Other assets":15865043},"Liabilities":{"value":73952508,"Accounts payable, accrued":16596314,"Grants payable":0,"Deferred, revenue":0,"Tax exempt bond liabilities":42529501,"Escrow account liability":0,"Loans from officers, directors":0,"Secured mortgages and notes payable":0,"Unsecured notes loans payable":0,"Other liabilities":14826693},"Fund balance":{"value":97227187},"Form990Details":{"program_service_accomplishments":[{"description":"Trinity Health System comprises the most complete health care option in Eastern Ohio. The hospital includes Trinity East and Trinity West which has combined capacity of over 500 beds. Trinity East offers a variety of services including Skilled Care, Long-Term Care, Inpatient Physical Rehabilitation and behavioral Medicine Services (Mental Health & Addiction Recovery). Trinity West is a full service acute care facility offering 24 hour emergency care, kidney dialysis, lithotripsy, endoscopy and related services, surgery and medical surgical inpatient units and all other diagnostic departments. The goal of Trinity Skilled Care Center is to provide services which in turn allow the patients to regain independence in daily living and return them to their highest level of well being. The Trinity Skilled Care Center, a hospital-based skilled and long term care nursing facility, is fully certified for 50 beds and was developed to meet the needs of patients who require additional skilled care beyond the acute phase of illness or injury. In 2010, Trinity Skilled Care Center had 435 admissions and 15,980 patient days. The Skilled Care Center also has an ongoing activity program. Patients are encouraged to participate in these enjoyable activities as a group or individually. The atmosphere is informal and relaxing to aid in the emotional well being of each patient. Discharge planning begins on admission to Trinity Skilled Care Center. Individualized goals are established with the patient, the patient's family and a highly qualified team of professionals. This team includes: the attending physician, nurse, social services, dietician, physical therapist, occupational therapist and speech therapist. This process assures the continuity of care upon discharge. Trinity's Rehabilitation Center provides an integrated and interdisciplinary team approach to help patients who have physical impairments. Programs are available for patients with strokes and other neurological disorders, arthritis, amputations, joint replacements and other orthopedic problems, brain injury, and spinal cord injury. The Center has 20 private rooms, each specially designed for rehabilitation. Patients also utilize a home-like apartment to regain skills such as cooking, bathing and dressing. Physical Therapy, Occupational Therapy and Speech-Language Pathology areas have state-of-the-art equipment, and the therapists are highly trained rehabilitation specialists. A van is available for community outings and home visits. These trips provide opportunities for patients to practice their skills in their community, home and work place when appropriate. With a team approach to treatment, a personalized rehabilitation program is designed to meet the unique needs and goals of each patient. The team consists of the patient, his/her family, physicians, rehabilitation nurses, physical therapists, occupational therapists, speech language pathologists, psychologists, social workers, therapeutic recreational specialists, dieticians, respiratory therapists, case coordinators and vocational counselors. Through a positive, personalized and interdisciplinary approach, the team helps patients regain physical, emotional, social and verbal skills In 2010, the Rehab Center had 271 admissiions and 3,471 patient days. The Renal Unit provides hemodialysis treatments to both acute and chronic population of patients with kidney disease. This procedure oriented department is staff with registered nurses and technicians who complete training in providing hemodialysis treatments. The department works very closely with the Biomedical Department in providing a safe enviroment for the patients. In 2010, the Renal Unit had over 500 chronic outpatients and over 400 chronic inpatients. The Women's Health & Birth Center is proud to offer total maternity care. Our specially qualified staff of dedicated nurses and physicians guides you and your family through a comprehensive education program and the childbirth experience. At the Women's Health & Birth Center you deliver your baby in a specially designed childbearing room for your entire hospital stay: admission procedures, labor, delivery, recovery. Your post-partum stay is in a speciually designed room that makes the family experience one you will always remember. Our private childbearing rooms are equipped for the entire birth experience. All forms of pain relief except general anesthesia may be provided in this room. The childbearing room also Cesarean deliveries are performed in the Women's Health & Birth Center in a modern, state of the art surgical suite, with labor and postpartum care provided in a Women's Health & Birth Center Suite. The surgical suite may also be used by those wishing a more traditional birth experience. Fathers are encouraged to stay at the hospital; sleeping accommodations are provided at no extra charge. At the Women's Health & Birth Center, rooming-in is flexible and designed to meet your individual needs. You and your family are partners with us in the care of your baby. If YOU want to rest or have time alone, we can care for your baby in our well-equipped nursery near your room. In the Women's Health & Birth Center, a specially trained perinatal nurse is assigned to each mother and baby to provide personal, individualized care. Extra time and teaching are integral parts of the attention we give all families. After discharge, we know that questions often arise and it is good to have someone with whom you can talk. But even more, we are interested in you and we want to provide as much care and assistance as we can during this special time in your life. Once home, a perinatal nurse from the Women's Health & Birth Center is available for consultation through telephone calls to all patients. Simply call at anytime of the day or night if you need assistance or information. In 2010, the Women's Health & Birth Center delivered 557 babies.","expense":73051276,"grants":0,"revenue":188526504},{"description":"Trinity Health System's Cancer Treatment capabilities grew substantially with the construction of the Tony Teramana Cancer Center. Opened in January, 2000, the Center houses one of the most powerful tools in cancer treatment; the Varian Clinic 21EX Linear Accelerator. This unit, termed the \"Gold Standard\" in Cancer treatment, was only one of four in the world when it was installed. The Center also utilizes a newly purchased Simulator which is directly linked to Trinity's CT Scanner. This feature allows Radiation Oncologists to perform treatment planning equal to major metropolitan health centers. The Tony Teramana Cancer Center also provides Chemotherapy and surgical consultation services for regional residents. The Chemotherapy Services at The Tony Teramana Cancer Center is provided with compassion, privacy and optimum results. In 2010, the Center saw 9,812 patients and performed 23,189 procedures. In line with Trinity Health System's values; Service, Reverence and Stewardship, The Tony Teramana Cancer Center can meet the needs of cancer patients through a holistic approach which includes compassion, concern, dignity and respect. This service is due largely to the generosity of the Tony Teramana Family, whose $1 million gift made this center a world-class cancer treatment facility. Trinity Health System's Cardiac Rehabilitation Program is designed to effect lifestyle change in patients enrolled. These changes are achieved through safe, physical conditioning, sound educational sessions, and group support, which emphasize the understanding of risk factors associated with heart disease. The program's goal is to enhance the quality of life for the patient. Age is not a factor. By participating lifestyle possible. Our specialy trained staff works with patients, their families, and physicians to develop a personalized program of health and wellness. The goals of the Cardiac Rehab program are increased understanding of heart disease, increased endurance, decreased heart rate and blood pressure, increased muscular fitness, reduced cholesterol/triglyceride levels, decreased body fat, better nutrition management and improved sense of well-being. An integral part of the overall program, education increases a patient's understanding of their illness and helps them to identify current habits that can negatively affect their cardiac condition. We cover issues like risk factor reduction, angina, heart attack, medication, dietary and exercise guidelines, smoking, and breathing and relaxation methods. Individuals enrolled in this phase are referred by their physician. After an assessment of condition is made, a patient is scheduled for exercise training with monitoring. Risk factors, diet, and lifestyle changes are also discussed. Convenient sessions are scheduled three times per week and last approximately one hour. Once the outpatient program is concluded, patients may continue this phase in order to insure their quality of life. Their ongoing participation in the program can offer them increased endurance, decreased heart rate and blood pressure, and increased muscular fitness. In 2010, the Cardiac Rehab program helped 437 outpatients and 1,396 maintenance patients. Trinity WorkCare is the Occupational Health Department of Trinity Health System and provides a comprehensive Occupational Health Service to the business community. Our program is designed to assist the client company decrease lost work time, medical expenses, insurance premiums and maintain compliance with company and government regulations. WorkCare services include medical surveillance, substance abuse testing, injury treatment and case management, physical therapy, wellness promotion and employee assistance program. In 2010, there were 8,264 visits to WorkCare. Outpatient occupational therapy at Trinity is provided both as an extension of services received as an inpatient or you can receive services as a new patient. We are staffed to provide expertise with all neurological and orthopedic disorders and specialize in the area of hand disorders. We provide exercise, modalities (paraffin, ultrasound, iontophoresis, fluidotherapy and E-stim), functional activities, splinting/bracing and ADL training. Physical therapy assesses your movement, strength and endurance and will help to restore quality of muscle tone, coordination, balance, strength, endurance, joint flexibility and functional mobility. Our department is fully equipped to allow for private treatment. Additionally a modern gym is utilized for your exercise needs. We provide specialized programs in exercise, functional activities and modalities. Our Speech Pathology Department is equipped to render a broad spectrum of diagnostic and rehabilitative services to children, adolescents and adults with disorders associated with decreased cognitive skills, aphasia, apraxia, dysarthria, voice and delayed speech and language. We also specialize in diagnostic and therapeutic interventions for patients with swallowing disorders. To support seniors through trying times, we proudly offer the Trinity Senior Program, a therapeutic program designed to meet the emotional and psychological needs of older adults. We see patients 55 years or older that are experiencing emotional difficulties such as depression, anxiety, grief, anger and other emotional issues. The sort term outpatient program includes support groups, occupational and recreational groups and health/medication education. Trinity Home Health is special home care for special people. The disciplines offered are skilled nursing care, physical therapy, occupational therapy, medical social services (Ohio) and home health aides. In 2010, the home health department did over 28,000 home visits.","expense":81012735,"grants":0,"revenue":209072986},{"description":"The Emergency Services of Trinity Health System are available at Trinity Medical Center West. The ER has been remodeled and expanded to accommodate patients requiring treatment - it has doubled in size and now has twice as many treatment beds available and more physician, professional and support staff have been added to provide care. A dedicated x-ray room has been constructed adjacent to the ER and special treatment areas have been constructed for cardiac emergencies, trauma, pediatric emergencies, obstetrical emergencies, suturing and fractures. The ER is open 24 hours/7 days a week for all levels of emergency and urgent care. In 2010, we had 49,500 Emergency Room visits.","expense":4793928,"grants":0,"revenue":12371893}],"program_service_revenue_detail":[{"business_code":"621990","description":"Medicare payments","total_revenue":85198165,"related_or_exempt_function_income":85198165,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Blue Cross payments","total_revenue":26862212,"related_or_exempt_function_income":26862212,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Medicaid payments","total_revenue":13721521,"related_or_exempt_function_income":13721521,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Commercial Insurance payments","total_revenue":48106241,"related_or_exempt_function_income":48106241,"unrelated_business_revenue":0,"exclusion_amount":0},{"business_code":"621990","description":"Self Pay / Other payments","total_revenue":7240225,"related_or_exempt_function_income":7240225,"unrelated_business_revenue":0,"exclusion_amount":0}],"functional_expense_allocations":{"current_officers_directors":{"program_services":0,"management_and_general":250560,"fundraising":0,"total":250560},"disqualified_persons":{"program_services":0,"management_and_general":0,"fundraising":0,"total":0},"other_salaries_and_wages":{"program_services":59218789,"management_and_general":8334712,"fundraising":0,"total":67553501},"pension_plan_contributions":{"program_services":4606851,"management_and_general":648389,"fundraising":0,"total":5255240},"other_employee_benefits":{"program_services":11112745,"management_and_general":1564057,"fundraising":0,"total":12676802},"payroll_taxes":{"program_services":4113339,"management_and_general":578929,"fundraising":0,"total":4692268},"management_fees":{"program_services":5599887,"management_and_general":788153,"fundraising":0,"total":6388040},"legal_fees":{"program_services":138869,"management_and_general":19545,"fundraising":0,"total":158414},"accounting_fees":{"program_services":204584,"management_and_general":28794,"fundraising":0,"total":233378},"lobbying_fees":{"program_services":0,"management_and_general":0,"fundraising":0,"total":0},"professional_fundraising_fees":{"fundraising":0,"total":0},"investment_management_fees":{"program_services":161388,"management_and_general":22714,"fundraising":0,"total":184102},"other_service_fees":{"program_services":318541,"management_and_general":44833,"fundraising":0,"total":363374},"advertising":{"program_services":618508,"management_and_general":87051,"fundraising":0,"total":705559},"office_expenses":{"program_services":1472906,"management_and_general":207303,"fundraising":0,"total":1680209},"information_technology":{"program_services":776120,"management_and_general":109234,"fundraising":0,"total":885354},"royalties":{"program_services":0,"management_and_general":0,"fundraising":0,"total":0},"occupancy":{"program_services":4484524,"management_and_general":631172,"fundraising":0,"total":5115696},"travel":{"program_services":194718,"management_and_general":27405,"fundraising":0,"total":222123},"conferences_meetings":{"program_services":23989,"management_and_general":3376,"fundraising":0,"total":27365},"interest":{"program_services":1776579,"management_and_general":250043,"fundraising":0,"total":2026622},"payments_to_affiliates":{"program_services":517296,"management_and_general":72807,"fundraising":0,"total":590103},"depreciation_depletion":{"program_services":7250584,"management_and_general":1020479,"fundraising":0,"total":8271063},"insurance":{"program_services":1327670,"management_and_general":186862,"fundraising":0,"total":1514532},"all_other_expenses":{"program_services":7496148,"management_and_general":1055041,"fundraising":0,"total":8551189}},"fundraising_and_gaming_summary":{"gross_income_fundraising_events":124991,"fundraising_direct_expenses":108205,"gross_income_gaming":0},"tax_and_disclosure_flags":{"activities_conducted_through_partnership":false,"foreign_financial_account":false,"backup_withholding_compliance":false,"employment_tax_returns_filed":true,"lobbying_activities":false,"deductible_non_cash_contributions":false,"deductible_contributions_of_art":false,"method_of_accounting_accrual":true,"schedule_o_part_vi":true,"schedule_o_part_xi":true},"principal_officer_detail":{"person_name":"Fred Brower","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952"},"audit_financial_statement_detail":{"financial_statement_attached":false,"accountant_compile_or_review":false,"audited_financial_statement_consolidated":true,"federal_grant_audit_required":true,"federal_grant_audit_performed":true},"related_party_due_diligence":{"officer_entity_with_business_relationship":true,"officer_mailing_address":false,"related_entity":true,"related_org_controlled_entity":false,"compensation_from_other_sources":false,"excess_benefit_transaction":false,"annual_disclosure_covered_persons":true},"grant_due_diligence":{"grants_to_organizations":true,"grants_to_individuals":true,"more_than_5000_to_organizations":false,"more_than_5000_to_individuals":false,"grants_payable_beginning_of_year":0,"grants_payable_end_of_year":0},"books_are_in_care_of":{"phone":"7402837000","business_name_line1":"Trinity Medical Center East","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"439522667"},"contractor_compensation":[{"business_name_line1":"ARUP Laboratories","compensation":812095,"services_description":"Lab Services","address_line1":"500 Chipeta Way","city":"Salt Lake City","state":"UT","zip":"84108","name":"ARUP Laboratories","address":"500 Chipeta Way, Salt Lake City, UT, 84108"},{"business_name_line1":"Washington Healthcare Strategies","compensation":632888,"services_description":"Anesthesia","address_line1":"702 Parkview Drive","city":"Gibsonia","state":"PA","zip":"15044","name":"Washington Healthcare Strategies","address":"702 Parkview Drive, Gibsonia, PA, 15044"},{"business_name_line1":"Biotronics Inc","compensation":410646,"services_description":"Cardiopulmonary and Infusion surgical services","address_line1":"1370 Beulah Riad","address_line2":"2nd Floor","city":"Pittsburgh","state":"PA","zip":"15235","name":"Biotronics Inc","address":"1370 Beulah Riad, 2nd Floor, Pittsburgh, PA, 15235"},{"business_name_line1":"Allegheny General Hospital","compensation":339181,"services_description":"Imaging Servcies","address_line1":"320 East North Avenue","city":"Pittsburgh","state":"PA","zip":"15212","name":"Allegheny General Hospital","address":"320 East North Avenue, Pittsburgh, PA, 15212"},{"business_name_line1":"Karlsberger Architecture","compensation":326635,"services_description":"Architects","address_line1":"PO Box 951402","city":"Cleveland","state":"OH","zip":"44193","name":"Karlsberger Architecture","address":"PO Box 951402, Cleveland, OH, 44193"}],"officers_directors_key_employees":[{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":9000,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member and Secretary","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true},{"title":"Board Member and Treasurer","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Board Member and Vice Chairman","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"Board Member & Vice Chair","average_hours_per_week":2.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":0,"other_compensation":0,"individual_trustee_or_director":true,"officer":true},{"title":"President and CEO","average_hours_per_week":40.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":360991,"other_compensation":85419,"individual_trustee_or_director":true,"officer":true},{"title":"CFO","average_hours_per_week":40.0,"reportable_comp_from_org":0,"reportable_comp_from_related_orgs":240312,"other_compensation":29036,"key_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":486560,"reportable_comp_from_related_orgs":0,"other_compensation":14622,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":1204519,"reportable_comp_from_related_orgs":0,"other_compensation":12968,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":743323,"reportable_comp_from_related_orgs":0,"other_compensation":12968,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":305103,"reportable_comp_from_related_orgs":0,"other_compensation":14622,"highest_compensated_employee":true},{"title":"Physician","average_hours_per_week":40.0,"reportable_comp_from_org":297929,"reportable_comp_from_related_orgs":0,"other_compensation":10509,"highest_compensated_employee":true}]},"ScheduleA":{"public_charity_status":{"hospital_170b1_aiii":true}},"ScheduleB":{"attached":true,"required":true},"ScheduleD":{"endowment_funds":{"current_year":{"beginning_year_balance":743000,"contributions":0,"investment_earnings_or_losses":68173,"grants_or_scholarships":0,"other_expenditures":60682,"administrative_expenses":7491,"end_year_balance":743000},"current_year_minus1":{"beginning_year_balance":586000,"contributions":0,"investment_earnings_or_losses":203695,"grants_or_scholarships":0,"other_expenditures":39282,"administrative_expenses":7413,"end_year_balance":743000},"current_year_minus2":{"beginning_year_balance":838000,"contributions":0,"investment_earnings_or_losses":-209389,"grants_or_scholarships":0,"other_expenditures":33771,"administrative_expenses":8840,"end_year_balance":586000},"board_designated_eoy_percentage":0.0,"permanent_endowment_eoy_percentage":1.0,"term_endowment_eoy_percentage":0.0,"held_by_unrelated_organizations":false,"held_by_related_organizations":false},"land_buildings_equipment":{"land":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":703748,"book_value":703748},"buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":35683962,"book_value":7060544,"depreciation":28623418},"leasehold_improvements":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":0,"book_value":0,"depreciation":0},"equipment":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":144859706,"book_value":42652276,"depreciation":102207430},"other_land_buildings":{"investment_cost_or_other_basis":0,"other_cost_or_other_basis":21089173,"book_value":4028089,"depreciation":17061084},"total_book_value":54444657},"other_assets":{"assets":[{"description":"Interest in net assets of the Foundation","book_value":14258155},{"description":"Due from Third Party Payors","book_value":929563},{"description":"Due ffrom affiliates","book_value":299491},{"description":"Other receivables","book_value":20517},{"description":"Accrued Interest","book_value":357317}],"total_book_value":15865043},"other_liabilities":{"federal_income_tax_liability":0,"liabilities":[{"description":"Amounts due to affiliates","amount":1061301},{"description":"Retirement Benefit Payable","amount":13765392}],"total_liability":14826693},"net_assets_reconciliation":{"total_revenue":187383075,"total_expenses":181442980,"excess_or_deficit_for_year":5940095,"net_unrealized_gains_losses_on_investments":5601474,"donated_services_and_facilities":0,"investment_expenses":0,"prior_period_adjustments":0,"other_amount":4302676,"total_adjustments":9904150,"excess_or_deficit_per_financial_statements":15844245},"revenue_reconciliation":{"total_revenue_audited_financial_statements":194901141,"net_unrealized_gains_investments":5601474,"donated_services_and_use_facilities":0,"recoveries_prior_year_grants":0,"other_revenue":2499525,"revenue_not_reported":8100999,"revenue_subtotal":186800142,"investment_expenses_not_included":0,"other_revenues_not_included":582933,"revenue_not_reported_financial_statement":582933,"total_revenue_per_990":187383075},"expense_reconciliation":{"total_expenses_audited_financial_statements":181442980,"donated_services_use_facilities":0,"prior_year_adjustments":0,"losses_reported":0,"other_expenses_included":0,"expenses_not_reported":0,"expenses_subtotal":181442980,"investment_expenses_not_included":0,"other_expenses_not_included":0,"expenses_not_reported_financial_statement":0,"total_expenses_per_990":181442980},"supplemental_information":[{"identifier":"SchD_P05_S00_L04","form_and_line_reference":"Schedule D, Part V, Line 4","explanation":"Trinity Hospital Holding Company's endowment funds are maintained to provide a permanent source of income. The principal must be invested and kept intact. Only the income is used by the organization."},{"identifier":"SchD_P11_S00_L08","form_and_line_reference":"Schedule D, Part XI, Line 8","explanation":"Net gain on extinguishment of debt and related interest swap $1,902,959. Change in pension obligation (2,662,673). Change in value of interest rate swap 4,032,000. Change in unrestricted interest in Foundation 596,566. Change in temporarily interest in Foundation 556,172. Change in permanently interest in Foundation 3,584. Auxiliary activity (125,929)."},{"identifier":"SchD_P12_S00_L02d","form_and_line_reference":"Schedule D, Part XII, Line 2d","explanation":"Change in interest in Foundation, Net gain on extinguishment of debt and related interest rate swap."},{"identifier":"SchD_P12_S00_L04b","form_and_line_reference":"Schedule D, Part XII, Line 4b","explanation":"Auxiliary activities, donation from Foundation"}]},"ScheduleG":{"fundraising_events":{"event1":{"name":"Uniform Sale","gross_receipts":41951,"charitable_contributions":0,"gross_revenue":41951,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":36534},"event2":{"name":"Book Sale","gross_receipts":64392,"charitable_contributions":0,"gross_revenue":64392,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":55094},"other_events":{"gross_receipts":18648,"charitable_contributions":0,"gross_revenue":18648,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":16577,"event_count":5},"total":{"gross_receipts":124991,"charitable_contributions":0,"gross_revenue":124991,"cash_prizes":0,"noncash_prizes":0,"rent_facility_costs":0,"food_and_beverage":0,"entertainment":0,"other_direct_expenses":108205},"direct_expense_summary":108205,"net_income_summary":16786}},"ScheduleH":{"policies":{"financial_assistance_policy":true,"written_policy":true,"policy_applied_to_all_hospitals":true,"fpg_reference_free_care":true,"free_care_percent_200":true,"fpg_reference_discounted_care":true,"discounted_care_percent_200":true,"free_or_discounted_care_medically_indigent":true,"financial_assistance_budget":true,"expenses_exceed_budget":false,"annual_community_benefit_report":true,"report_publicly_available":true},"bad_debt_medicare_collections":{"bad_debt_expense_reported":true,"bad_debt_expense":4584859,"bad_debt_expense_attributable_to_financial_assistance":153000,"reimbursed_by_medicare":57445305,"cost_of_care_reimbursed_by_medicare":59663612,"medicare_surplus_or_shortfall":-2218307,"cost_to_charge_ratio":true,"written_debt_collection_policy":true,"financial_assistance_provision":true},"community_benefit":{"financial_assistance_at_cost":{"persons_served":0,"total_community_benefit_expense":4159682,"direct_offsetting_revenue":0,"net_community_benefit_expense":4159682,"total_expense_percentage":0.0229},"unreimbursed_medicaid":{"persons_served":36784,"total_community_benefit_expense":23102406,"direct_offsetting_revenue":16455440,"net_community_benefit_expense":6646966,"total_expense_percentage":0.0366},"unreimbursed_costs":{"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"total_financial_assistance":{"activities_or_programs":0,"persons_served":36784,"total_community_benefit_expense":27262088,"direct_offsetting_revenue":16455440,"net_community_benefit_expense":10806648,"total_expense_percentage":0.0595},"community_health_services":{"activities_or_programs":11,"persons_served":13322,"total_community_benefit_expense":479576,"direct_offsetting_revenue":57190,"net_community_benefit_expense":422386,"total_expense_percentage":0.0023},"health_professions_education":{"activities_or_programs":12,"persons_served":259,"total_community_benefit_expense":825027,"direct_offsetting_revenue":1950,"net_community_benefit_expense":823077,"total_expense_percentage":0.0045},"subsidized_health_services":{"activities_or_programs":4,"persons_served":21409,"total_community_benefit_expense":11267185,"direct_offsetting_revenue":8924266,"net_community_benefit_expense":2342919,"total_expense_percentage":0.0129},"research":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"cash_and_inkind_contributions":{"activities_or_programs":5,"persons_served":300,"total_community_benefit_expense":33998,"direct_offsetting_revenue":0,"net_community_benefit_expense":33998,"total_expense_percentage":0.0002},"total_other_benefits":{"activities_or_programs":32,"persons_served":35290,"total_community_benefit_expense":12605786,"direct_offsetting_revenue":8983406,"net_community_benefit_expense":3622380,"total_expense_percentage":0.0199},"total_community_benefits":{"activities_or_programs":32,"persons_served":72074,"total_community_benefit_expense":39867874,"direct_offsetting_revenue":25438846,"net_community_benefit_expense":14429028,"total_expense_percentage":0.0794}},"community_building":{"physical_improvements_and_housing":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"economic_development":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"community_support":{"activities_or_programs":1,"persons_served":29,"total_community_benefit_expense":46,"direct_offsetting_revenue":0,"net_community_benefit_expense":46,"total_expense_percentage":0.0},"environmental_improvements":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"leadership_development":{"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"coalition_building":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"health_improvement_advocacy":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"workforce_development":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"other_community_building_activities":{"activities_or_programs":0,"persons_served":0,"total_community_benefit_expense":0,"direct_offsetting_revenue":0,"net_community_benefit_expense":0,"total_expense_percentage":0.0},"total_community_building_activities":{"activities_or_programs":1,"persons_served":29,"total_community_benefit_expense":46,"direct_offsetting_revenue":0,"net_community_benefit_expense":46,"total_expense_percentage":0.0}},"hospital_facility_count":2,"hospital_facilities":[{"facility_number":1,"business_name_line1":"Trinity Medical Center West","address_line1":"4000 Johnson Road","city":"Steubenville","state":"OH","zip":"43952","licensed_hospital":true,"general_medical_and_surgical":true,"emergency_room_24_hours":true,"name":"Trinity Medical Center West","address":"4000 Johnson Road, Steubenville, OH, 43952"},{"facility_number":2,"business_name_line1":"Trinity Medical Center East","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","licensed_hospital":true,"general_medical_and_surgical":true,"name":"Trinity Medical Center East","address":"380 Summit Avenue, Steubenville, OH, 43952"}],"facility_policies":[{"business_name_line1":"Trinity Medical Center West","facility_number":1,"name":"Trinity Medical Center West"},{"business_name_line1":"Trinity Medical Center East","facility_number":2,"name":"Trinity Medical Center East"}],"supplemental_information":[{"form_and_line_reference":"Schedule H, Part I, Line 7","explanation":"Line 7 was calculated on a cost to charge ratio."},{"form_and_line_reference":"Schedule H, Part I, Line 7, Column f","explanation":"n/a"},{"form_and_line_reference":"Schedule H, Part I, Line 7g","explanation":"In Schedule H, Part I, Line 7g, Trinity reported the OB Clinic. The costs reported associated with the clinic are fringe benefits, purchased services, supplies and indirect expenses."},{"form_and_line_reference":"Schedule H, Part II","explanation":"Trinity Health System is organized to promote the health of the community. Our mission is to be a community partner dedicated to excellence in serving the health needs of the Tri-State area. We pursue that mission through two respected hospitals, as well as in outpatient facilities, physicians' offices, community outreach sites and homes throughout the Tri-State area. We put our exceptional resources to work out in the community as well, through our primary care and specialty physician practices and our hospice, home care and outreach services."},{"form_and_line_reference":"Schedule H, Part III, Section A, Line 4","explanation":"The bad debt at cost number is derived using the applicable cost to charge ratio for the hospital. Total costs for the Hospital divided by the gross charges and the factor is applied to the gross bad debt number less recoveries of bad debt. Trinity does not have a specific footnote for bad debt expense. Trinity maintains an allowance for doubtful accounts to reserve for estimated losses based on length of time the account has been outstanding and historical collection experience. Trinity performs an evaluation of the collectability of net revenues recorded and records and allowance of doubtful accounts based on probability of collection."},{"form_and_line_reference":"Schedule H, Part III, Section B, Line 8","explanation":"The Medicare shortfall in the amount of $2,218,307 should be treated as a community benefit. Jefferson County, where Trinity Health System is located, has the highest proportion of elderly in the state of Ohio. As a result, the use of health care service and also Medicare is higher than the state average. Trinity accepts all patients regardless of their ability to pay and our 2010 charity care approximated $10,343,271. In providing this charity care to those patients where no payment is anticipated, this is seen as a community benefit."},{"form_and_line_reference":"Schedule H, Part III, Section C, Line 9b","explanation":"The Health System is committed to serve everyone, accepts all patients regardless of their ability to pay. A patient is classified as a charity patient by reference to certain established policies of the Health System. Essentially, these policies define charity services as those services for which no payment is anticipated. In assessing a patient's ability to pay, the Health System utilizes the generally recognized poverty income levels established by the federal government, but also includes certain cases where incurred charges are significant when compared to patient income and resources. The Health System's policy provides charity care to patients up to 200% of the federal poverty level. The hospital provides care to persons covered by governmental programs at below cost. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, the hospital recognized these amounts as charity care in meeting its mission to the entire community. In 2010, charity care approximated $10,343,271. To educate and inform our patients about their eligibility for assisstance under federal, state or local government programs or under our charity care policy, self-pay inpatients are interviewed by the organization's Financial Counselors. At this time, the charity is discussed and explained to the patient and they may request a charity application to complete. If a patient happens to be discharged without being interviewed, the first patient billing statement also states the Charity guidelines and they are given the opportunity to contact us for an application. For outpatient accounts, any balance billing after insurance also explains the charity guidelines to patients."},{"form_and_line_reference":"Schedule H, Part VI, Line 2","explanation":"Trinity Health System, which consists of two hospitals - Trinity East and Trinity West, is a 500 bed health system located in Steubenville, Ohio. Trinity Health System is an extension of the missions and proud heritages of its co-sponsors, Tri State Health Services (reflecting the perspectives of the local community) and Franciscan Services Corporation (representing the perspectives of the health care ministry of the Sisters of St. Francis of Sylvania, Ohio). As a non-profit, charitable health care delivery system, Trinity Health System is dedicated to preserving the secular Community traditions and the Catholic traditions of it co-sponsors in the delivery of health care in the Greater Steubenville, Ohio region. The Sisters of St. Francis of Sylvania, Ohio sponsor their health and human services ministry through Franciscan Services Corporation. The organization, located in Ohio, Texas and Kentucky include six hospitals, eight long-term care facilities, four assisted living facilities, independent senior housing, a counseling center and a long-term domestic shelter. Trinity Health System is organized to promote the health of the community. Our mission is to be a community partner dedicated to excellence in serving the health needs of the Tri-State area. We pursue that mission through two respected hospitals, as well as in outpatient facilities, physicians' offices, community outreach sites and homes throughout the Tri-State area. We put our exceptional resources to work out in the community as well, through our primary care and specialty physician practices and our hospice, home care and outreach services. Our mission is the purpose of the organization. We are organized to identify and respond to community needs. We execute our mission under the authority of our board. Members include community representatives who reside in the organization's primary service area and are neither employees nor contractors of the organization, nor family members thereof. The board's mission also includes processes for determining and responding to health needs. Serving more than 188,000 patients in 2010, Trinity is a leading healthcare system in the valley. Our 1,700 employees and physicians utilize state-of-the-art facilities, advanced technologies and the latest procedures to accomplish our mission and to improve the health of the communities we serve. In conjunction with Tri-State Health Services, one of our sponsors, we provide a Mobile Medical Van that goes to various places in our community to educate the population about different topics and provide healthcare for the poor and other disadvantaged population. At each site the van visits, the following tests are available: free breathing test, free blood pressure, free blood test for AAT Deficiency (determines those at risk of developing those at risk of developing COPD). The Health System's primary service area encompasses a three county area in Ohio and West Virginia. The counties are Jefferson County, Ohio and Brooke and Hancock Counties, WV. Residents from these 3 counties provide for over 11,000 admissions to the System and account for 85% of the Hospital's admissions. Jefferson County is located on the Ohio and West Virginia borders along the Ohio River, approximately 40 miles west of Pittsburgh, PA. Jefferson County has experienced a declining population over the past 20 years and has the highest proportion of elderly in that state of Ohio. As a result, the use of health care services is higher than the state average."},{"form_and_line_reference":"Schedule H, Part VI, Line 3","explanation":"The Health System is committed to serve everyone regardless of their ability to pay. A patient is classified as a charity patient by reference to certain established policies of the Health System. Essentially, these policies define charity services as those services for which no payment is anticipated. In assessing a patient's ability to pay, the Health System utilizes the generally recognized poverty income levels established by the federal government, but also includes certain cases where incurred charges are significant when compared to patient income and resources. The Health System's policy provides charity care to patients up to 200% of the federal poverty level. The hospital provides care to persons covered by governmental programs at below cost. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, the hospital recognized these amounts as charity care in meeting its mission to the entire community. In 2010, charity care approximated $10,343,271. (Part I, line 7) To educate and inform our patients about their eligibility for assistance under federal, state, or local government programs or under our charity care policy, self-pay inpatients are interviewed by the organization's Financial Counselors. At this time, the charity is discussed and explained to the patient and they may request a charity application to complete. If a patient happens to be discharged without being interviewed, the first patient billing statement also states the Charity guidelines and they are given the opportunity to contact us for charity applications. For outpatient accounts, any balance billing after insurance also explains the charity guidelines to patients."},{"form_and_line_reference":"Schedule H, Part VI, Line 4","explanation":"The Health System considers Jefferson County, Ohio and Brooke and Hancock, West Virginia, to be its primary service area, with the majority of business coming from Jefferson County residents (Jefferson County accounts for 66% of inpatient business). The population of Jefferson County has declined over the past 20 years and is projected to continue to decline in all age cohorts, recording a 3.5% decline for the period of 2000-2006 (the most recent publicly reported census data). The unemployment rate of the service area is well above both state and national averages, with the most recent data reported for the first quarter of 2009 for Jefferson County to be 10.5%. Brooke and Hancock counties report similar unemployment rates for the first quarter at 9.9% and 10.4%, respectively. A key challenge for the Health System is operating within an area that is experiencing significant population declines and a deteriorating economic climate. The Health System experiences significant out-migration, both directed by the Hospital as well as by patient/physician preference. Until 2006, out migration had been on a rise for primary service area residents who utilize Pennsylvania and Ohio hospitals. However, beginning in 2007, out migration from Trinity's primary service area to other hospitals in Ohio, Pennsylvania and west Virginia has declined. In 2007,(most recent public data available), we have seen reductions in out migration from our primary service area to Pennsylvania, Ohio and West Virginia hospitals of (10.1%), (4.8%) and (2.5%) respectively. We have also realized an increase in market share in Jefferson County from 2006 level of 65.68% to 2007 level of 66.27%. We have seen similar increases in Brooke and Hancock counties as well with the market share increasing from 2006 level of 20.99% to 2007 level of 21.46%. Overall, the data documents that we met our planning goal of improving the market share by 1 percentage point a year. Overall, the service area of the System has a lower average household income than the State of Ohio and a higher unemployment rate. Jefferson County is economically depressed with a per-capita income lower than State averages. All 3 counties in the System's immediate service area have a high proportion of the population at or below the poverty level. The economic conditions of the area have hindered the growth of the Hospital and more self-pay patients have taken advantage of the Hospital's services. Charity Care and Bad Debt accounts have increased each year for the last few years with levels in 2010 appearing to be 10% higher than the level in 2009. As recently unemployed residents lose their health benefits, we expect higher charity care levels. We are working on strategies to address this increase and have recently engaged an organization to focus solely on converting our uninsured population to Medical Assistance, as appropriate. The Payer mix at THS is heavily weighted to the governmental payers, with 56% of the 2010 YTD revenue generated from Medicare and 14% generated from the Medicaid program - and increase of 2% over the same period in 2009. With the 2 programs recording significant shortfalls between payment to hospitals and hospital costs, the economic challenges for THS are great. A competitor analysis identifies independent physician groups as the most significant threat to the System's market position. Area physician groups have established competing ancillary services, which have historically been profitable services for the Hospital. A long term acute care hospital owned by approximately 50 of our area physicians opened in the fall of 2009. It offers key ancillary services and other profitable treatment programs. Limiting the loss in revenue, maintaining competitive outpatient services and terminating services, in which we can no longer compete, has been a focus for 2010."}]},"ScheduleI":{"grant_records_maintained":true,"reported_domestic_org_grants":69216,"reported_domestic_individual_grants":100459,"reported_domestic_org_grants_program_services":69216,"reported_domestic_individual_grants_program_services":100459,"no_grant_over_5000":true,"individual_grants":[{"type":"Employee medical education assistance","recipient_count":7,"cash":57363,"noncash":0,"noncash_description":"n/a","valuation_method":"FMV"},{"type":"Physician medical education assistance","recipient_count":1,"cash":43096,"noncash":0,"noncash_description":"n/a","valuation_method":"FMV"}],"total_domestic_grants":169675,"total_domestic_program_services":169675,"detail_individual_grants_total":100459,"detail_domestic_grants_total":100459,"supplemental_information":[{"identifier":"SchI_P01_S00_L02","form_and_line_reference":"Schedule I, Part I, Line 2","explanation":"Our policies for monitoring the use of grant funds in the United States is following the policies and procedures of the granting organization in regards to the distribution and reporting of grants."}],"grant_monitoring":{"claims_monitoring_procedures":true,"requires_financial_reports":false,"requires_narrative_reports":false,"conducts_site_visits":false,"conducts_field_audits":false,"requires_grant_agreements":false,"may_suspend_future_funding":false,"may_require_repayment":false,"monitoring_description":"Our policies for monitoring the use of grant funds in the United States is following the policies and procedures of the granting organization in regards to the distribution and reporting of grants.","form_and_line_reference":"Schedule I, Part I, Line 2"}},"ScheduleF":{"reported_foreign_grants":0,"reported_foreign_grants_program_services":0},"ScheduleJ":{"compensation_process":{"compensation_committee":true,"compensation_survey_or_study":true,"board_or_committee_approval":true},"compensation_arrangements":{"compensation_based_on_revenue_filing_org":false,"compensation_based_on_revenue_related_orgs":false,"compensation_based_on_net_earnings_filing_org":false,"compensation_based_on_net_earnings_related_orgs":false,"nonfixed_payments":false,"initial_contract_exception":false,"severance_payment":false,"supplemental_nonqualified_retirement_plan":true,"equity_based_compensation_arrangement":false},"compensation":[{"person_name":"Fred B Brower","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":7339,"compensation_based_on_related_orgs":311126,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":49171,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":36247,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":42526,"total_compensation_filing_org":85418,"total_compensation_related_orgs":360991,"name":"Fred B Brower"},{"person_name":"Elizabeth Allen","base_compensation_filing_org":0,"bonus_filing_org":0,"bonus_related_orgs":6117,"compensation_based_on_related_orgs":233376,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":16928,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":12108,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":819,"total_compensation_filing_org":29036,"total_compensation_related_orgs":240312,"name":"Elizabeth Allen"},{"person_name":"Kumar B Amin MD","base_compensation_filing_org":597411,"bonus_filing_org":607107,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":12968,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":1217486,"total_compensation_related_orgs":0,"name":"Kumar B Amin MD"},{"person_name":"Jeffrey F Shall MD","base_compensation_filing_org":610466,"bonus_filing_org":132857,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":12968,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":756291,"total_compensation_related_orgs":0,"name":"Jeffrey F Shall MD"},{"person_name":"Amjad Alkaed MD","base_compensation_filing_org":316279,"bonus_filing_org":170281,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":14622,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":501182,"total_compensation_related_orgs":0,"name":"Amjad Alkaed MD"},{"person_name":"Basel Termanini MD","base_compensation_filing_org":297929,"bonus_filing_org":0,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":10509,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":308438,"total_compensation_related_orgs":0,"name":"Basel Termanini MD"},{"person_name":"Mark Kissinger","base_compensation_filing_org":250516,"bonus_filing_org":54587,"bonus_related_orgs":0,"compensation_based_on_related_orgs":0,"comp_report_prior_990_filing_org":0,"comp_report_prior_990_related_orgs":0,"deferred_compensation_filing_org":0,"deferred_compensation_related_orgs":0,"nontaxable_benefits_filing_org":14622,"nontaxable_benefits_related_orgs":0,"other_compensation_filing_org":0,"other_compensation_related_orgs":0,"total_compensation_filing_org":319725,"total_compensation_related_orgs":0,"name":"Mark Kissinger"}],"supplemental_information":[{"identifier":"SchJ_P01_S00_L03","form_and_line_reference":"Schedule J, Part I, Line 3","explanation":"The organization bases the CEO's compensation on review from the compensation committee, a compensation survey and then approval from the Board."},{"identifier":"SchJ_P01_S00_L04","form_and_line_reference":"Schedule J, Part I, Line 4","explanation":"The President ($13,469) and Vice President ($4,680) of Human Resources participated in a supplemental retirement plan."}]},"ScheduleK":{"bond_issues":[{"issuer_ein":346002729,"business_name_line1":"City of Steubenville Ohio","cusip_number":"860068BZ7","date_issued":"2010-08-12T00:00:00","issue_price":42796876,"purpose":"refinance 2007 bond issue","defeased":false,"on_behalf_of_issuer":false,"pool_financing":false,"name":"City of Steubenville Ohio"}],"bond_proceeds":[{"total_proceeds":42976876,"gross_proceeds_in_reserve_funds":0,"capitalized_interest":0,"issuance_costs_from_proceeds":609276,"credit_enhancement":0,"working_capital_expenditures":32387,"capital_expenditures":0,"other_spent_proceeds":34961794,"refunding_escrow":0,"amount_bond_defeased":0,"amount_retired":0,"amount_unspent":20445,"substantial_completion_year":2010,"current_refunding":true,"advance_refunding":false,"final_allocation_made":true,"adequate_books_and_records_maintained":true}],"private_business_use":[{"private_business_use_by_others_percentage":0.0,"private_business_concerning_ubi_percentage":0.0,"total_private_business_use_percentage":0.0,"post_issuance_compliance_procedures":true,"management_contract":false,"research_agreements":false,"lease_arrangements":false,"partnership_or_llc_owning_property":false}],"arbitrage":[{"gross_proceeds_invested":false,"gross_proceeds_invested_in_gic":false,"hedge_identified_in_books_and_records":false,"variable_rate_issue":false,"exception_to_rebate":false,"form_8038t_filed":false}],"supplemental_information":[{"identifier":"SchK_P02_S00_L03","form_and_line_reference":"Schedule K, Part II, Line 3","explanation":"Proceeds of 2010 Issue = $43,930,000. Original issue discount = $1,133,124. 2010 proceeds = $42,976,876."}]},"ScheduleL":{"business_transactions_involving_interested_persons":[{"person_name":"Michael Barber","relationship":"Board Member of Trinity","description":"he owns National Colloid, a company which we purchase chemicals from","amount":129260,"sharing_of_revenues":false,"name":"Michael Barber"}]},"ScheduleR":{"tax_exempt_organizations":[{"ein":341818681,"business_name_line1":"Trinity Health System","primary_activities":"support and management services","exempt_code_section":"501(c)3","public_charity_status":"11b","legal_domicile_state":"OH","direct_controlling_business_name_line1":"Tri-State Health Services & FSC","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","name":"Trinity Health System","address":"380 Summit Avenue, Steubenville, OH, 43952"},{"ein":341329423,"business_name_line1":"Trinity Health System Foundation","primary_activities":"charitable fundraising supporting Trinity Health System","exempt_code_section":"501(c)3","public_charity_status":"11a","legal_domicile_state":"OH","direct_controlling_business_name_line1":"Trinity Health System","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","name":"Trinity Health System Foundation","address":"380 Summit Avenue, Steubenville, OH, 43952"}],"taxable_corporations_and_trusts":[{"ein":341471026,"business_name_line1":"Trinity Management Services Organization","primary_activity":"mgmt serv,provide dr staff","ownership_percentage":0.0,"legal_domicile_state":"OH","address_line1":"380 Summit Avenue","city":"Steubenville","state":"OH","zip":"43952","type_of_entity":"C","name":"Trinity Management Services Organization","address":"380 Summit Avenue, Steubenville, OH, 43952"}],"transaction_flags":{"gift_grant_or_capital_contribution_from_other_org":true,"gift_grant_or_capital_contribution_to_other_org":false,"loans_or_guarantees_from_other_org":false,"loans_or_guarantees_to_other_org":false,"performance_of_services_by_other_orgs":false,"performance_of_services_for_other_orgs":false,"sharing_of_facilities":false,"sharing_of_paid_employees":false,"reimbursement_paid_by_other_org":false,"reimbursement_paid_to_other_org":true,"rental_of_facilities_from_other_orgs":false,"rental_of_facilities_to_other_orgs":false,"purchase_of_assets_from_other_org":false,"sale_of_assets_to_other_org":false,"exchange_of_assets":false,"receipt_of_interest_annuities_rents_royalties":false,"other_transfer_from_other_org":false,"other_transfer_to_other_org":false},"transactions":[{"business_name_line1":"Trinity Health System","amount_involved":4427618,"method_of_amount_determination":"FMV","transaction_type":"o","name":"Trinity Health System"},{"business_name_line1":"Trinity Management Services Organization","amount_involved":1763842,"method_of_amount_determination":"FMV","transaction_type":"o","name":"Trinity Management Services Organization"},{"business_name_line1":"Trinity Health System Foundation","amount_involved":457000,"method_of_amount_determination":"FMV","transaction_type":"c","name":"Trinity Health System Foundation"}]},"Ratings":{"Mission Deployment Rate":{"score":null},"Program Expense Ratio":{"score":null},"Fundraising Efficiency":{"score":null,"percentile":null},"Filing Consistency Score":{"score":0.9375},"Grant Itemization Coverage":{"score":0.5920671872697805},"Independent Voting Board Pct":{"score":0.8636363636363636},"Operating Margin":{"score":0.031700274958130555,"percentile":0.5140606786685662},"Operating Reserve Ratio":{"score":0.9434352048230249,"percentile":0.44615331377000167},"Liabilities to Assets Ratio":{"score":0.4320168230233148,"percentile":0.16526963862145946},"Officer Compensation Ratio":{"score":0.017733273560652497,"percentile":0.921749008361422},"Program Expense Growth":{"score":null,"percentile":null},"Revenue Growth":{"score":null,"percentile":null},"Asset Growth":{"score":null,"percentile":null},"Foreign Oversight Score":{"score":null},"Major-Donor Itemization":{"score":1.0},"Related-Party Transparency":{"score":null},"Pay-Setting Controls":{"score":0.5,"weight":5,"atoms":{"Compensation committee":{"value":true},"Independent compensation consultant":{"value":false},"Form 990 of other organizations reviewed":{"value":false},"Written employment contract":{"value":false},"Compensation survey or study":{"value":true},"Board or committee approval":{"value":true}}},"Governance Policy Score":{"score":0.8888888888888888,"weight":5,"atoms":{"Conflict of interest policy":{"value":true},"Whistle blower policy":{"value":true},"Document retention policy":{"value":true},"Compensation process for CEO":{"value":true},"Compensation process for other employees":{"value":true},"Form 990 provided to governing body":{"value":false},"Minutes of governing body":{"value":true},"Audit committee":{"value":true},"Independent audit financial statements":{"value":true}}},"Categories":{"Financial Efficiency":{"score":null,"weight":45},"Transparency & Controls":{"score":0.765288437453956,"weight":20},"Accountability":{"score":0.8741582491582491,"weight":14},"Sustainability":{"score":0.5010170171861353,"weight":13},"Growth":{"score":null,"weight":8}},"Overall Score":{"score":0.7246213927811568,"percentile":0.41559752181814275}},"source_xml":"201113139349300416_public.xml"},"sector":"Health","donation_categories":[],"zakat_policy":null},"error":null}