TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Michael Biasi Board Member	2	X			0	0
(2) Dan Daily Board Member	2	X			0	0
(3) Sheila Hendricks Board Member	2	X			0	0
(4) Bruce Hitchcock Board Member	2	X			0	0
(5) William Johns MD Board Member	2	X			0	0
(6) Douglas W Schaefer Board Member	2	X			0	0
(7) Sr Jeanette Zielenski OSF Board Member	2	X			0	0
(8) David Skiviat Sr Board Member	2	X			0	0
(9) Brijinder Kochar MD Board Member	2	X			9,000	0
(10) Terence Schuessler Board Member	2	X			0	0
(11) Patrick Macedonia Board Member	2	X			0	0
(12) Eric Exley Board Member and Secretary	2	X			0	0
(13) James Padden Board Member and Treasurer	2	X	X		0	0
(14) Michael Barber Board Member and Vice Chairman	2	X	X		0	0
(15) Clyde C Metzger MD Board Member & Vice Chair	2	X	X		0	0
(16) Fred B Brower President and CEO	40	X	X		360,991	85,419
(17) Elizabeth Allen CFO	40			X	240,312	29,036

(A) Name and business address	(B) Description of services	(C) Compensation
ARUP Laboratories 500 Chipeta Way Salt Lake City,UT84108	Lab Services	812,095
Washington Healthcare Strategies 702 Parkview Drive Gibsonia,PA15044	Anesthesia	632,888
Biotronics Inc 1370 Beulah Riad 2nd Floor Pittsburgh,PA15235	Cardiopulmonary and Infusion surgical services	410,646
Allegheny General Hospital 320 East North Avenue Pittsburgh,PA15212	Imaging Servcies	339,181
Karlsberger Architecture PO Box 951402 Cleveland,OH44193	Architects	326,635
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 17

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21	69,216	69,216
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22	100,459	100,459
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	250,560	0	250,560	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0	0	0	0
7	Other salaries and wages	67,553,501	59,218,789	8,334,712	0
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	5,255,240	4,606,851	648,389	0
9	Other employee benefits .......	12,676,802	11,112,745	1,564,057	0
10	Payroll taxes ...........	4,692,268	4,113,339	578,929	0
11	Fees for services (non-employees):
a	Management ......	6,388,040	5,599,887	788,153	0
b	Legal .........	158,414	138,869	19,545	0
c	Accounting ...........	233,378	204,584	28,794	0
d	Lobbying ...........	0	0	0	0
e	Professional fundraising. See Part IV, line 17..	0			0
f	Investment management fees ......	184,102	161,388	22,714	0
g	Other ..........	363,374	318,541	44,833	0
12	Advertising and promotion ....	705,559	618,508	87,051	0
13	Office expenses .......	1,680,209	1,472,906	207,303	0
14	Information technology ......	885,354	776,120	109,234	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	5,115,696	4,484,524	631,172	0
17	Travel ............	222,123	194,718	27,405	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0	0	0	0
19	Conferences, conventions, and meetings ....	27,365	23,989	3,376	0
20	Interest ...........	2,026,622	1,776,579	250,043	0
21	Payments to affiliates .......	590,103	517,296	72,807	0
22	Depreciation, depletion, and amortization .....	8,271,063	7,250,584	1,020,479	0
23	Insurance ..............	1,514,532	1,327,670	186,862	0
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	Drugs	7,615,933	6,676,284	939,649	0
b	Provision for bad debt	11,407,960	10,000,452	1,407,508	0
c	Repairs and Maintenance	3,282,508	2,877,514	404,994	0
d	Outside purchased services	4,653,029	4,078,941	574,088	0
e	Medical Supplies	26,968,381	23,641,038	3,327,343	0
f	All other expenses	8,551,189	7,496,148	1,055,041	0
25	Total functional expenses. Add lines 1 through 24f	181,442,980	158,857,939	22,585,041	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	75,258	1	31,783
2	Savings and temporary cash investments .......	8,383,606	2	6,655,363
3	Pledges and grants receivable, net .........	0	3	0
4	Accounts receivable, net .........	18,282,742	4	19,814,655
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........	0	5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........	0	6	0
7	Notes and loans receivable, net .............	1,224,488	7	851,216
8	Inventories for sale or use ..............	2,665,097	8	2,978,134
9	Prepaid expenses and deferred charges ............	1,237,146	9	1,753,575
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	202,336,589
b	Less: accumulated depreciation. .....	10b	147,891,932	52,941,654	10c	54,444,657
11	Investments—publicly traded securities ..........	60,975,636	11	67,085,269
12	Investments—other securities. See Part IV, line 11 ......	0	12	0
13	Investments—program-related. See Part IV, line 11 ..	0	13	0
14	Intangible assets .........	0	14	1,700,000
15	Other assets. See Part IV, line 11 ...........	13,557,074	15	15,865,043
16	Total assets. Add lines 1 through 15 (must equal line 34)...	159,342,701	16	171,179,695
	17	Accounts payable and accrued expenses .	14,169,766	17	16,596,314
18	Grants payable ..........	0	18	0
19	Deferred revenue ..........	0	19	0
20	Tax-exempt bond liabilities ..........	45,706,429	20	42,529,501
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	23,874	24	0
25	Other liabilities. Complete Part X of Schedule D.....	18,059,690	25	14,826,693
26	Total liabilities. Add lines 17 through 25.....	77,959,759	26	73,952,508
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	73,417,005	27	88,701,494
28	Temporarily restricted net assets .....	5,845,523	28	6,401,695
29	Permanently restricted net assets .....	2,120,414	29	2,123,998
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	81,382,942	33	97,227,187
34	Total liabilities and net assets/fund balances .....	159,342,701	34	171,179,695

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SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

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Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization TRINITY HOSPITAL HOLDING COMPANY
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization TRINITY HOSPITAL HOLDING COMPANY
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:	10000077
Software Version:	v1.00

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back
1a	Beginning of year balance ....	743,000	586,000	838,000
b	Contributions ........	0	0	0
c	Investment earnings or losses ...	68,173	203,695	-209,389
d	Grants or scholarships .....	0	0	0
e	Other expenditures for facilities and programs ........	60,682	39,282	33,771
f	Administrative expenses ....	7,491	7,413	8,840
g	End of year balance ......	743,000	743,000	586,000

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

0 %

Permanent endowment: SchDMd Bullet

100 %

Term endowment: SchDMd Bullet

0 %

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	0	703,748		703,748
b	Buildings ................	0	35,683,962	28,623,418	7,060,544
c	Leasehold improvements ............	0	0	0	0
d	Equipment ................	0	144,859,706	102,207,430	42,652,276
e	Other .................	0	21,089,173	17,061,084	4,028,089
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........					54,444,657

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Interest in net assets of the Foundation				14,258,155
(2) Due from Third Party Payors				929,563
(3) Due ffrom affiliates				299,491
(4) Other receivables				20,517
(5) Accrued Interest				357,317




Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				15,865,043

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes		0
Amounts due to affiliates		1,061,301
Retirement Benefit Payable		13,765,392







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		14,826,693
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	187,383,075
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	181,442,980
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	5,940,095
4	Net unrealized gains (losses) on investments ..........................	4	5,601,474
5	Donated services and use of facilities .............................	5	0
6	Investment expenses ...................................	6	0
7	Prior period adjustments ..................................	7	0
8	Other (Describe in Part XIV) .................................	8	4,302,676
9	Total adjustments (net). Add lines 4 - 8 .............................	9	9,904,150
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	15,844,245

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	194,901,141
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	5,601,474
b	Donated services and use of facilities .........	2b	0
c	Recoveries of prior year grants ...........	2c	0
d	Other (Describe in Part XIV): ............	2d	2,499,525
e	Add lines 2a through 2d .....................			2e	8,100,999
3	Subtract line 2e from line 1.....................			3	186,800,142
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	0
b	Other (Describe in Part XIV): ...........	4b	582,933
c	Add lines 4a and 4b.......................			4c	582,933
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	187,383,075

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	181,442,980
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a	0
b	Prior year adjustments ..............	2b	0
c	Other losses ................	2c	0
d	Other (Describe in Part XIV): ............	2d	0
e	Add lines 2a through 2d......................			2e	0
3	Subtract line 2e from line 1.....................			3	181,442,980
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	0
b	Other (Describe in Part XIV): ............	4b	0
c	Add lines 4a and 4b.......................			4c	0
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......			5	181,442,980

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
SchD_P05_S00_L04	Schedule D, Part V, Line 4	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.
SchD_P11_S00_L08	Schedule D, Part XI, Line 8	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).
SchD_P12_S00_L02d	Schedule D, Part XII, Line 2d	Change in interest in Foundation, Net gain on extinguishment of debt and related interest rate swap.
SchD_P12_S00_L04b	Schedule D, Part XII, Line 4b	Auxiliary activities, donation from Foundation

Schedule D (Form 990) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

SCHEDULE G
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization
TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2010

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 Uniform Sale (event type)	(b) Event #2 Book Sale (event type)	(c) Other Events 5 (total number)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	41,951	64,392	18,648	124,991
2	Less: Charitable contributions . . .	0	0	0	0
3	Gross income (line 1 minus line 2) . . .	41,951	64,392	18,648	124,991
4	Cash prizes . . .	0	0	0	0
5	Non-cash prizes . .	0	0	0	0
6	Rent/facility costs . .	0	0	0	0
7	Food and beverages . .	0	0	0	0
8	Entertainment . . .	0	0	0	0
9	Other direct expenses .	36,534	55,094	16,577	108,205
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........				108,205
11	Net income summary. Combine lines 3 and 10 in column (d)............				16,786

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ...........................

YesNo

Schedule G (Form 990 or 990-EZ) 2010

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..		0	4,159,682	0	4,159,682	2.29 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .		36,784	23,102,406	16,455,440	6,646,966	3.66 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....			0	0	0	0 %
dTotal Charity Care and Means-Tested Government Programs .....	0	36,784	27,262,088	16,455,440	10,806,648	5.95 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	11	13,322	479,576	57,190	422,386	0.23 %
f Health professions education (from Worksheet 5) ..	12	259	825,027	1,950	823,077	0.45 %
g Subsidized health services (from Worksheet 6) ..	4	21,409	11,267,185	8,924,266	2,342,919	1.29 %
h Research (from Worksheet 7)	0	0	0	0	0	0 %
i Cash and in-kind contributions to community groups (from Worksheet 8) ..	5	300	33,998	0	33,998	0.02 %
jTotal Other Benefits ...	32	35,290	12,605,786	8,983,406	3,622,380	1.99 %
kTotal. Add lines 7d and 7j. ..	32	72,074	39,867,874	25,438,846	14,429,028	7.94 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(e) Net community building expense
1	Physical improvements and housing	0	0	0	0
2	Economic development	0	0	0	0
3	Community support	1	29	46	46
4	Environmental improvements	0	0	0	0
5	Leadership development and training for community members		0	0	0
6	Coalition building	0	0	0	0
7	Community health improvement advocacy	0	0	0	0
8	Workforce development	0	0	0	0
9	Other	0	0	0	0
10	Total	1	29	46	46

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense (at cost).....

4,584,859

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

153,000

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

57,445,305

Enter Medicare allowable costs of care relating to payments on line 5.....

59,663,612

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-2,218,307

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?2 Name and address		Other (Describe)
1	Trinity Medical Center West 4000 Johnson Road Steubenville,OH43952	X	X	X
2	Trinity Medical Center East 380 Summit Avenue Steubenville,OH43952	X	X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:Trinity Medical Center West

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:Trinity Medical Center East

Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?
Name and address		Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
SchH_P01_S00_L07	Schedule H, Part I, Line 7	Line 7 was calculated on a cost to charge ratio.
SchH_P01_S00_L072f	Schedule H, Part I, Line 7, Column f	n/a
SchH_P01_S00_L07g	Schedule H, Part I, Line 7g	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.
SchH_P02_S00_L00	Schedule H, Part II	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.
SchH_P03_S0A_L04	Schedule H, Part III, Section A, Line 4	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.
SchH_P03_S0B_L08	Schedule H, Part III, Section B, Line 8	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.
SchH_P03_S0C_L09b	Schedule H, Part III, Section C, Line 9b	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.
SchH_P06_S00_L02	Schedule H, Part VI, Line 2	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.
SchH_P06_S00_L03	Schedule H, Part VI, Line 3	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.
SchH_P06_S00_L04	Schedule H, Part VI, Line 4	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.

Schedule H (Form 990) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
TRINITY HOSPITAL HOLDING COMPANY

Employer identification number
34-1842025

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet

(a) Name and address of organization or government	(b) EIN	(c) IRC Code section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image

Enter total number of other organizations ................................ . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2010

Page 2

Part III

Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance
(1) Employee medical education assistance	7	57,363	0	FMV	n/a
(2) Physician medical education assistance	1	43,096	0	FMV	n/a

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
SchI_P01_S00_L02	Schedule I, Part I, Line 2	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.

Schedule I (Form 990) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) Fred B Brower	(i) (ii)	0 311,126	0 7,339	0 42,526	49,171 0	36,247 0	85,418 360,991	0 0
(2) Elizabeth Allen	(i) (ii)	0 233,376	0 6,117	0 819	16,928 0	12,108 0	29,036 240,312	0 0
(3) Kumar B Amin MD	(i) (ii)	597,411 0	607,107 0	0 0	0 0	12,968 0	1,217,486 0	0 0
(4) Jeffrey F Shall MD	(i) (ii)	610,466 0	132,857 0	0 0	0 0	12,968 0	756,291 0	0 0
(5) Amjad Alkaed MD	(i) (ii)	316,279 0	170,281 0	0 0	0 0	14,622 0	501,182 0	0 0
(6) Basel Termanini MD	(i) (ii)	297,929 0	0 0	0 0	0 0	10,509 0	308,438 0	0 0
(7) Mark Kissinger	(i) (ii)	250,516 0	54,587 0	0 0	0 0	14,622 0	319,725 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
SchJ_P01_S00_L03	Schedule J, Part I, Line 3	The organization bases the CEO's compensation on review from the compensation committee, a compensation survey and then approval from the Board.
SchJ_P01_S00_L04	Schedule J, Part I, Line 4	The President ($13,469) and Vice President ($4,680) of Human Resources participated in a supplemental retirement plan.

Schedule J (Form 990) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization
TRINITY HOSPITAL HOLDING COMPANY

Employer identification number
34-1842025

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	City of Steubenville Ohio	34-6002729	860068BZ7	08-12-2010	42,796,876	refinance 2007 bond issue		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired. . . . .	0
2 Amount of bonds defeased . . . .	0
3 Total proceeds of issue . . . .	42,976,876
4 Gross proceeds in reserve funds . .	0
5 Capitalized interest from proceeds.	0
6 Proceeds in refunding escrow. . . . .	0
7 Issuance costs from proceeds . . .	609,276
8 Credit enhancement from proceeds.	0
9 Working capital expenditures from proceeds . .	32,387
10 Capital expenditures from proceeds . .	0
11 Other spent proceeds . .	34,961,794
12 Other unspent proceeds. . .	20,445
13 Year of substantial completion . . .	2010
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue?	X
15 Were the bonds issued as part of an advance refunding issue?		X
16 Has the final allocation of proceeds been made? . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .		X

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2010

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use?		X
b Are there any research agreements that may result in private business use of bond-financed property? . .		X
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? .
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . .	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .	0 %
6 Total of lines 4 and 5 . . .. . . . . .	0 %
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities?	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X
2 Is the bond issue a variable rate issue?		X
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?		X
b Name of provider .
c Term of hedge . .
d Was the hedge superintegrated? .
e Was a hedge terminated? .
4a Were gross proceeds invested in a GIC? .		X
b Name of provider .
c Term of GIC . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? .
5 Were any gross proceeds invested beyond an available temporary period? .		X
6 Did the bond issue qualify for an exception to rebate? . . .		X

Schedule K (Form 990) 2010

Page 3

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule K (see instructions).

Identifier	Return Reference	Explanation
SchK_P02_S00_L03	Schedule K, Part II, Line 3	Proceeds of 2010 Issue = $43,930,000. Original issue discount = $1,133,124. 2010 proceeds = $42,976,876.

Schedule K (Form 990) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part I

Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(b) Description of transaction	(c) Corrected?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.

(a) Name of interested person and purpose	(b) Loan to or from the organization?		(c)Original principal amount	(d)Balance due	(e) In default?		(f) Approved by board or committee?		(g)Written agreement?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b)Relationship between interested person and the organization	(c)Amount of grant or type of assistance

For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2010

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Michael Barber	Board Member of Trinity	129,260	he owns National Colloid, a company which we purchase chemicals from		No

Part V

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule L (see instructions).

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Identifier	Return Reference	Explanation
F990_P06_S0A_L06	Form 990, Part VI, Section A, Line 6	Trinity Hospital Holding Company is a not-for-profit corporation with board members.
F990_P06_S0A_L07a	Form 990, Part VI, Section A, Line 7a	Trinity Health System has 2 co-sponsoring members - Tri-State Health Services, Inc. and Franciscan Services Corporation. All Trustees of Trinity Health System are elected by the members. Recommendations for appointment to the Board of Trustees are made by the Trinity Health System Board of Trustees through its nominating committee. Final approval of each nominee by the co-sponsoring members is required.
F990_P06_S0A_L07b	Form 990, Part VI, Section A, Line 7b	Trinity Health System has 2 co-sponsoring members - Tri-State Health Services, Inc. and Franciscan Services Corporation. Both Members must approve the following actions of the Corporation or any of its subsidiaries as condition before they become effective: 1. merger,condolidation or substantial sale. 2. Creation of subsidiaries or affiliation with other entities. 3. Conveyancing real property or creating liens theron. 4. Transfer of personal property, incurring or guaranteeing indebtedness or granting liens in excess of an amount prescribed from time to time by the Members. 5. Approval of Corporation or subsidiary trustees and directors based on agreed upon criteria. 6. Capital expenditures or grants in excess of an amount prescribed from time to time by the Members. 7. Addition or termination of services. 8. Approval of selection of the slate of candidates for the office of CEO of the Corporation or any of its subsidiaries, provided, however, that a representative of each Member will serve on the selection committee. 9. Approval of the annual budget and strategic plan for the Corporation and its subsidiaries.
F990_P06_S0B_L11a	Form 990, Part VI, Section B, Line 11a	The Trinity Health System Board of Trustees, represented by its Executive Committee, reviews the System's and related entities Form 990's at a meeting. Each document is reviewed in detail, including each of the related schedules on their entirety. The Board's Executive Committee endorses the 990 filings and reports on their review of the organization's 990's at the regular Board of Trustees meeting.
F990_P06_S0B_L12c	Form 990, Part VI, Section B, Line 12c	Each Board Member, Officer and Vice President is required to complete a disclosure of potential conflicts, which are defined by the applicable policy, on an annual basis. Each submission is reviewed by the Board Chair and the System CEO, then incorporated into a summary report that is provided to the Board and the individual originals are maintained in each member's Board book. Upon the hearing or deliberation of any matter that comes before the Board, the Board Chair or any individual member of the Board can raise a question related to any conflict that they may identify. The Board Chair, in consultation with the CEO and the full Board, will make a determination on the question and the procedure to be followed in the individual case. The Board Chair, or his designee if the Chair is conflicted, will manage the conflict to assure an unbiased and objective discussion and decision.
F990_P06_S0B_L15	Form 990, Part VI, Section B, Line 15	Each executive's compensation is reviewed and approved by the Executive Committee of the Board of Trustees. The Board is provided with salary comparison data, which is prepared by the Ohio Hospital Association (reported by MSA/Crank Consulting) each year.
F990_P06_S0C_L19	Form 990, Part VI, Section C, Line 19	Trinity Hospital Holding Company makes its governing documents, conflict of interest policy and financial statements available to the public upon request.
F990_P11_S00_L05	Form 990, Part XI, Line 5	Change in pension obligation (2,662,673), change in value of interest rate swap 4,032,000, net gain on extinguishment of debt and related interest rate swap 1,902,959, change in unrestricted interest in Foundation 596,566, change in temporarily interest in Foundation 556,172, change in permanently interest in Foundation 3,584, net unrealized gains on investments 5,601,474, Auxiliary activity (125,929).

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

TRINITY HOSPITAL HOLDING COMPANY

Employer identification number

34-1842025

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Trinity Health System 380 Summit Avenue Steubenville,OH43952 34-1818681	support and management services	OH	501(c)3	11b	Tri-State Health Services & FSC
(2) Trinity Health System Foundation 380 Summit Avenue Steubenville,OH43952 34-1329423	charitable fundraising supporting Trinity Health System	OH	501(c)3	11a	Trinity Health System

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(h) Percentage ownership
(1) Trinity Management Services Organization 380 Summit Avenue Steubenville,OH43952 34-1471026	mgmt serv,provide dr staff	OH	N/A	C	0 %

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) Trinity Health System	o	4,427,618	FMV
(2) Trinity Management Services Organization	o	1,763,842	FMV
(3) Trinity Health System Foundation	c	457,000	FMV
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:	10000077
Software Version:	v1.00

- TIN:

TY 2010 ReasonableCauseExplanation

Name:

TRINITY HOSPITAL HOLDING COMPANY

EIN: 34-1842025

Software ID:10000077

Software Version:v1.00

Explanation:

n/a

1	Briefly describe the organization’s mission or most significant activities: A community partner dedicated to the excellence in serving the health needs of the Tri-State area.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	19
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	1,897
6	Total number of volunteers (estimate if necessary) ....	6	75
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,087,445	743,691
9	Program service revenue (Part VIII, line 2g) .........	174,011,490	182,144,432
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,444,187	472,221
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,308,481	4,022,731
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	183,851,603	187,383,075
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	166,829	169,675
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	87,814,545	90,428,371
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	86,860,263	90,844,934
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	174,841,637	181,442,980
19	Revenue less expenses. Subtract line 18 from line 12......	9,009,966	5,940,095
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	159,342,701	171,179,695
21	Total liabilities (Part X, line 26)............	77,959,759	73,952,508
22	Net assets or fund balances. Subtract line 21 from line 20 .....	81,382,942	97,227,187

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 73,051,276 including grants of $ 0 ) (Revenue $ 188,526,504 )
	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.

4b	(Code: ) (Expenses $ 81,012,735 including grants of $ 0 ) (Revenue $ 209,072,986 )
	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.

4c	(Code: ) (Expenses $ 4,793,928 including grants of $ 0 ) (Revenue $ 12,371,893 )
	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.

4d	Other program services. (Describe in Schedule O.)
	(Expenses $ 0 including grants of $ 0 ) (Revenue $ 0 )
4e	Total program service expenses$ 158,857,939

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Amjad Alkaed MD Physician	40	X	486,560	0	14,622
(19) Kumar B Amin MD Physician	40	X	1,204,519	0	12,968
(20) Jeffrey F Shall MD Physician	40	X	743,323	0	12,968
(21) Mark Kissinger Physician	40	X	305,103	0	14,622
(22) Basel Termanini MD Physician	40	X	297,929	0	10,509

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,037,434	610,303	180,144

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a		0
b	Membership dues....1b		0
c	Fundraising events....1c		0
d	Related organizations...1d		460,209
e	Government grants (contributions)1e		219,537

f	All other contributions, gifts, grants, and similar amounts not included above1f		63,945
g	Noncash contributions included in lines 1a-1f:$ 0
h	Total. Add lines 1a-1f.......			743,691
			Business Code
2a	Medicare payments		621,990	85,198,165	85,198,165	0	0
b	Blue Cross payments		621,990	26,862,212	26,862,212	0	0
c	Medicaid payments		621,990	13,721,521	13,721,521	0	0
d	Commercial Insurance payments		621,990	48,106,241	48,106,241	0	0
e	Self Pay / Other payments		621,990	7,240,225	7,240,225	0	0
f	All other program service revenue .			1,016,068	1,016,068	0	0
g	Total. Add lines 2a–2f........			182,144,432
3	Investment income (including dividends, interest
	and other similar amounts).....			1,581,652	0	0	1,581,652
4	Income from investment of tax-exempt bond proceeds..			1,883	0	0	1,883
5	Royalties............			0	0	0	0
		(i) Real	(ii) Personal
6a	Gross Rents	0	0
b	Less: rental expenses	0	0
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0	0	0	0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	37,556,038	9,298
b	Less: cost or other basis and sales expenses	38,676,650	0
c	Gain or (loss)	-1,120,612	9,298
d	Net gain or (loss)..........			-1,111,314	0	0	-1,111,314
8a	Gross income from fundraising events (not including $ 0 of contributions reported on line 1c). See Part IV, line 18 ...
	a		124,991
b	Less: direct expenses ...b		108,205
c	Net income or (loss) from fundraising events..			16,786		0	16,786
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities...			0	0	0	0
10a	Gross sales of inventory, less returns and allowances .
	a		380,324
b	Less: cost of goods sold ..b		271,176
c	Net income or (loss) from sales of inventory..			109,148	0	0	109,148
Miscellaneous Revenue			Business Code
11a	Cafeteria Income		722,210	1,922,104	0	0	1,922,104
b	Nursing School Tuition		900,099	675,913	675,913	0	0
c	Purchase Discounts		900,099	438,469	0	0	438,469
d	All other revenue ....			860,311	0	0	860,311
e	Total. Add lines 11a–11d ......			3,896,797
12	Total revenue. See Instructions....			187,383,075	182,820,345	0	3,819,039


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			75,258	1	31,783
2	Savings and temporary cash investments .......			8,383,606	2	6,655,363
3	Pledges and grants receivable, net .........			0	3	0
4	Accounts receivable, net .........			18,282,742	4	19,814,655
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........			0	5	0
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........			0	6	0
7	Notes and loans receivable, net .............			1,224,488	7	851,216
8	Inventories for sale or use ..............			2,665,097	8	2,978,134
9	Prepaid expenses and deferred charges ............			1,237,146	9	1,753,575
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	202,336,589
b	Less: accumulated depreciation. .....	10b	147,891,932	52,941,654	10c	54,444,657
11	Investments—publicly traded securities ..........			60,975,636	11	67,085,269
12	Investments—other securities. See Part IV, line 11 ......			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets .........			0	14	1,700,000
15	Other assets. See Part IV, line 11 ...........			13,557,074	15	15,865,043
16	Total assets. Add lines 1 through 15 (must equal line 34)...			159,342,701	16	171,179,695
17	Accounts payable and accrued expenses .			14,169,766	17	16,596,314
18	Grants payable ..........			0	18	0
19	Deferred revenue ..........			0	19	0
20	Tax-exempt bond liabilities ..........			45,706,429	20	42,529,501
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			23,874	24	0
25	Other liabilities. Complete Part X of Schedule D.....			18,059,690	25	14,826,693
26	Total liabilities. Add lines 17 through 25.....			77,959,759	26	73,952,508
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			73,417,005	27	88,701,494
28	Temporarily restricted net assets .....			5,845,523	28	6,401,695
29	Permanently restricted net assets .....			2,120,414	29	2,123,998
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			81,382,942	33	97,227,187
34	Total liabilities and net assets/fund balances .....			159,342,701	34	171,179,695