Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
TRINITY HOSPITAL HOLDING CO |
341842025 | 3 | Yes | 0 | 0 | |
| (B)
TRINITY EAST |
340714474 | 3 | Yes | 0 | 0 | |
| (C)
TRINITY WEST |
340875691 | 3 | Yes | 0 | 0 | |
Total 3
|
0 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
||||
| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
||||
|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
||||
|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A PART I LINE 11H | INSTEAD OF MONETARY SUPPORT, SUPPORTED ORGANIZATIONS RECEIVE SUPPORT IN THE MEANS OF MANAGEMENT AND SUPPORT SERVICES. |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | TRINITY HEALTH SYSTEM HAS TWO CO-SPONSORING MEMBERS, TRI-STATE HEALTH SERVICES AND SYLVANIA FRANCISCAN HEALTH. |
| FORM 990, PART VI, SECTION A, LINE 7A | TRINITY HEALTH SYSTEM HAS TWO CO-SPONSORING MEMBERS, TRI-STATE HEALTH SERVICES AND SYLVANIA FRACISCAN HEALTH. ALL TRUSTEES ARE ELECTED BY 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. |
| FORM 990, PART VI, SECTION A, LINE 7B | TRINITY HEALTH SYSTEM HAS TWO CO-SPONSORING MEMBERS, TRI-STATE HEALTH SERVICES AND SYLVANIA FRANCISCAN HEALTH. BOTH MEMBERS MUST APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION OR ANY OF ITS SUBSIDIARIES AS A CONDITION BEFORE THEY BECOME EFFECTIVE: 1) MERGER, CONSOLIDATION, OR SUBSTANTIAL SALE; 2) CREATION OF SUBSIDIARIES OR AFFILIATION WITH OTHER ENTITIES; 3) CONVEYANCING REAL PROPERTY OR CREATING LIENS THEREON; 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. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 TAX RETURN FOR THE FOUNDATION, HEALTH SYSTEM AND GROUP RETURN IS REVIEWED ANNUALLY WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE COMPLETE BOARD WILL BE NOTIFIED THE 990 IS COMPLETE AND WILL BE MADE AVAILABLE TO THEM AT THEIR REQUEST. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH BOARD MEMBER, OFFICER AND VICE PRESIDENT IS REQUIRED TO COMPLETE A DISCLOSURE OF POTENTIAL CONFLICTS FORM. CONFLICTS ARE DEFINED BY THE APPLICABLE POLICY, ON AN ANNUAL BASIS. EACH SUBMISSION IS REVIEWED BY THE BOARD CHAIR AND THE SYSTEM CEO, 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 OF TRUSTEES, 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. |
| FORM 990, PART VI, SECTION B, LINE 15 | EACH EXECUTIVE'S COMPENSATION, INCLUDING THE CEO, IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE REVIEW IS DOCUMENTED IN THE MEETING MINUTES. THE BOARD IS PROVIDED WITH SALARY COMPARISON DATA, WHICH IS PREPARED BY THE OHIO HOSPITAL ASSOCIATION EACH YEAR. AN OUTSIDE FIRM DOES A COMPENSATION SURVEY THAT IS ALSO PROVIDED TO THE BOARD. THIS PROCESS WAS LAST UNDERTAKEN IN 2013. |
| FORM 990, PART VI, SECTION C, LINE 19 | TRINITY HEALTH SYSTEM MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS FROM THE PRIOR YEAR. |
| FORM 990, PAGE 1, LINE H(C), GROUP EXEMPTION NUMBER: | TRINITY HEALTH SYSTEM IS INCLUDED WITHIN TWO GROUP EXEMPTION NUMBERS, #5388 FOR TRINITY HOSPITAL HOLDING COMPANY (TRINITY HEALTH SYSTEM, #34-1818681, PARENT), AND #0928 TO THE CATHOLIC HEALTH ASSOCIATION AND ITS AFFILIATED ORGANIZATIONS, OF WHICH IT IS A SUBORDINATE. |
| FORM 990, SCHEDULE R, PART II: | THE RELATED TAX EXEMPT ORGANIZATIONS ARE ALL MEMBERS OF GROUP EXEMPTION # 0928. |
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