SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
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OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
TRINITY HEALTH MID-ATLANTIC MEDICAL
GROUP F/K/A LANGHORNE PHYSICIAN SERVICES
Employer identification number

23-2571699
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF LANGHORNE PHYSICIAN SERVICE IS SMMC. SEE LINE 7 FOR ADDITIONAL INFORMATION.
FORM 990, PART VI, SECTION A, LINE 7A SMMC IS THE SOLE MEMBER OF LANGHORNE PHYSICIAN SERVICE. SMMC HAS THE RIGHT TO APPOINT ALL PERSONS TO THE BOARD OF DIRECTORS OF LANGHORNE PHYSICIAN SERVICE.
FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER, SMMC MUST APPROVE CERTAIN DECISIONS OF THE GOVERNING BODY, INCLUDING THE STRATEGIC PLAN, ANNUAL CAPITAL PLAN, AND ANNUAL OPERATING BUDGET. SMMC MUST ALSO APPROVE SIGNIFICANT CHANGES SUCH AS A MERGER, DISSOLUTION, SALE OF ASSETS IN EXCESS OF CERTAIN LIMITS, AND MODIFICATIONS TO GOVERNING DOCUMENTS. CERTAIN POWERS ARE RESERVED TO TRINITY HEALTH OF THE MID ATLANTIC, AS THE SOLE MEMBER OF SMMC, AND TO TRINITY HEALTH CORPORATION, AS THE PARENT OF THE NATIONAL TRINITY HEALTH SYSTEM. THESE INCLUDE THE AUTHORITY TO ADOPT OR MODIFY THE ORGANIZATION'S GOVERNING DOCUMENTS, TO APPROVE MAJOR CHANGES SUCH AS A MERGER OR DISSOLUTION, AND TO APPROVE SIGNIFICANT FINANCE MATTERS IN EXCESS OF CERTAIN LIMITS ESTABLISHED BY TRINITY HEALTH CORPORATION.
FORM 990, PART VI, SECTION A, LINE 8B LINE 8B IS ANSWERED "NO" BECAUSE LANGHORNE PHYSICIAN SERVICES HAD NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, THE FORM 990 FOR LANGHORNE PHYSICIAN SERVICE IS REVIEWED BY MANAGEMENT. EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE RETURN IN ITS FINAL FORM BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C LANGHORNE PHYSICIAN SERVICE HAS ADOPTED TRINITY HEALTH'S GOVERNANCE POLICY NO. 1, WHICH SETS FORTH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND PROCESSES. IT APPLIES TO ALL "INTERESTED PERSONS" OF LANGHORNE PHYSICIAN SERVICE, WHICH INCLUDES DIRECTORS, PRINCIPAL OFFICERS, AND KEY EMPLOYEES. INTERESTED PERSONS ARE EXPECTED TO DISCHARGE THEIR DUTIES IN A MANNER THE PERSON REASONABLY BELIEVES TO BE IN THE BEST INTERESTS OF LANGHORNE PHYSICIAN SERVICE AND TO AVOID SITUATIONS INVOLVING A CONFLICT OF INTEREST. ON AN ANNUAL BASIS, INTERESTED PERSONS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT AND TO AFFIRM THEIR RECEIPT OF THE CONFLICT OF INTEREST POLICY, COMPLIANCE WITH ITS REQUIREMENTS, AND AGREE TO NOTIFY THE ORGANIZATION OF CHANGES IMPACTING THEIR ANNUAL DISCLOSURE IN ACCORDANCE WITH THE POLICY. THE ANNUAL DISCLOSURES ARE PROVIDED TO THE INTEGRITY AND COMPLIANCE OFFICER. IF A POTENTIAL CONFLICT IS IDENTIFIED, THE INTEGRITY AND COMPLIANCE OFFICER SHARES THE DISCLOSURES WITH INTERNAL LEGAL COUNSEL, FROM WHICH LEGAL COUNSEL PREPARES A REPORT FOR THE BOARD CHAIR AND CEO. A SUMMARY OF POTENTIAL CONFLICTS IS REVIEWED WITH THE BOARD OF DIRECTORS OF LANGHORNE PHYSICIAN SERVICE ON A YEARLY BASIS. INTERESTED PERSONS ARE REQUIRED TO MAKE FULL DISCLOSURE TO LANGHORNE PHYSICIAN SERVICE OF ANY FINANCIAL OR BUSINESS INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT OF INTEREST. THE BOARD OF DIRECTORS OF LANGHORNE PHYSICIAN SERVICE IS RESPONSIBLE FOR THE REVIEW OF TRANSACTIONS TO DETERMINE WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS. IN THE EVENT OF AN ACTUAL CONFLICT, THE BOARD WILL EITHER AVOID THE CONFLICT OR APPROPRIATELY SCRUTINIZE THE TRANSACTION TO ENSURE IT IS IN THE BEST INTERESTS OF LANGHORNE PHYSICIAN SERVICE. INTERESTED PERSONS ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION AND VOTING ON MATTERS INVOLVING A CONFLICT OF INTEREST. THE POLICY FURTHER ADDRESSES THE PROPER DOCUMENTATION OF THE PROCEEDINGS AND POTENTIAL DISCIPLINARY AND CORRECTIVE ACTION FOR VIOLATIONS OF THE POLICY. THE POLICY IS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15 QUESTIONS 15A AND 15B ARE ANSWERED "NO" BECAUSE THE COMPENSATION FOR CERTAIN OFFICERS AND KEY MANAGEMENT OFFICIALS OF LANGHORNE PHYSICIAN SERVICE IS ESTABLISHED BY TRINITY HEALTH, A RELATED ORGANIZATION. IN ESTABLISHING CEO AND CFO COMPENSATION, TRINITY HEALTH FOLLOWS A PROCESS AND POLICY THAT IS INTENDED TO MIRROR THE IRC SECTION 4958 GUIDELINES FOR OBTAINING A "REBUTTABLE PRESUMPTION OF REASONABLENESS" WITH REGARD TO COMPENSATION AND BENEFITS. AS PART OF THAT PROCESS, THE COMPENSATION AND BENEFITS OF THE CEO AND CFO OF LANGHORNE PHYSICIAN SERVICE ARE REVIEWED AT LEAST ANNUALLY BY THE TRINITY HEALTH BOARD OR THE TRINITY HEALTH HUMAN RESOURCES AND COMPENSATION COMMITTEE (HRCC) OF THE BOARD, AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH RESPECT TO CERTAIN COMPENSATION MATTERS. AS PART OF ITS REVIEW PROCESS, THE HRCC RETAINS AN INDEPENDENT FIRM EXPERIENCED IN COMPENSATION AND BENEFIT MATTERS FOR NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS TO ADVISE IT IN THE DETERMINATIONS IT MAKES ON THE REASONABLENESS OF PROPOSED COMPENSATION AND BENEFITS ARRANGEMENTS. TO ESTABLISH THE COMPENSATION OF OTHER EXECUTIVES, THE TRINITY HEALTH EXECUTIVE COMPENSATION PHILOSOPHY DESCRIBED ABOVE IS USED AS A BASIS FOR BOTH BASE SALARY AND TOTAL CASH COMPENSATION, IN CONJUNCTION WITH A MARKET ANALYSIS, TO DETERMINE THE APPROPRIATENESS OF THE EXECUTIVE'S COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19 LANGHORNE PHYSICIAN SERVICE IS A SUBSIDIARY ORGANIZATION IN THE TRINITY HEALTH SYSTEM. TRINITY HEALTH MAKES CERTAIN OF ITS KEY DOCUMENTS AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.TRINITY-HEALTH.ORG, IN THE "ABOUT US" SECTION. IN THIS SECTION, THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE. LANGHORNE PHYSICIAN SERVICES' GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9: EQUITY TRANSFER FROM AFFILIATES 505,439.
FORM 990, PART XII, LINE 2: LANGHORNE PHYSICIAN SERVICES' FINANCIAL STATEMENTS WERE INCLUDED IN THE FY22 CONSOLIDATED FINANCIAL STATEMENTS OF TRINITY HEALTH, WHICH WERE AUDITED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM.
FORM 990, PAGE 1, DOING BUSINESS AS NAMES: THE BARIATRIC AND METABOLIC SURGERY PROGRAM AT ST MARY ST MARY BARIATRIC & METABOLIC SURGERY LANGHORNE BUCKS COUNTY GERIATRICS ST MARY BUCKS COUNTY GERIATRICS COMPREHENSIVE CARDIOLOGY CONSULTANTS, LANGHORNE PHYSICIAN SERVICE ST MARY COMPREHENSIVE CARDIOLOGY LANGHORNE COMPREHENSIVE INTERNAL MEDICINE ST MARY COMPREHENSIVE INTERNAL MEDICINE NEWTOWN COMPREHENSIVE UROLOGIC SPECIALISTS ST MARY COMPREHENSIVE UROLOGIC SPECIALISTS LANGHORNE FAIRLESS HILLS MEDICAL CENTER, LANGHORNE PHYSICIAN SERVICE HEART CARE ASSOCIATES OF BUCKS COUNTY, LANGHORNE PHYSICIAN SERVICE ST MARY HEART CARE ASSOCIATES BUCKS COUNTY JUNEWOOD MEDICAL PRACTICE ST MARY JUNEWOOD FAMILY PRACTICE LEVITTOWN LANGHORNE INTERNAL MEDICINE ST MARY LANGHORNE INTERNAL MEDICINE LANGHORNE PLASTIC AND RECONSTRUCTIVE SURGERY ST MARY PLASTIC AND RECONSTRUCTIVE SURGERY LANGHORNE PHYSICIAN SERVICE BUCKS COUNTY FAMILY PRACTICE MEDICAL ARTS, LANGHORNE PHYSICIAN SERVICE ST MARY MEDICAL ARTS INTERNAL MEDICINE LANGHORNE NORTHAMPTON FAMILY PRACTICE LANGHORNE PHYSICIAN SERVICE ST MARY NORTHAMPTON FAMILY PRACTICE OB HOUSE PHYSICIANS ST MARY MEDICAL CENTER PAIN MANAGEMENT ST MARY OB/GYN BUCKS COUNTY ST MARY PHYSICIANS GROUP WHALEN & MCELMOYLE FAMILY MEDICINE WOMEN'S HEALTH ASSOCIATES OF BUCKS COUNTY ST MARY WOMEN'S HEALTH ASSOCIATES OF BUCKS COUNTY WOODBOURNE FAMILY PRACTICE ST MARY WOODBOURNE FAMILY PRACTICE LEVITTOWN ST MARY COMPREHENSIVE INTERNAL MEDICINE RICHBORO ST MARY SURGICAL ASSOCIATES LANGHORNE ST MARY FAMILY PRACTICE SOUTHAMPTON
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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