2025-05-15T09:53:46-05:00 2024-06-30 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2023-07-01 200934451 AVITA HEALTH FOUNDATION AVIT 4194684841 269 PORTLAND WAY SOUTH GALION OH 44833 D ERIC DRAIME CFO 4194684841 2025-05-13 1 1 AMY CIMINELLO P00796388 6148493000 2025-03-26 2023 2025-03-06 01:10:19Z JERRY MORASKO 269 PORTLAND WAY SOUTH GALION OH 44833 1337187 0 X HTTPS://AVITAHEALTH.ORG/FOUNDATION/ X 2004 OH INSPIRE PHILANTHROPY AND PROVIDE FINANCIAL SUPPORT TO GALION COMMUNITY HOSPITAL AND AVITA HEALTH SYSTEM IN WAYS THAT HAVE A POSITIVE IMPACT ON PATIENTS, EMPLOYEES, AND THE COMMUNITY. 12 11 0 11 0 0 1067540 1149323 0 0 38527 46923 -132030 -46804 974037 1149442 466070 432234 0 0 0 0 0 0 249351 286856 273752 752926 705986 221111 443456 3242643 3892159 3377 9627 3239266 3882532 TO INSPIRE PHILANTHROPY AND TO PROVIDE FINANCIAL SUPPORT TO GALION AND BUCYRUS COMMUNITY HOSPITALS IN ORDER TO ENHANCE HEALTHCARE SERVICES AND TO IMPROVE THE WELL BEING OF THE RESIDENTS OF OUR COMMUNITIES. 0 0 432234 432234 0 SUPPORT AVITA HEALTH SYSTEM, GALION, BUCYRUS, AND ONTARIO HOSPITALS AND SUBSIDIARY ORGANIZATIONS THAT PROMOTE HEALTH CARE IN CRAWFORD COUNTY, OHIO AND SURROUNDING COUNTIES. 432234 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X D ERIC DRAIME 4194680501 269 PORTLAND WAY SOUTH GALION OH 44833 JERRY MORASKO PRESIDENT 0.20 40.60 X X 0 775227 19187 D ERIC DRAIME CFO 0.20 40.60 X X 0 405852 3050 MYLES CREED SECRETARY/TREASURER/VP OF MEDICAL STAFF 0.20 39.80 X X 0 229576 5867 MATT HORN VICE CHAIR 0.20 0.00 X X 0 0 0 RANDY MCDONALD CHAIR 0.20 0.00 X X 0 0 0 DR ERIC HAUS DIRECTOR 0.20 40.60 X 0 475748 9565 LARRY MORRISON DIRECTOR 0.20 0.00 X 0 0 0 MARYLYN STRANG DIRECTOR 0.20 0.00 X 0 0 0 BOYD EPPERSON HONORARY DIRECTOR 0.20 0.00 X 0 0 0 DAWN RATLIFF DIRECTOR 0.20 0.00 X 0 0 0 NICHOLAS GESOURAS DIRECTOR 0.20 0.00 X 0 0 0 ERIC GEYER HONORARY DIRECTOR 0.20 0.00 X 0 0 0 RICHARD HARER DIRECTOR 0.20 0.00 X 0 0 0 TROY SAPP DIRECTOR 0.20 0.00 X 0 0 0 CALEB ULMER DIRECTOR 0.20 0.00 X 0 0 0 DR GWENDOLINE FANG DIRECTOR 0.20 40.60 X 0 376384 9958 0 2262787 47627 0 0 1 0 0 466728 391298 23710 267587 1149323 46923 46923 140941 466728 187745 -46804 -46804 1149442 0 0 119 407734 407734 24500 24500 189769 189769 9860 9860 49067 49067 22908 14541 8367 2148 2148 705986 432234 24401 249351 1915187 2357463 9935 9585 1317521 1525111 3242643 3892159 3377 9627 3377 9627 X 1622971 1987250 1616295 1895282 3239266 3882532 3242643 3892159 443456 199810 0 X X 0 1 X 1 1 0 X 722337 1237953 1253985 1067540 1149323 5431138 722337 1237953 1253985 1067540 1149323 5431138 840776 4590362 859 28390 33447 38527 46923 148146 57320 13823 50396 180728 140941 443208 6022492 0.76220 0.72400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 HELD FOR FUTURE INVESTMENTS 1525111 1525111 COMPREHENSIVE CAMPAIGN 116625 116625 CORNERSTONE 180640 180640 1 310404 169463 140941 187745 607669 466728 140941 187745 187745 -46804 1 GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 448332399 344451872 501(C)(3) 407734 0 SUPPORT THE HOSPITAL'S TAX EXEMPT PURPOSE 1 0 AVITA EMPLOYEE CRISIS 12 12000 SCHOLARSHIP 23 12500 PART I, LINE 2: GRANTS ARE USED TO SUPPORT THE TAX-EXEMPT PURPOSE OF RELATED ENTITIES. THESE ARE MONITORED INTERNALLY. SCHEDULE I, PART III: GALION COMMUNITY HOSPITAL EMPLOYEES ARE ELIGIBLE FOR REIMBURSEMENT. APPLICATIONS ARE APPROVED BY HUMAN RESOURCES. TUITION INVOICES AND GRADES ARE MONITORED BY THE CONTROLLER TO MAKE SURE THE STUDENT MEETS CERTAIN CRITERIA TO RECEIVE THE FUNDS. 0 0 0 0 0 0 0 0 0 JERRY MORASKO PRESIDENT 0 706318 0 68909 0 0 0 0 0 19187 0 794414 0 0 DR ERIC HAUS DIRECTOR 0 320005 0 155743 0 0 0 0 0 9565 0 485313 0 0 D ERIC DRAIME CFO 0 353139 0 52713 0 0 0 0 0 3050 0 408902 0 0 DR GWENDOLINE FANG DIRECTOR 0 355367 0 21017 0 0 0 0 0 9958 0 386342 0 0 MYLES CREED SECRETARY/TREASURER/VP OF MEDICAL ST 0 200237 0 29339 0 0 0 0 0 5867 0 235443 0 0 PART I, LINE 3: AVITA HEALTH FOUNDATION RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD -COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL, AT ALL TIMES, BE GALION COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR DIRECTORS SHALL HAVE THE APPROVAL OF THE BOARD OF DIRECTORS OF GALION COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, SUCH AS APPROVAL OF THE GOVERNING BODY'S ELECTION OR REMOVAL OF MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE SUB-COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND SENT TO THE EXECUTIVE COMMITTEE OF GALION COMMUNITY HOSPITAL'S BOARD FOR THEIR REVIEW PRIOR TO FILING. THE BOARD EXECUTIVE COMMITTEE APPROVES THE FORM 990 FOLLOWING REVIEW, AS AUTHORIZED BY THE FULL GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C GALION COMMUNITY HOSPITAL HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL BOARD OF DIRECTORS AND OFFICERS OF THE CORPORATION. CONFLICT OF INTEREST SURVEYS ARE REVIEWED BY BOARD CHAIRMAN AND THE CEO TO ENSURE COMPLIANCE. VARIOUS RESTRICTIONS ARE IMPOSED ON INDIVIDUALS WITH POTENTIAL CONFLICTS OF INTEREST (I.E. INABILITY TO VOTE) UNTIL DECISION HAS BEEN MADE ON POTENTIAL CONFLICT. AVITA HEALTH FOUNDATION HAS ADOPTED THIS POLICY. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC, OTHER THAN THE FINANCIAL STATEMENTS WHICH ARE ATTACHED TO GALION COMMUNITY HOSPITAL'S FORM 990. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A FINANCE COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 3B: SINGLE AUDIT IS IN PROCESS AND WILL BE COMPLETED ON A CONSOLIDATED BASIS. GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 44833 344451872 HOSPITAL SERVICES OH 501(C)(3) LINE 3 AVITA HEALTH SYSTEM 1 COMMUNITY HEALTH ASSOCIATES INC 955 BUCYRUS ROAD GALION OH 44833 341784017 PHYSICIAN OFFICE OH 501(C)(3) LINE 12A, I GALION COMMUNITY HOSPITAL 1 NORTH CENTRAL OHIO FAMILY CARE CENTER INC 269 PORTLAND WAY SOUTH GALION OH 44833 341807906 PHYSICIAN OFFICE OH 501(C)(3) LINE 12A, I GALION COMMUNITY HOSPITAL 1 AVITA HEALTH SYSTEM 269 PORTLAND WAY SOUTH GALION OH 44833 274385692 HEALTHCARE OH 501(C)(3) LINE 12B, II N/A 0 CRAWFORD COUNTY SHARED HEALTH SERVICES INC 1220 NORTH MARKET STREET GALION OH 44833 341484014 HOME HEALTH & HOSPICE OH 501(C)(3) LINE 11 GALION COMMUNITY HOSPITAL 1 GALION COMMUNITY PAIN MANAGEMENT LLC 269 PORTLAND WAY SOUTH GALION OH 44833 300602607 HOSPITAL SUPPORT OH N/A 0 0 GALION COMMUNITY VASCULAR SERVICES LLC 269 PORTLAND WAY SOUTH GALION OH 44833 611613817 HOSPITAL SUPPORT OH N/A 0 0 AMERICAN SURGICAL SPINE SERVICES 629 N SANDUSKY AVE BUCYRUS OH 44820 371786727 HOSPITAL SUPPORT OH N/A 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1