AULTMAN HEALTH FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
AULTMAN HEALTH FOUNDATION (EIN 34-0714538)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201313199349301191
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T09:17:03-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1200 E Main St Suite 700AddressLine1
CityFort WayneCity
StateINState
ZIP Code46802ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN340714538EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1AULTMAN HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MARK WRIGHTInCareOfName
Name ControlAULTNameControl
Phone3303636352Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 SIXTH STREET SWAddressLine1
Address Line2SuiteAddressLine2
CityCANTONCity
StateOHState
ZIP Code44710ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK WRIGHTName
TitleCFOTitle
Phone3303636352Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJoyce A DulworthName
Phone2604604000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK WRIGHTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12600 SIXTH STREET SWAddressLine1
CityCANTONCity
StateOHState
ZIP Code44710ZIPCode
FieldValueIRS element (for citing)
Gross Receipts471299262GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.AULTMAN.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1935YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION STATEMENT OF AULTMAN HOSPITAL IS TO "LEAD OUR COMMUNITY TO IMPROVED HEALTH."ActivityOrMissionDescription
Nbr Voting Members Governing Body43NbrVotingMembersGoverningBody
Nbr Independent Voting Members37NbrIndependentVotingMembers
Total Nbr Employees4487TotalNbrEmployees
Total Nbr Volunteers548TotalNbrVolunteers
Total Gross UBI1267681TotalGrossUBI
Contributions Grants Prior Year2609151ContributionsGrantsPriorYear
Contributions Grants Current Year1456000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year461048043ProgramServiceRevenuePriorYear
Program Service Revenue CY460599872ProgramServiceRevenueCY
Investment Income Prior Year30814InvestmentIncomePriorYear
Investment Income Current Year18226InvestmentIncomeCurrentYear
Other Revenue Prior Year9744529OtherRevenuePriorYear
Other Revenue Current Year9225164OtherRevenueCurrentYear
Total Revenue Prior Year473432537TotalRevenuePriorYear
Total Revenue Current Year471299262TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year308128GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY586875GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year233458628SalariesEtcPriorYear
Salaries Etc Current Year231349666SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year228287208OtherExpensePriorYear
Other Expenses Current Year240704171OtherExpensesCurrentYear
Total Expenses Prior Year462053964TotalExpensesPriorYear
Total Expenses Current Year472640712TotalExpensesCurrentYear
Revenues Less Expenses Prior Year11378573RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1341450RevenuesLessExpensesCY
Total Assets BOY310198352TotalAssetsBOY
Total Assets EOY305767460TotalAssetsEOY
Total Liabilities BOY44395791TotalLiabilitiesBOY
Total Liabilities EOY59720229TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY265802561NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY246047231NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAULTMAN HOSPITAL'S MISSION IS TO LEAD OUR COMMUNITY TO IMPROVED HEALTH. AULTMAN HOSPITAL HAS BEEN MEETING THE HEALTH CARE NEEDS OF STARK AND SURROUNDING COUNTIES FOR NEARLY 120 YEARS. AULTMAN CARES FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. AULTMAN CONTINUOUSLY INVESTS IN FACILITIES AND TECHNOLOGY TO IMPROVE PATIENT CARE. AULTMAN PROVIDES EDUCATIONAL OPPORTUNITIES FOR STUDENTS IN HIGH SCHOOL, COLLEGE, MEDICAL SCHOOL AND RESIDENCY PROGRAMS. THROUGH OUTREACH EFFORTS INCLUDING THE WELLNESS ON WHEELS (WOW) MOBILE HEALTH-FAIR UNIT, AULTMAN OFFERS HEALTH AND WELLNESS EDUCATION FOR OUR COMMUNITY. AULTMAN IS ONE OF THE LOWEST-COST HEALTH CARE PROVIDERS IN NORTHEASTERN OHIO, HELPING LOCAL BUSINESSES STAY FINANCIALLY HEALTHY AND MAINTAIN GOOD JOBS IN OUR COMMUNITY. IN RECOGNITION OF THE HOSPITALS LOW-COST AND HIGH-QUALITY PHILOSOPHY, AULTMAN WAS HONORED BY BEING NAMED ONE OF THE 100 TOP HOSPITALS IN THE UNITED STATES BY THOMSON REUTERS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense360213551Expense
Grants586875Grants
Revenue399827580Revenue
DescriptionAULTMAN HOSPITAL IS A NOT-FOR-PROFIT TEACHING HOSPITAL SERVING STARK AND SURROUNDING COUNTIES IN NORTHEAST OHIO. THE HOSPITAL'S MAJOR PROGRAMS INCLUDE WOMEN AND CHILDREN'S SERVICES, EMERGENCY AND TRAUMA SERVICES, HEART SERVICES, CANCER CARE, NEUROSURGERY AND ORTHOPEDICS AND CRITICAL-CARE MEDICINE. EACH YEAR, AULTMAN HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF THE AREA'S TOTAL CARE FOR PATIENTS HAVING NO GOVERNMENT OR PRIVATE HEALTH CARE INSURANCE. IN 2012, AULTMAN CARED FOR UNINSURED PATIENTS. AULTMAN ALSO SERVES THOUSANDS OF PATIENTS COVERED BY PROGRAMS SUCH AS MEDICAID.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense24681765Expense
Revenue32734524Revenue
DescriptionSUBACUTE SERVICES: AULTMAN PROVIDES POST-ACUTE SERVICES AT ITS AULTMAN WOODLAWN FACILITY. AULTMAN WOODLAWN INCLUDES A 60-BED UNIT FOR PATIENTS REQUIRING SKILLED NURSING CARE AND A 30-BED UNIT FOR PATIENTS NEEDING REHABILITATION. AULTMAN WOODLAWN FEATURES INDOOR THERAPY ENVIRONMENTS SUCH AS A MOCK KITCHEN, BEDROOM, STORE AND GAS STATION - ALONG WITH AN OUTDOOR COURTYARD FEATURING A HYDROPONIC GARDEN - TO HELP PATIENTS IMPROVE THEIR MOBILITY AND PREPARE FOR DISCHARGE. AULTMAN WOODLAWN ALSO HOUSES AULTMAN'S HOSPICE, PALLIATIVE CARE, HOME HEALTH CARE, ALTERNATIVE DAILY LIVING AND GRIEF SERVICES PROGRAMS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense22907735Expense
Revenue30815355Revenue
DescriptionAULTMAN PROVIDES AN ARRAY OF MEDICAL SERVICES AT COMMUNITY CENTERS LOCATED THROUGHOUT STARK AND CARROLL COUNTIES. IMMEDIATE CARE SERVICES ARE AVAILABLE FOR MINOR INJURIES AND ILLNESSES - SEVEN DAYS A WEEK, EVERY DAY OF THE YEAR. SERVICES SUCH AS PHYSICAL AND OCCUPATIONAL THERAPY, CARDIAC REHABILITATION, OUTPATIENT LABORATORY SERVICES, SPORTS MEDICINE PROGRAMS AND DIAGNOSTIC TESTING ARE ALSO AVAILABLE AT THE AULTMAN SATELLITE FACILITIES.Description
FieldValueIRS element (for citing)
Total Program Service Expense407803051TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096502NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees4487NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members43NbrVotingGoverningBodyMembers
Number Independent Voting Members37NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARK WRIGHTNamePerson
Telephone Number3303636192TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12600 SIXTH STREET SWAddressLine1
CityCANTONCity
StateOHState
ZIP Code44710ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (55 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
T STEPHEN GREGORY
CHAIR1.0XX000
JOSEPH R HALTER JR
VICE CHAIR1.0XX000
EDWARD J ROTH III
CEO AND PRESIDENT - AHF5.0XX05997101709350.0
DAVID W BARTLEY II
DIRECTOR1.0X000
WILLIAM H BELDEN JR
DIRECTOR1.0X000
BARBARA HAMMONTREE BENNETT
DIRECTOR1.0X000
PAUL R BISHOP
DIRECTOR1.0X000
SHEILA MARKLEY BLACK ESQ
DIRECTOR1.0X000
THEODORE V BOYD
DIRECTOR1.0X000
STEPHEN G DEUBLE
DIRECTOR1.0X000
DARRYL J DILLENBACK
DIRECTOR1.0X000
MILAN R DOPIRAK MD
DIRECTOR/PHYSICIAN54.0X0388530139971.0
LEO E DOYLE
DIRECTOR1.0X000
GLENN A EISENBERG
DIRECTOR1.0X000
NORMAN J GAYNOR III
DIRECTOR1.0X000
PATRICIA A GRISCHOW
DIRECTOR1.0X000
RICK L HAINES
DIRECTOR1.0X04168342020254.0
MICHAEL E HANKE
DIRECTOR1.0X000
GEORGE W LEMON
DIRECTOR1.0X000
GENE E LITTLE
DIRECTOR1.0X000
HARRY C MACNEALY
DIRECTOR1.0X000
MICHAEL RICH MD
DIRECTOR1.0X000
MARC L SCHNEIDER
DIRECTOR1.0X025382020.0
LOUIS G SHAHEEN MD
DIRECTOR1.0X000
DOUGLAS J SIBILA
2ND VICE CHAIR & SECRETARY1.0XX000
JOHN A SIRPILLA
DIRECTOR1.0X000
VICKY L STERLING
DIRECTOR1.0X000
R CLINT ZOLLINGER ESQ
DIRECTOR1.0X000
JEFFERY MILLER MD
DIRECTOR1.0X
BRIAN S BELDEN
DIRECTOR1.0X000
WILLIAM WALLACE MD
DIRECTOR1.0X000
JOHN B HUMPHREY JR MD
DIRECTOR1.0X000
DAVID M FINDLEY
DIRECTOR1.0X000
PEGGY R CLAYTON
DIRECTOR1.0X000
JAMES E KNISELY
DIRECTOR1.0X000
RONALD R LYONS
DIRECTOR1.0X000
ROBERT W SABOTA MD
DIRECTOR6.0X3000000
TODD M SOMMER
DIRECTOR1.0X000
TIMOTHY O'TOOLE MD
DIRECTOR3.0X500000
CHARLES B SCHEURER
DIRECTOR1.0X000
DENISE HILL
DIRECTOR1.0X000
SUE HOSTETLER
DIRECTOR1.0X000
NATE J COOKS
DIRECTOR1.0X000
MARK D WRIGHT
CHIEF FINANCIAL OFFICER - AHF5.0X03368821709350.0
CHRISTOPHER E REMARK
TREASURER & COO50.0X3391170177525.0
ALLISON M OPRANDI MD
PHYSICIAN55.0341225017093X
ANNE M GUNTHER
CHIEF NURSING OFFICER55.0235989010227X
SUSAN E MERCER
MEDICAL DIRECTOR55.0237402019449X
EILEEN F GOOD
CEO OF POST ACUTE SERVICES50.00307689148075.0X
ROBERT C MOLNAR
VP PHYSICIAN RELATIONS55.0158592013030X
PRABHCHARAN P GILL MD
PHYSICIAN55.0626073019663X
MICHAEL A KREW MD
PHYSICIAN55.0609593017752X
ELETHERIOS P MAMOUNAS MD
PHYSICIAN55.0544732019663X
TIMOTHY E MCDANIEL MD
PHYSICIAN55.0629576019663X
LORI L MERTES
CHIEF QUALITY OFFICER55.028564807500X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4042947TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2075027TotalReportableCompFrmRltdOrgs
Total Other Compensation244984TotalOtherCompensation
Number Individuals GT100 K93NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
BREWER-GARRETT COMPANY
PO BOX 72324CLEVELANDOH44192CONTRACTING6318508
WHISLER PLUMBING HEATING
2521 LINCOLN WAY EASTMASSILLONOH446465052CONTRACTING2390405
CANTON MEDICAL EDUCATION FOUNDATION
2600 6TH ST SWCANTONOH44710PHYSICIAN SERVICES2053840
PERINATAL PEDIATRICS
2600 6TH STREET SOUTHWESTCANTONOH44710PHYSICIAN SERVICES1338605
PULMONARY PHYSICIANS INC
2600 TUSCARAWAS STREET WESTCANTONOH44708PHYSICIAN SERVICES1002900
FieldValueIRS element (for citing)
Number Of Contractors GT100 K220NumberOfContractorsGT100K
All Other Contributions1456000AllOtherContributions
Total Contributions1456000TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE621110372023713372023713
PREMIUM REVENUE6211108257666982576669
PHARMACY REVENUE62111059994905999490
FieldValueIRS element (for citing)
Total Program Service Revenue460599872TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column18226TotalRevenueColumn
Exclusion$18,226ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2028106Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real2028106Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column2028106TotalRevenueColumn
Exclusion$2,028,106ExclusionAmount

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
FOOD SERVICES6211102924272$2,924,272
LAUNDRY INCOME812300190264190264
LABORATORY INCOME62150010774171077417

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column3005105TotalRevenueColumn
Related Or Exempt Function Income2777587RelatedOrExemptFunctionIncome
Exclusion$227,518ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue7197058TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column471299262TotalRevenueColumn
Related Or Exempt Function Income463377459RelatedOrExemptFunctionIncome
Unrelated Business Revenue1267681UnrelatedBusinessRevenue
Exclusion$5,198,122ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total586875Total
Program Services586875ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2035612Total
Program Services1669202ProgramServices
Management And General366410ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total172447208Total
Program Services141406711ProgramServices
Management And General31040497ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6177388Total
Program Services5065458ProgramServices
Management And General1111930ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total37076375Total
Program Services30402628ProgramServices
Management And General6673747ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total13613083Total
Program Services11162728ProgramServices
Management And General2450355ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1171477Total
Program Services960611ProgramServices
Management And General210866ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total1121Total
Program Services919ProgramServices
Management And General202ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total103208Total
Program Services84631ProgramServices
Management And General18577ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total32712403Total
Program Services26824170ProgramServices
Management And General5888233ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1570002Total
Program Services1287402ProgramServices
Management And General282600ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22299460Total
Program Services18285557ProgramServices
Management And General4013903ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1688338Total
Program Services1384437ProgramServices
Management And General303901ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total10922766Total
Program Services8956668ProgramServices
Management And General1966098ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1352405Total
Program Services1108972ProgramServices
Management And General243433ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total147785Total
Program Services121184ProgramServices
Management And General26601ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total21893Total
Program Services17952ProgramServices
Management And General3941ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total23678225Total
Program Services19416145ProgramServices
Management And General4262080ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total21151824Total
Program Services17344496ProgramServices
Management And General3807328ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1178616Total
Program Services966465ProgramServices
Management And General212151ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES8502369585023695
EDUCATION23220671904096417971
BAD DEBT EXPENSE2682090126820901
FRANCHISE FEE719999759039981295999

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1337988Total
Program Services1097150ProgramServices
Management And General240838ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total472640712Total
Program Services407803051ProgramServices
Management And General64837661ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY16481BOY
EOY17165EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8785816BOY
EOY8549672EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY57557410BOY
EOY51662576EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY83273BOY
EOY19854EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3131637BOY
EOY2843275EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1941447BOY
EOY3394084EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis483080481LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec252000482LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
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Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1341450ReconcilationRevenueExpenses
Reconciliation Unrealized Invest19055ReconciliationUnrealizedInvest
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FS Audited Basis FSAuditedBasis

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Financial Statement ConsolidatedXFinancialStatementConsolidated
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Schedule A IRS990ScheduleA

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Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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Contributor Name Business ContributorNameBusiness

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Contributor Address US ContributorAddressUS

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Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
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ZIP CodeRESTRICTEDZIPCode
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Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

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Art Public Exhibition AmtsArtPublicExhibitionAmts
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Current Year CurrentYear

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Administrative Expenses6067AdministrativeExpenses
End Of Year Balance722589EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

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Administrative Expenses5572AdministrativeExpenses
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Current Year Minus2 Years CurrentYearMinus2Years

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Administrative Expenses5508AdministrativeExpenses
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Current Year Minus3 Years CurrentYearMinus3Years

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Current Year Minus4 Years CurrentYearMinus4Years

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Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
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Land Land

FieldValueIRS element (for citing)
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Book Value28298782BookValue

Buildings Buildings

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Other Cost Or Other Basis146298723OtherCostOrOtherBasis
Depreciation66738578Depreciation
Book Value79560145BookValue
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Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

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Other Land Buildings OtherLandBuildings

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Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
EST. THIRD-PARTY PAYOR SETTLEM$2,442,348
INTEREST RATE SWAP$86,269
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Tot Revenue Etc Audited Fincl Stmt448808920TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments19055NetUnrealizedGainsInvestments
Other Revenues4311504OtherRevenues
Revenue Not Rptd F9904330559RevenueNotRptdF990
Revenue Subtotal444478361RevenueSubtotal
Other Revenues Not Included26820901OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt26820901RevenueNotRptdOnFinStmt
Total Revenue Per Form990471299262TotalRevenuePerForm990
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Expenses Not Rptd On Fin Stmt26820901ExpensesNotRptdOnFinStmt
Total Expenses Per Form990472640712TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ENDOWMENT FUNDSPART V, LINE 4THE INTENDED USE FOR AULTMAN HOSPITAL'S ENDOWMENT IS TO SUPPORT THE CHAPLAINCY PROGRAM. ASC 740 FOOTNOTE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES FROM AUDITED CONSOLIDATED FINANCIAL STATEMENTS WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. IN ACCORDANCE WITH THE INCOME TAXES TOPIC OF THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION, THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS RECORDED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION.
RECONCILIATIONPART XI LINE 2D SEPARATELY REPORTED SUBSIDIARY REVENUE $4,311,504 LINE 4B BAD DEBT EXPENSE $26,820,901 PART XII LINE 2D SEPARATELY REPORTED SUBSIDIARY EXPENSE $4,818,188 LINE 4B BAD DEBT EXPENSE $26,820,901

Schedule H IRS990ScheduleH

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Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

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Discounted Other Percentage0DiscountedOtherPercentage
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Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense15188520TotalCommunityBenefitExpense
Direct Offsetting Revenue4285659DirectOffsettingRevenue
Net Community Benefit Expense10902861NetCommunityBenefitExpense
Percent Of Total Expense0.02450PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense53631947TotalCommunityBenefitExpense
Direct Offsetting Revenue35839297DirectOffsettingRevenue
Net Community Benefit Expense17792650NetCommunityBenefitExpense
Percent Of Total Expense0.03990PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
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Percent Of Total Expense0.06440PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
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Percent Of Total Expense0.00300PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
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Net Community Benefit Expense8870587NetCommunityBenefitExpense
Percent Of Total Expense0.01990PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
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Net Community Benefit Expense8027787NetCommunityBenefitExpense
Percent Of Total Expense0.01800PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense989352TotalCommunityBenefitExpense
Direct Offsetting Revenue969728DirectOffsettingRevenue
Net Community Benefit Expense19624NetCommunityBenefitExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
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Net Community Benefit Expense587757NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
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Direct Offsetting Revenue52398976DirectOffsettingRevenue
Net Community Benefit Expense18831675NetCommunityBenefitExpense
Percent Of Total Expense0.04220PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
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Direct Offsetting Revenue92523932DirectOffsettingRevenue
Net Community Benefit Expense47527186NetCommunityBenefitExpense
Percent Of Total Expense0.10660PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1325TotalCommunityBuildingExpense
Net Community Building Expense1325NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense1325TotalCommunityBuildingExpense
Net Community Building Expense1325NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$13,810,133BadDebtExpenseAmount
Amount Attributable To3089527AmountAttributableTo
Amount Reimbursed By Medicare88364983AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare89132645CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-767662MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
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Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1AULTMAN ONCOLOGY CENBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityONCOLOGY SERVICESDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.64770OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.35230PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities3NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (3 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalResearch FacilityResearchFacilityEr24 HoursEr24HoursOtherOther
AULTMAN HOSPITAL
12600 SIXTH ST NWCANTONOH44708XXXXXMAIN HOSPITAL
AULTMAN WOODLAWN
22821 WOODLAWN AVE NWCANTONOH44708XSKILLED NURSING REHABILITATION CTR HOME CARE & HOSPICE
AULTMAN WEST
32051 WALES AVE NWMASSILLONOH44646XXIMMEDIATE CARE DIAGNOSTICS, THERAPY AND SURGERY

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (3 entries)

Eligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesPosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
AULTMAN HOSPITAL
truetrue100truetrueXXXXXXXtruetrueXXXXXXtruefalsetrueXfalsefalse
AULTMAN WOODLAWN
truetrue100truetrueXXXXXXXtruetrueXXXXXXtruefalsetrueXfalsefalse
AULTMAN WEST
truetrue100truetrueXXXXXXXtruetrueXXXXXXtruefalsetrueXfalsefalse

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities11NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
AULTMAN NORTH
6100 WHIPPLE AVE NWNORTH CANTONOH44720Immediate Care, Diagnostics Therapy and Surgery
AULTMAN CENTER FOR DIALYSIS
2912 W TUSCARAWAS STCANTONOH44710Dialysis Center
CENTER FOR PAIN MANAGEMENT
2302 FULTON DR NWCANTONOH44718GENERAL MEDICAL & SURGICAL
HOME MEDICAL SUPPLY EQUIPMENT
5200 TUSCARAWAS STCANTONOH44708Medical Supply Co.
AULTWORKS
4650 HILLS DALES RD NWCANTONOH44708BWC Certified Treatment FACILITY
AULTMAN CARROLLTON
1020 TRUMP RDCARROLLTONOH44615Immediate Care, Diagnostics and Therapy
AULTMAN TUSCARAWAS
2615 Tuscarawas St WCANTONOH44708Therapy Clinic
WEIGHT MANAGEMENT
2615 TUSCARAWAS ST WCANTONOH44708Weight Management Program
AULTMAN FAMILY MEDICINE CENTER
4319 Hills Dales NWCANTONOH44708Outpatient Physician Clinic
AULTMAN FAMILY MEDICINE CENTER
8320 Waynesburg Dr SEWAYNESBURGOH44688Outpatient Physician Clinic
AULTMAN LOUISVILLE
1925 Williamsburg WayLOUISVILLEOH44641Therapy Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

IdentifierIdentifierExplanationExplanation
PART I, LINE 3B & 3CACCORDING TO AULTMAN HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), ALL MEDICALLY NECESSARY SELF PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE FEDERAL POVERTY GUIDELINES (FPG) AND ARE UPDATED ANNUALLY BASED ON THE UPDATES PUBLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% TO 100% OF FPG RECEIVES A 100% DISCOUNT, 101% TO 150% OF FPG IS DISCOUNTED 90%, 151% TO 200% IS DISCOUNTED 80%, 201% TO 250% IS DISCOUNTED 65%, 251% TO 300% IS DISCOUNTED 55%, 301% TO 350% IS DISCOUNTED 40%, 351% TO 400% IS DISCOUNTED 35%, AND 401% AND ABOVE IS DISCOUNTED 30%. PART I, LINE 6A Aultman Health Foundation, the parent company, publishes annually its annual report which includes all related organizations' programs and services designed to lead the community to improved health and promote healthy lifestyles. This report is available on Aultman's website.
PART I, LINE 7, COLUMN FBAD DEBT EXPENSE IN THE AMOUNT OF $26,820,901 IS INCLUDED ON FORM 990, PART IX, LINE 24, COLUMN (A) ("TOTAL FUNCTIONAL EXPENSES"), BUT IS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN THIS COLUMN. THE ORGANIZATION USES A COMBINATION OF THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H AND DIRECT COSTING METHOD OF CERTAIN PROGRAMS.
PART III, LINE 3Methodology for Bad Debt Related to Charity Care According to Aultman Hospitals Financial Assistance Policy (FAP), all medically necessary self-pay patients are eligible for financial assistance.(1) Eligibility criteria is based on the Federal Poverty guidelines and are updated annually based on the updates published by the United States of Health and Human Services. The FAP discount is based on income and family size. Self-pay balances will receive a minimum of 30% discount and up to 100% as long as the necessary Financial Assistance Application is complete. Patients must cooperate with the facility to provide the information and documentation necessary to determine eligibility. To determine the amount of bad debt expense that potentially could have been attributable to patients eligible under the organization's charity care policy the organization looked at all bad debt balances that were self-pay. From this population the organization identified those self-pay balances that did not receive any form of FAP or HCAP discount. Because all self-pay patients receive at least a minimum of 30% regardless of income, the assumption was made that if the account had no discount the proper paper work was not turned in to determine eligibility criteria. From this remaining population the estimated discount at cost that would have been provided if documentation had been received was calculated by applying the actual FAP distribution of patients who received discounts in 2012 and then multiplying this amount by the cost to charge ratio calculated in worksheet 2. PART III, LINE 4 Patient accounts receivable are reduced by an allowance for amounts that could become uncollectible in the future. Premium receivables are carried at original billed amount less an estimate for doubtful receivables based on a review of all outstanding amounts on a monthly basis. Premium receivables are considered past due to the extent that there is no related unearned premium. Additions to the allowance for doubtful accounts are made by means of the provision for doubtful accounts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The Foundation has determined, based on an assessment at the consolidated entity level, that patient service revenue is primarily recorded prior to assessing the patients ability to pay and as such, the entire provision for doubtful accounts related to patient revenue is recorded as a deduction from patient service revenue in the accompanying consolidated statements of operations. The amount of the provision for doubtful accounts, $30,159,000 and $24,339,000 for 2012 and 2011, respectively, is based upon managements assessment of the historical and expected net collections.
PART III, LINE 9BThe Collections Department will attempt to contact the patient; by phone, letter or a combination of the two, to settle a debt with payment in full or monthly installments. If it has been determined an account is approved for HCAP the account is removed from Bad Debt and the adjustment is applied. Also, if an account is approved for FAP, the account is removed from Bad Debt and the adjustment is applied. After the guideline adjustment has been made the remaining balance is sent back to resume collections. Once it has been determined that internal collection efforts will cease, the collector will request the account to be cancelled in both Ontario and MPAC. These accounts will then be referred to a secondary outside collection agency.
PART VAULTMAN HOSPITAL INCLUDES ONE DURABLE MEDICAL EQUIPMENT COMPANY, ONE PAIN MANAGEMENT CENTER, ONE SKILLED NURSING FACILITY, ONE HOME CARE, ONE HOSPICE, TWO BUREAU OF WORKMAN'S COMPENSATION CERTIFIED TREATMENT FACILITIES, ONE DIALYSIS CENTER, TWO FAMILY PRACTICES, ONE WEIGHT MANAGEMENT FACILITY, SIX THERAPY CLINICS, THREE DIAGNOSTIC CENTERS, TWO SAME DAY SURGERY CENTERS, ONE INPATIENT SURGERY CENTER, THREE IMMEDIATE CARE CENTERS. PART V LINE 10 ACCORDING TO AULTMAN HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), ALL MEDICALLY NECESSARY SELF PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE FEDERAL POVERTY GUIDELINES (FPG) AND ARE UPDATED ANNUALLY BASED ON THE UPDATES PUBLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% TO 100% OF FPG RECEIVES A 100% DISCOUNT, 101% TO 150% OF FPG IS DISCOUNTED 90%, 151% TO 200% IS DISCOUNTED 80%, 201% TO 250% IS DISCOUNTED 65%, 251% TO 300% IS DISCOUNTED 55%, 301% TO 350% IS DISCOUNTED 40%, 351% TO 400% IS DISCOUNTED 35%, AND 401% AND ABOVE IS DISCOUNTED 30%. PART V, LINE 20D A SLIDING SCALE IS USED TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE.
NEEDS ASSESSMENTAultman Hospital assesses the community's health care needs a variety of ways. We study protocol volume and patient satisfaction surveys. In our SHaron Lane Health Center Health Library, we document the medical conditions about which thousands of community members and our medical staff members have inquired. We track attendance at the more than 100 Health Talk presentations held each year to determine what topics are of most interest to the community. In 2011, Aultman collaborated with area hospitals and health care facilities to conduct a community health survey. The goal was to gauge the health status and health habits of Stark County residents and identify areas where Aultman can improve the health of our community. Fifteen questions were included on the poll of 1,067 Stark County households. The survey showed access to health insurance coverage and health care as the top priority; along with obesity and lack of healthy lifestyle choice; other areas of concern were prescription drug misuse, larger need for mental health services, and greater access to dental care.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEThe application and guidelines are provided on the back of every patient statement. At the time of registration patients are asked to fill out the Hospital Care Assurance Program application which includes contact information for questions and assistance in completing the form. Signs and applications are posted at all points of admissions informing patients of the free care programs which are available. In 2010, the application was added to the internet for easy patient access. Aultmans outreach department assists self pay inpatients with the initial Medicaid application process and other charity care programs under which they are eligible for assistance. Patients who are unable to be screened during their admission or outpatient visit are sent an application, upon request, after they have been discharged. Improvement processes for 2011 included formal patient outreach staff training in HCAP program requirements and customer service skills.
COMMUNITY INFORMATIONAultman's service area is Northeast Ohio, including Stark, Wayne, Holmes, Carroll and Tuscarawas counties. The U.S. Census Bureau estimated the 2012 population of these five counties to be over 653,720. There are ten registered hospitals in these five counties. Two of these are Aultman facilities. Aultman provided care for 25% of the total 304,514 Medicaid cases in this service area for 2012. Aultman provided care for 34% OF THE 120,872 SELF-PAY CASES IN THIS SERVICE AREA.
PROMOTION OF COMMUNITY HEALTHAultmans board of directors has 40 non-employed members, all of which reside within Aultman's service area. Community physicians requesting and ultimately qualifying for medical staff privileges would be granted privileges in their respective medical departments. Aultman has more than 535 physicians on active staff in more than 40 medical specialties. From educational programs to health screenings, Aultman actively promotes health and wellness in the community. Educational programs include more than 100 free Health Talk presentations each year, featuring local physicians and health care professionals. The Sharon Lane Health Information Center offers a comprehensive collection of health care and consumer-health materials ranging from books and DVDs available for lending to anatomical models. The center is open to patients and their family members, students, physicians and the general public. Additional health resources include the A.D.A.M. illustrated health encyclopedia on the Aultman website. Aultmans Working on Wellness (WOW) mobile health-fair unit debuted in February 2009. Staffed by medical professionals, the WOW van visits schools, community centers, churches, senior centers and neighborhood events to provide free screenings and health education. Screenings such as blood pressure checks, height, weight and Body Mass Index/percentage of body fat are provided. In 2012, the WOW van has reached more than 20,000 people. In 2012, Aultman encouraged members of the community to take a proactive approach to their health. The online Health Assessment Center at www.aultman.org offered free risk assessments for heart disease (HeartAware); joint problems (JointAware); breast, lung, prostate and colorectal cancer (CancerAware); and sleep disorders (SleepAware). Participants received customized reports based on the responses provided during the assessment. Those at high risk for health problems were invited for a personal consultation or group presentation with Aultman health professionals. In 2012, the Aware sites garnered a total of 2,038 hits with an average survey completion rate of 80 percent. Additional outreach efforts included a "Wear Red" event to promote womens heart health and Wellness Week for Aultman visitors and staff. Aultman representatives also attended health fairs throughout the year, including Senior Citizens Day at the Pro Football Hall of Fame, the Canton Farmers' Market, the Senior Expo and health fairs at local schools. 2012 marked the third year Aultman hosted the Minority Medical Career Symposium for students interested in becoming doctors, nurses and pharmacists. Participants included minority high school students from Stark County schools as well as students in Multi-Development Services of Stark County programs and the Stark State Upward Bound Math-Science Academy. The symposium included a career panel discussion with minority physicians, pharmacists and nurses, along with a health care career fair held in conjunction with the Aultman Medical Education Department. Aultman's Level III Neonatal Intensive Care Unit, designated by the Ohio Department of Health, is a transfer hospital for the aforementioned counties and Coshocton and Columbiana counties. Aultman provides specialized care for mothers with high-risk pregnancies and premature babies, under one roof. Critically injured patients who need specialized care are brought to Aultman's Level II Trauma Center. Aultman Hospital has the only Level II trauma center for adult and pediatric patients in its five-county service area. The Level II designation from the American College of Surgeons certifies Aultman has the facilities, technology and specially trained clinical staff to treat trauma patients. In 2012, Aultman Trauma Services was selected to perform research on the treatment of traumatic brain injury (TBI). Aultman was the only Ohio hospital and one of 18 in the United States, along with facilities in Canada and Australia. In 2012, Aultman Health Foundation contributed to the betterment of the Stark County community with the following activities. Safety First Through the Safety First program, Aultman strives to keep our community's kids safe by preventing head trauma and other bike-related injuries. In 2012, hundreds of Aultman employees volunteered to teach nearly 5,000 local first-grade students about bike safety. Topics included the importance of wearing a bike helmet and other safety gear; obeying traffic signs and signals; and using hand signals. In addition to the in-class education, each student received a free bicycle safety booklet and bike helmet. Since the programs inception in 2005, Safety First has reached about 27,000 students with the important message of bicycle safety. Health Vision 2020 Aultman launched its Health Vision 2020 initiative in response to a national study (http://www.countyhealthrankings.org) that ranked every U.S. County based on factors ranging from low birth weight to diet and exercise to education and unemployment. Wanting to make a measurable impact in those health rankings, the Aultman Health Vision 2020 committee targeted tobacco use and obesity in 2012. Aultman provided free educational programs, health screenings and tobacco cessation classes to equip local residents with the tools they need to make healthier lifestyle choices. Cancer Screening Day At the annual Cancer Screening Day, 161 patients were screened for breast, cervical, colon, lung, prostate and skin cancers. A total of 353 free cancer screenings were performed. The Aultman Cancer Center also offered a Breast Screening Day in 2012 to underserved women in the Carrollton area. Harvest for Hunger Aultman team members helped hungry people in need by donating 11,168 pounds of food and $43,285 to the Harvest for Hunger campaign, which benefited the Akron-Canton Regional Foodbank. United Way Aultman Health Foundation contributed $462,414 to the United Way. Employees also supported United Way through the annual Day of Caring, with efforts ranging from cleaning at the Domestic Violence Project in Canton to teaching Junior Achievement in a Day sessions at Cedar Elementary School. Neighborhood Cleanup Day More than two dozen Aultman employees and students from nearby St. Joseph elementary school teamed up to help beautify Aultman Hospitals surrounding neighborhood. They collected trash along the sidewalks and tree lines to celebrate Earth Day in April 2012. Wonderful Week of Giving During the Wonderful Week of Giving in November 2012, the Aultman Blood Center contributed $10 to the Stark County Hunger Task Force for every good blood donation for a total of $4,200. Fundraising Walks Aultman also supports community endeavors that improve the quality of life for area residents. Aultman and its employees support health-related causes such as fundraising walks for the American Cancer Society, American Heart Association, the March of Dimes and Juvenile Diabetes Research Foundation. Additional Community Benefit In addition to providing care for patients with no insurance, Aultman also serves thousands of patients covered by programs such as Medicaid. Payments from these federally funded programs do not always cover the total cost of service. In 2012, Aultman provided services to Medicaid patients resulting in more than $17.4 million in unreimbursed cost. Through its resident teaching programs, Aultman delivers a significant level of quality outpatient and inpatient health care to insured, underinsured, and uninsured individuals in our market. For members of the Amish community, Aultman offers free transportation to and from doctors' appointments and Aultman Hospital. An Amish House is also located adjacent to the Aultman campus, giving visitors a free place to stay when loved ones are hospitalized.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAddress Line2AddressUS/AddressLine2
UNITED WAY GREATER STARK COUNTY
4825 HIGBEE AVE NW STE 101CANTONOH447182597134254191501(C)(3)204070SUPPORT
GOODWILL INDUSTRIES OF GREATER CLEVELAND
408 NINTH ST SWCANTONOH44707340909974501(C)(3)140000SUPPORT
STARK DEVELOPMENT BOARD INC
116 CLEVELAND AVE SUITE 600CANTONOH44702341476938501(C)(3)96667SUPPORT
NATIONAL FOOTBALL MUSEUM
2121 GEORGE HALAS DR NWCANTONOH44708340898576501(C)(3)83750SUPPORT
CITY OF MASSILLON
ONE JAMES DUNCAN PLAZAMASSILLONOH446466686346001829CITY OF MASSILL42592SUPPORT
MOUNT UNION COLLEGE
1972 CLARK AVEALLIANCEOH44601340714687501(C)(3)35000SUPPORT
AKRON CANTON FOOD BANK
350 OPPORTUNITY PKWYAKRONOH443072234341369388501(C)(3)32904SUPPORT
OHIO FOUNDATION OF INDEPENDENT COLLEGES
250 E BROAD ST STE 1700COLUMBUSOH432153722314441082501(C)(3)25200SUPPORT
CANTON SYMPHONY ORCHESTRA
1001 MARKET AVE NCANTONOH44702346533119501(C)(3)25000SUPPORT
STARK EDUCATION PARTNERSHIP
400 MARKET AVE N SUITE BCANTONOH44702341625250501(C)(3)20000SUPPORT
ECONOMIC GROWTH FOUNDATION
100 PUBLIC SQUARE STE 210CLEVELANDOH441132225341916518501(C)(3)20000SUPPORT
ARTS IN STARK
1001 MARKET AVE NCANTONOH44702346609771501(C)(3)15100SUPPORT100 PUBLIC SQUARE STE 210
AMERICAN CANCER SOCIETY
5555 FRANTZ RDDUBLINOH43017240726080501(C)(3)10000SUPPORT
STARK COUNTY OUT OF POVERTY
126 CENTRAL PLZ NCANTONOH447021404341706993501(C)(3)10000SUPPORT
COMMUNITY BUILDING PARTNERSHIP
601 CLEVELAND AVE NCANTONOH447021805451560552501(C)(3)10000SUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants15TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE IIdentifier
Return ReferencePART I, LINE 2ReturnReference
ExplanationTHE AULTMAN HOSPITAL COMMUNITY SUPPORT POLICY/PROCEDURE PROVIDES GUIDANCE IN RESPONSE TO COMMUNITY ORGANIZATION REQUESTS FOR SUPPORT. AULTMAN HOSPITAL DEEMS IT BENEFICIAL AND NECESSARY TO BE A GOOD CORPORATE CITIZEN AND WILL CONSIDER SUPPORT OF COMMUNITY ENDEAVORS AND PROJECTS THAT WILL IMPROVE THE LIVES AND LIVELIHOOD OF THE COMMUNITY IT SERVES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
EDWARD J ROTH III
CEO AND PRESIDENT - AHF0533365060000063450750009593061680300
MILAN R DOPIRAK MD
DIRECTOR/PHYSICIAN0294511090851031680750006497040252700
PRABHCHARAN P GILL MD
PHYSICIAN536795070000019278075000121630645736000
RICK L HAINES
DIRECTOR03556650588000236907500012702043703600
MARK D WRIGHT
CHIEF FINANCIAL OFFICER - AHF030421503190007670750009593035397500
MICHAEL A KREW MD
PHYSICIAN533658065000010935075000102520627345000
ELETHERIOS P MAMOUNAS MD
PHYSICIAN474160050000020572075000121630564395000
TIMOTHY E MCDANIEL MD
PHYSICIAN514641040000074935075000121630649239000
ALLISON M OPRANDI MD
PHYSICIAN3062150339300108007500095930358318000
ANNE M GUNTHER
CHIEF NURSING OFFICER215174020384043106462037650246216000
CHRISTOPHER E REMARK
TREASURER & COO3052650331110741075000102520356869000
LORI L MERTES
CHIEF QUALITY OFFICER258000026790085807500000293148000
SUSAN E MERCER
MEDICAL DIRECTOR2271600786002382072860121630256851000
EILEEN F GOOD
CEO OF POST ACUTE SERVICES02657740318150101000750007307032249600
ROBERT C MOLNAR
VP PHYSICIAN RELATIONS148046010098044804454085760171622000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSCHEDULE JIdentifier
Return ReferencePART IReturnReference
ExplanationLINE 1: ALL EMPLOYEES ARE ELIGIBLE TO RECEIVE REIMBURSEMENT FOR HEALTH CLUB COSTS UP TO $120 ANNUALLY AS PART OF THE ORGANIZATION'S EFFORT TO PROMOTE HEALTHY LIVING STYLES. LINE 3: SEE SCHEDULE O FOR THE EXPLANATION OF EXECUTIVE COMPENSATION REVIEW. LINE 4B: CHRISTOPHER E REMARK, EDWARD J ROTH, III, RICK L HAINES, EILEEN F GOOD, AND MARK D WRIGHT ARE PARTICIPANTS IN THE ORGANIZATION'S 457(F) PLAN. THERE WERE NO CONTRIBUTIONS IN 2012.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
TIFFANY GOOD-WITMER
FAMILY MBR TO EILEEN GOOD154747WAGESfalse
ELIZABETH GOOD
FAMILY MBR TO EILEEN GOOD91969WAGESfalse
DOREEN GOOD
FAMILY MBR TO EILEEN GOOD69843WAGESfalse
VICTORIA HAINES
FAMILY MBR TO RICK HAINES121372WAGESfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
GOVERNING BODY AND MANAGEMENTAULTMAN HOSPITAL IS A SUBSIDIARY OF AULTMAN HEALTH FOUNDATION (AHF). PART VI, SECTION A, LINE 1B EdWARD J Roth III is an employee of Aultman Hospital. Rick Haines and Milan Dopirak MD are paid employees of a related organization. Marc Schneider resigned his directorship mid-year and is now an independent contractor of a related organization. Robert Sabota and Timothy O'Toole perform medical directorship duties for the organization. PART VI, SECTION A, LINE 2 JOHN SIRPILLA AND THEODORE BOYD ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. R CLINT ZOLLINGER ESQ AND SHEILA MARKLEY BLACK ESQ ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. T STEPHEN GREGORY AND LISA WARBURTON-GREGORY ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A FAMILY RELATIONSHIP.
GOVERNING BODY AND MANAGEMENTAULTMAN HEALTH FOUNDATION'S FINANCE DEPARTMENT CAREFULLY REVIEWS AND ANALYZES THE TAX RETURN. THE DEPARTMENT RECONCILES THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARES THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. AN INDEPENDENT CPA FIRM ALSO REVIEWS FORM 990. IN ADDITION, THE FINANCE DEPARTMENT DOES A COMPARATIVE ANALYSIS TO THE PRIOR YEAR RETURN. THE ANALYSIS AND RECONCILIATION SCHEDULES ALONG WITH A COMPLETE COPY OF THE 990 ARE PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. A COMPLETE COPY OF THE 990 IS THEN MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH A SECURED INTERNET PORTAL PRIOR TO THE FILING DATE.PART VI, SECTION A, LINE 11B
POLICIESTHE AULTMAN'S BOARD OF DIRECTORS HAS A CONFLICT OF INTEREST POLICY. AS A RESULT OF THIS POLICY, EACH YEAR BOARD MEMBERS, OFFICERS, AND SENIOR STAFF COMPLETE A FORM DISCLOSING ANY CONFLICTS OF INTEREST THEY MAY HAVE. THE COMPLIANCE OFFICE REVIEWS THESE DISCLOSURE FORMS AND INFORMS THE BOARD CHAIRMAN, AND OTHER APPROPRIATE OFFICERS, OF NOTABLE CONFLICTS, IF ANY. THOSE WITH CONFLICTS ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS RELATING TO THE CONFLICT.PART VI, SECTION B, LINE 12C
POLICIESTHE AULTMAN HOSPITAL USES THE FOLLOWING REFERENCE MATERIALS FOR THE DEVELOPMENT OF EXECUTIVE COMPENSATION: OHIO HOSPITAL ASSOCIATION (OHA), MERCER INTEGRATED HEALTH NETWORK, INCLUDING SURVEY DATA FOR BOTH HOSPITALS AND HEALTH PLANS, AND SULLIVAN COTTER AND ASSOCIATES (SCA). ADDITIONAL SOURCES OF SALARY SURVEY DATA ARE AVAILABLE FOR USE WHERE APPROPRIATE INCLUDING COMPDATASURVEYS.COM, SALARY.COM, AND CHAMPS. IN THESE CASES, THE SURVEY IS REFERENCED WHERE APPLICABLE. EXECUTIVE PERFORMANCE, WAGE RECOMMENDATIONS, AND BONUS PAYMENTS ARE REVIEWED BY THE COMPENSATION COMMITTEE OF THE AULTMAN HEALTH FOUNDATION BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE OF THE AULTMAN HEALTH FOUNDATION BOARD OF DIRECTORS HAS ENGAGED SULLIVAN COTTER & ASSOCIATES, INC., AN INDEPENDENT COMPENSATION CONSULTING FIRM FOR REVIEW OF EXECUTIVE COMPENSATION PRACTICES. THE AULTMAN HOSPITAL USES THE FOLLOWING REFERENCE MATERIALS FOR THE DEVELOPMENT OF PHYSICIAN COMPENSATION: MEDICAL GROUP MANAGEMENT ASSOCIATES (MGMA), AMERICAN MEDICAL GROUP ASSOCIATION (AMGA), HOSPITAL AND HEALTHCARE COMPENSATION SERVICE (HHCS) AND SULLIVAN COTTER AND ASSOCIATES (SCA). IN ADDITION TO SALARY SURVEYS, AULTMAN HOSPITAL ALSO RETAINS AN INDEPENDENT CONSULTING FIRM FOR PHYSICIANS COMPENSATION SERVICES. ALL PHYSICIAN COMPENSATION RECOMMENDATIONS ARE SENT TO THE CEO, VP OF PHYSICIAN SERVICES, COO, AND CNO FOR FINAL APPROVAL.PART VI, SECTION B, LINE 15A AND 15B
DISCLOSUREAULTMAN HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.PART VI, SECTION C, LINE 19
PART VIIICLINICAL TRIAL AND RESEARCH 1,658,475 PARKING DECK 227,518 SCIENCE LAB CAMPAIGN 200,000 ANSWERING SERVICE 181,066 CO-MANAGEMENT INCENTIVE 320,000 FLOWER SHOP 109,937 EDUCATION 37,207 FITNESS AND SPORTS MEDICINE 270,902 PART IX STATEMENT OF FUNCTIONAL EXPENSE DETAIL LINE 11G PROFESSIONAL FEES - PHYSICIAN 19,019,939 PROFESSIONAL FEES - NON PHYSICIANS 985,006 SERVICE CONTRACTS 3,819,096 PURCHASED TESTS 1,376,778 PURCHASED SERVICES 2,635,229 OTHER 4,876,355 LINE 24E RECRUITMENT 640,926 MEMBERSHIP FEES 256,413 COLLECTIONS EXPENSE 103,797 MISCELLANEOUS 336,852 PART X LINE 15 INTERCOMPANY ACCOUNTS 3,820,607 DEFERRED TAX ASSET 452,724 RECONCILIATION OF NET ASSETS PART XI LINE 9 INTERFUND TRANSFERS ON SEPARATELY REPORTED SUBSIDIARY (18,312,936) ADJUSTMENT TO PAID IN CAPITAL (120,000)STATEMENT OF REVENUE OTHER REVENUE DETAIL

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1ACUTE CARE SPECIALTY HOSPITALBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12600 SIXTH ST SWAddressLine1
CityCANTONCity
StateOHState
ZIP Code44710ZIPCode
FieldValueIRS element (for citing)
EIN134246188EIN
Primary ActivitiesMED SERVICEPrimaryActivities
Legal Domicile StateOHLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1AHFBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
AULTMAN HEALTH FOUNDATION
2600 SIXTH ST SWCANTONOH44710341445390SUPPORT ORGOH501(c)(3)11 BNAfalse
AULTMAN COLLEGE OF NURSING AND HEALTH
2600 SIXTH ST SWCANTONOH47710201359433COLLEGEOH501(c)(3)2AULTMAN HOSPtrue
THE AULTMAN FOUNDATION
2600 SIXTH ST SWCANTONOH44710208090459FUNDRAISEROH501(c)(3)7AHFfalse
ORRVILLE HOSPITAL FOUNDATION
832 S MAIN STREETORRVILLEOH446672208340733138HOSPITALOH501(C)(3)3AHFfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
WTPM LLC
2600 SIXTH ST SWCANTONOH44710200090246PROPERTY MGMTOHAHF
AULTMAN ONCOLOGY CENTER OF EXCELLENCE
2600 SIXTH STREET SWCANTONOH44710454215510ONCOLOGY SERVICESOHAHRELATED202047-41463falsefalse0.64770

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
NORTH CENTRAL MEDICAL RESOURCES INC
2600 SIXTH ST SWCANTONOH44710341610344MED EQUIP RENOHAHFC CORPfalse
AULTRA ADMINISTRATIVE GROUP
4845 FULTON DR NWCANTONOH44718204951704ADMIN SERVICEOHAHFC CORPfalse
MCKINLEY LIFE INSURANCE COMPANY
2600 SIXTH ST SWCANTONOH44710341624818INSURANCEOHAHFC CORPfalse
MCKINLEY ASSURANCE SPC
980468384PORTFOLIOAHFC CORPfalsePO BOX 1051GEORGE TOWNGRAND CAYMANSCJCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES
A337678ACTUAL COST
AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES
O3485701ACTUAL COST
AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES
P1335388ACTUAL COST
AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES
Q4818188ACTUAL COST
AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES
S96817ACTUAL COST

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