2012-11-14T13:01:21-06:00 2011-12-31 BKD LLP 200 E Main St Suite 700 Fort Wayne IN 46802 990 2011-01-01 340714538 AULTMAN HOSPITAL % MARK WRIGHT AULT 3303636352 2600 SIXTH STREET SW CANTON OH 44710 MARK WRIGHT 2012-11-15 true Joyce A Dulworth 2604604000 2011 2016-02-24 21:20:13Z MARK WRIGHT 2600 SIXTH STREET SW CANTON OH 44710 473582738 false X WWW.AULTMAN.ORG X 1935 OH THE MISSION STATEMENT OF AULTMAN HOSPITAL IS TO "LEAD OUR COMMUNITY TO IMPROVED HEALTH." 41 36 4323 431 1327797 1833045 2609151 420855530 461048043 -20986 30814 8834620 9744529 431502209 473432537 108593 308128 0 0 225071585 233458628 0 0 0 205499544 228287208 430679722 462053964 822487 11378573 372884164 310198352 40697018 44395791 332187146 265802561 X AULTMAN 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. false false 333660503 306928 404868748 AULTMAN 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 2011, AULTMAN CARED FOR UNINSURED PATIENTS. AULTMAN ALSO SERVES THOUSANDS OF PATIENTS COVERED BY PROGRAMS SUCH AS MEDICAID. 21431847 1200 28323589 SUBACUTE SERVICES: AULTMAN PROVIDES SUBACUTE 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. 23847364 34298487 AULTMAN 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. 378939714 true true false false false false false false false true true false false false true true false true false false false false false false false false true true true false true false false false false false false true false false false false false true true true true false false true 457 0 true 4323 true true true false false false false false false false false false X 41 36 true false false false false false false true true false false true true true true true true true true false X MARK WRIGHT 3303636192 2600 SIXTH STREET SW CANTON OH 44710 X T STEPHEN GREGORY 1.0 X X 0 0 0 JOSEPH R HALTER JR 1.0 X X 0 0 0 EDWARD J ROTH III 5.0 X X 0 525281 19325 DAVID W BARTLEY II 1.0 X 0 0 0 WILLIAM H BELDEN JR 1.0 X 0 0 0 BARBARA HAMMONTREE BENNETT 1.0 X 0 0 0 PAUL R BISHOP 1.0 X 0 0 0 SHEILA MARKLEY BLACK ESQ 1.0 X 0 0 0 THEODORE V BOYD 1.0 X 0 0 0 STEPHEN G DEUBLE 1.0 X 0 0 0 DARRYL J DILLENBACK 1.0 X 0 0 0 MILAN R DOPIRAK MD 54.0 X 0 400081 13550 LEO E DOYLE 1.0 X 0 0 0 GLENN A EISENBERG 1.0 X 0 0 0 NORMAN J GAYNOR III 1.0 X 0 0 0 PRABHCHARAN P GILL MD 54.0 X 619676 0 20071 PATRICIA A GRISCHOW 1.0 X 0 0 0 RICK L HAINES 1.0 X 0 352955 19298 MICHAEL E HANKE 1.0 X 0 0 0 GEORGE W LEMON 1.0 X 0 0 0 GENE E LITTLE 1.0 X 0 0 0 HARRY C MACNEALY 1.0 X 0 0 0 STEVEN OAKLAND 1.0 X 0 0 0 MICHAEL RICH MD 1.0 X 0 0 0 MARC L SCHNEIDER 1.0 X 0 0 0 LOUIS G SHAHEEN MD 1.0 X 0 0 0 DOUGLAS J SIBILA 1.0 X X 0 0 0 JOHN A SIRPILLA 1.0 X 0 0 0 VICKY L STERLING 1.0 X 0 0 0 R CLINT ZOLLINGER ESQ 1.0 X 0 0 0 JEFFERY MILLER MD 1.0 X 0 0 0 BRIAN S BELDON 1.0 X 0 0 0 WILLIAM WALLACE MD 1.0 X 0 0 0 JOHN B HUMPHREY JR MD 1.0 X 0 0 0 DAVID M FINDLEY 1.0 X 0 0 0 LISA WARBURTON GREGORY 1.0 X 0 0 0 JAMES E KNISELY 1.0 X 0 0 0 RONALD R LYONS 1.0 X 0 0 0 ROBERT W SABOTA MD 1.0 X 0 0 0 TODD M SOMMER 1.0 X 0 0 0 MARK D WRIGHT 5.0 X 0 304025 16478 CHRISTOPHER E REMARK 50.0 X 295299 0 17193 EILEEN F GOOD 50.0 X 0 276955 15171 ALLISON M OPRANDI MD 55.0 X 308192 0 16478 ANNE M GUNTHER 55.0 X 198443 0 9096 SUSAN E MERCER 55.0 X 234370 0 19858 THOMAS F BOGGS 55.0 X 274252 0 20041 MICHAEL A KREW MD 55.0 X 581995 0 17193 ELETHERIOS P MAMOUNAS MD 55.0 X 542770 0 8189 TIMOTHY E MCDANIEL MD 55.0 X 626349 0 20071 JAMES S YOUNG 55.0 X 263091 0 15171 LORI L MERTES 55.0 X 252163 0 7059 4196600 1859297 254242 88 false true false CANTON AULTMAN EMERGENCY PHYSICIANS 2600 6TH STREET SW CANTON OH 447101702 PHYSICIAN SERVICES 1557486 WHISLER PLUMBING HEATING 2521 LINCOLN WAY EAST MASSILLON OH 446465052 CONTRACTING 1830381 HAMMOND CONSTRUCTION INC 1278 PARK AVE SW CANTON OH 44706 CONTRACTING 1331144 PERINATAL PEDIATRICS 2600 6TH STREET SOUTHWEST CANTON OH 44710 PHYSICIAN SERVICES 1208053 PULMONARY PHYSICIANS INC 2600 TUSCARAWAS STREET WEST CANTON OH 44708 PHYSICIAN SERVICES 1171852 216 2609151 2609151 NET PATIENT REVENUE 621110 420154353 420154353 PREMIUM REVENUE 621110 34859785 34859785 PHARMACY REVENUE 621110 6033905 6033905 461048043 31015 31015 0 0 1973951 1973951 1973951 1973951 150000 150201 -201 -201 -201 0 0 0 FOOD SERVICES 621110 2853450 2853450 LAUNDRY INCOME 812300 194061 194061 LABORATORY INCOME 621500 1133736 1133736 3589331 3589331 7770578 473432537 467490824 1327797 2004765 308128 308128 0 0 0 1635646 1341230 294416 397321 325803 71518 173010499 141868609 31141890 6030650 4945133 1085517 38756652 31780455 6976197 13627860 11174845 2453015 0 1022737 838644 184093 27102 22224 4878 0 0 5683 4660 1023 28241522 23158048 5083474 1724973 1414478 310495 22701343 18615101 4086242 1386142 1136636 249506 0 11005635 9024621 1981014 1257824 1031416 226408 0 124711 102263 22448 0 22704221 18617461 4086760 21038226 17251345 3786881 1016124 833222 182902 MEDICAL SUPPLIES 83724505 68654094 15070411 EDUCATION 2341714 1920206 421508 BAD DEBT EXPENSE 23478559 19252418 4226141 FRANCHISE FEE 5192058 4257488 934570 1294129 1061186 232943 462053964 378939714 83114250 0 16129 16481 4574767 8785816 0 0 54764391 57557410 0 0 0 0 432986 83273 3219675 3131637 1921162 1941447 465898188 232006021 238375689 233892167 1911871 1940418 0 0 1929106 1705611 0 0 65738388 1144092 372884164 310198352 36867730 40799905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3829288 3595886 40697018 44395791 X 328348792 261525008 3558145 3997344 280209 280209 332187146 265802561 372884164 310198352 X 11378573 -77763158 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 681425 20946 5572 696799 668598 100 18235 5508 681425 532238 118967 22208 4815 668598 516342 20632 4736 532238 1.00000 false false 39048663 39048663 141290355 62429218 78861137 250678968 163326519 87352449 34880203 6250285 28629918 233892167 0 EST. THIRD-PARTY PAYOR SETTLEM 3595886 3595886 473432537 462053964 11378573 2007 -77765165 -77763158 -66384585 476921400 2007 3486856 3488863 473432537 473432537 466519632 4465668 4465668 462053964 462053964 ENDOWMENT FUNDS PART V, LINE 4 THE INTENDED USE FOR AULTMAN HOSPITAL'S ENDOWMENT IS TO SUPPORT THE CHAPLAINCY PROGRAM. RECONCILIATION PART XI, LINE 8 INTERFUND TRANSFERS (77,765,165) PART XII, LINE 2D SEPARATELY REPORTED SUBSIDIARY REVENUE $3,486,856 PART XIII, LINE 2D SEPARATELY REPORTED SUBSIDIARY EXPENSE $4,465,668 ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES FIN 48 FOOTNOTE 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. MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X 0 true true true false true true 14063879 5366836 8697043 0.01980 48493445 31049079 17444366 0.03980 62557324 36415915 26141409 0.05960 1304188 25996 1278192 0.00290 8902299 177487 8724812 0.01990 54117266 48130830 5986436 0.01360 583607 634116 -50509 0.00000 356829 356829 0.00080 65264189 48968429 16295760 0.03720 127821513 85384344 42437169 0.09680 5686 5686 2760 2760 3091 3091 221 221 2484 2484 4030 4030 18272 18272 false 11450708 2926320 94500055 91376959 3123096 X true true 3 1 AULTMAN HOSPITAL

2600 SIXTH ST SW CANTON OH 44708

X X X X X MAIN HOSPITAL 2 AULTMAN WOODLAWN

2821 WOODLAWN AVE NW CANTON OH 44708

X SKILLED NURSING REHABILITATION CTR HOME CARE & HOSPICE 3 AULTMAN WEST

2051 WALES AVE NW MASSILLON OH 44646

X X IMMEDIATE CARE, DIAGNOSTICS, THERAPY AND SURGERY AULTMAN HOSPITAL 1 X true true 100 true 100 true X X X X X X X true true X X X X X X true false true X false false AULTMAN WOODLAWN 2 true true 100 true 100 true X X X X X X X true true X X X X X X true false true X false false AULTMAN WEST 3 true true 100 true 100 true X X X X X X X true true X X X X X X true false true X false false 12 AULTMAN NORTH

6100 WHIPPLE AVE NW NORTH CANTON OH 44720

Immediate Care, Diagnostics Therapy and Surgery AULTMAN CENTER FOR DIALYSIS

2912 W TUSCARAWAS ST CANTON OH 44708

Dialysis Center CENTER FOR PAIN MANAGEMENT

2302 FULTON DR CANTON OH 44718

GENERAL MEDICAL & SURGICAL HOME MEDICAL SUPPLY EQUIPMENT

5200 TUSCARAWAS ST CANTON OH 44708

Medical Supply Co. AULTWORKS

3730 WHIPPLE AVE NE CANTON OH 44718

BWC Certified Treatment FACILITY AULTWORKS

2021 WALES AVE NW MASSILLON OH 44646

BWC Certified Treatment FACILITY AULTMAN CARROLLTON

1020 TRUMP RD CARROLLTON OH 44615

Immediate Care, Diagnostics and Therapy AULTMAN TUSCARAWAS

2615 Tuscarawas St CANTON OH 44708

Therapy Clinic WEIGHT MANAGEMENT

2732 Fulton Dr NW CANTON OH 44718

Weight Management Program AULTMAN FAMILY MEDICINE CENTER

4319 Hills Dales NW CANTON OH 44708

Outpatient Physician Clinic AULTMAN FAMILY MEDICINE CENTER

8320 Waynesburg Dr SE WAYNESBURG OH 44688

Outpatient Physician Clinic AULTMAN LOUISVILLE

1925 Williamsburg Way LOUISVILLE OH 44641

Therapy Clinic PART I, LINE 3C 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 45%, 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 F BAD DEBT EXPENSE IN THE AMOUNT OF $23,478,559 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 4 Receivables and Provisions for Bad Debts 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 not 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 amount of the provision for doubtful accounts, $12,315,000 and $19,186,000 for 2011 and 2010, respectively, is based upon managements assessment of the historical and expected net collections. Methodology 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. 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 organizations 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 2011 and then multiplying this amount by the cost to charge ratio calculated in worksheet 2. PART III, LINE 8 The hospital does not have a shortfall with their Medicare patients. The costing methodology used in determining the amount reported on line 6 is Medicare Cost Report. PART III, LINE 9B The 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 V AULTMAN 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 45%, 351% TO 400% IS DISCOUNTED 35%, AND 401% AND ABOVE IS DISCOUNTED 30%. PART V, LINE 19D 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 ASSESSMENT Aultman Hospital assesses the community's health care needs a variety of ways. We study protocol volume and patient satisfaction surveys. We document the medical conditions thousands of community members and medical staff members inquire about in our Sharon Lane Health Center health library. 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 ASSISTANCE The 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 INFORMATION Aultman's service area includes Stark, Wayne, Holmes, Carroll and Tuscarawas counties. The core market for Aultman Hospital is Stark County. The U.S. Census Bureau estimated the population of our five county areas to be over 654,000. There are ten registered hospitals in the five county areas. Two of these are Aultman facilities. Aultman provided care for 23% of the total 279,529 Medicaid cases in the primary service area for 2011. Of the 125,060 self pay cases in our primary service area Aultman provided care for 39%. PROMOTION OF COMMUNITY HEALTH Aultmans board of directors has 36 non-employed members. A total of 30 of the 39 voting board members reside in the core market area. The remaining portion resides in the tertiary market. Community physicians requesting and ultimately qualifying for medical staff privileges would be granted privileges in their respective medical departments. 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 and access to medical information through the Sharon Lane Health Center. Additional health resources include the A.D.A.M. illustrated health encyclopedia on the Aultman website and community health presentations offered by nurses with the Aultman Wellness on Wheels (WOW) mobile health-fair unit. In 2011, 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 2011, a total of 615 members of the community completed Aware risk assessments and 174 people took advantage of the free follow-up consultations. Additional outreach efforts a diabetes health fair and "Wear Red" events to promote womens heart health. 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. Through the Safety First program, Aultman is striving to keep our community's kids safe by preventing head trauma and other bike-related injuries. In 2011, Aultman volunteers visited 84 Stark County schools and taught more than 200 classes. The safety lesson which reached approximately 5,000 students included topics such as 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 22,000 students with free helmets and the important message of bicycle safety. 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. In 2011, Aultman collaborated with Northeastern Ohio Universities Colleges of Medicine and Pharmacy (NEOUCOM) and Aultman College of Nursing and Health Sciences to provide a day of education and activities for minority high school students interested in becoming physicians, pharmacists or nurses. The Minority Medical Career Symposium included presentations from health care professionals, a panel discussion, a career fair and tours of Aultman College and the Aultman Pharmacy. More than two dozen local high school students attended. 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. The Aultman Trauma Center was re-verified as a Level II center in 2011. Aultmans WOW mobile health-fair unit debuted in February 2009. Staffed by medical professionals, the WOW van visits schools, community centers, churches, senior centers and block parties 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 2011, the WOW van has reached more than 21,000 people. In 2011, Aultman Health Foundation contributed to the betterment of the Stark County community with the following activities. 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. Stark County ranked 44 out of Ohios 88 counties in current health outcomes and 37 in future health based on current actions. Wanting to make a measurable impact in those health rankings, the Aultman Health Vision 2020 committee targeted tobacco use and obesity 2011. 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 For a decade, the Aultman Cancer Center has held Cancer Screening Day to help underinsured people in our community. The 2011 event brought 173 patients to Aultman, who received a total of 375 free screenings for breast, cervical, colon, lung, prostate and skin cancer. Close the Gap In conjunction with the OJays Celebration Weekend in August 2011, Aultman Health Foundation and Boston Scientific collaborated on a Close the Gap event to raise awareness about health disparities in heart care for women, African-Americans and Latino Americans. Aultman provided free health screenings and information, healthy food samples and cooking demonstrations, tobacco cessation materials and the opportunity to take the HeartAware risk assessment. Look Good Feel Better The Aultman Infusion Therapy Department offers an American Cancer Society program called Look Good Feel Better. It is a free program that helps individuals with cancer improve their self-esteem and manage their treatment and recovery with greater confidence. The program is provided in collaboration with the Cosmetic, Toiletry and Fragrance Association Foundation and the National Cosmetology Association. Participants in the Look Good, Feel Better program are given makeup kits that contain more than $300 worth of cosmetics. Specially trained, licensed cosmetologists help patients apply makeup to help cover the effects of chemotherapy. Aultman Infusion Therapy also has a wig bank that provides free wigs to anyone in need. A total of 50 women took advantage of the Look Good, Feel Better program in 2011. Harvest for Hunger Aultman Health Foundation team members generously donated 7,775 pounds of food and $36,053 during the 2011 Harvest for Hunger campaign. Aultman donations provided more than 114,000 meals to hungry families served by the Akron-Canton Regional Foodbank. United Way Aultman Health Foundation made a significant contribution to the United Way of Greater Stark Countys 2011 fundraising campaign. Aultman team members and physicians donated more than $450,000 while Aultman Health Foundations corporate contribution brought the total donation to more than $896,000. Adopt-a-Need Created by an Aultman employee, the Adopt-a-Need program provides year-round support for six location organizations that do not receive government or United Way funding. On the second Friday each month, Aultman employees donate personal care items, cleaning supplies and baby necessities to six local outreach organizations that help people in need. In 2011, Aultman employees donated nearly 14,000 items such as shampoo, deodorant, toilet paper, feminine hygiene products, baby necessities and soap. Cedar Elementary School Reading Program Each school year, Aultman provides volunteers to help nearby Cedar Elementary School students improve their reading skills. In 2011, 34 Aultman employees donated 228 hours of time to mentor students and help the children improve their reading skills and confidence. Aultman Career Academy Aultman partners with eight local high schools to provide top-performing junior and senior students with the opportunity to explore health care careers. The Aultman Career Academy also helps nurture local talent and keeps young individuals connected to Aultman Health Foundation. Career Academy students participate in clinical rotations in areas such as the Aultman Emergency Department, the Aultman Birth Center and various nursing units, in addition to learning about support areas such as corporate communications, the consumer health library and finance. In the 2011-12 school year, 34 students participated in the Aultman Career Academy. Students and Aultman staff members collectively contributed 5,474 hours of their time to the Career Academy. Project SEARCH The goal of Project SEARCH is to train, improve and build workplace skills for adults with disabi true City of Massillon One James Duncan Plaza Massillon OH 446466686 346001829 N/A 55000 Support Stark Development Board 116 Cleveland Ave Suite 600 Canton OH 44702 341476938 501(c)(3) 20000 Support NATIONAL FOOTBALL MUSEUM 2121 George Halas Dr NW Canton OH 44708 340898576 501(C)(3) 36000 Support Stark Education Partnership 400 Market Ave N Suite B Canton OH 44702 341625250 501(C)(3) 15000 Support United Way Greater Stark County 825 Higbee Ave NW Ste 101 Canton OH 44718 134254191 501(C)(3) 100568 Support Stark Community Foundation 220 Market Ave S Canton OH 447022181 340943665 501(c)(3) 70000 Support Ohio Foundation of Independent Colleges 250 E BROAD ST STE 1700 Columbus OH 43215 314441082 501(c)(3) 25000 Support Stark County Agricultural Society 305 WERTZ AVE NW PO BOX 80279 Canton OH 44708 340801375 501(c)(3) 9820 Support Akron Canton Food Bank 350 OPPORTUNITY PKWY Akron OH 443072234 341369388 501(c)(3) 23325 Support Goodwill Industries of Greater Cleveland 408 NINTH ST SW Canton OH 44707 340909974 501(c)(3) 100000 Support Economic Growth Foundation The Higbee Building 100 PUBLIC SQUARE STE 210 Cleveland OH 441132225 341916518 501(c)(3) 20000 Support Yes For Stark 2745 DUNKEITH DR NW Canton OH 447081331 452977754 N/A 15000 Support 10 2 SCHEDULE I PART I, LINE 2 THE 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. X true true X X X X X false true false false false false false false false EDWARD J ROTH III 0 519216 0 0 0 6065 0 7350 0 11975 0 544606 0 0 MILAN R DOPIRAK MD 0 296956 0 99957 0 3168 0 7350 0 6200 0 413631 0 0 PRABHCHARAN P GILL MD 473559 0 65000 0 81117 0 7350 0 12721 0 639747 0 0 0 RICK L HAINES 0 350633 0 0 0 2322 0 7350 0 11948 0 372253 0 0 EILEEN F GOOD 0 266888 0 0 0 10067 0 7350 0 7821 0 292126 0 0 MARK D WRIGHT 0 303448 0 0 0 577 0 7350 0 9128 0 320503 0 0 MICHAEL A KREW MD 470417 0 65000 0 46578 0 7350 0 9843 0 599188 0 0 0 ELETHERIOS P MAMOUNAS MD 475900 0 46241 0 20629 0 7350 0 839 0 550959 0 0 0 TIMOTHY E MCDANIEL MD 510867 0 35000 0 80482 0 7350 0 12721 0 646420 0 0 0 ALLISON M OPRANDI MD 300898 0 6250 0 1044 0 7350 0 9128 0 324670 0 0 0 ANNE M GUNTHER 198056 0 0 0 387 0 5460 0 3636 0 207539 0 0 0 CHRISTOPHER E REMARK 294856 0 0 0 443 0 7350 0 9843 0 312492 0 0 0 JAMES S YOUNG 247888 0 10250 0 4953 0 7350 0 7821 0 278262 0 0 0 LORI L MERTES 251500 0 0 0 663 0 7059 0 0 0 259222 0 0 0 SUSAN E MERCER 224948 0 7900 0 1522 0 7137 0 12721 0 254228 0 0 0 THOMAS F BOGGS 273724 0 0 0 528 0 7350 0 12691 0 294293 0 0 0 SCHEDULE J PART I LINE 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 2011. TIFFANY GOOD-WITMER FAMILY MBR TO EILEEN GOOD 129908 WAGES false ELIZABETH GOOD FAMILY MBR TO EILEEN GOOD 90739 WAGES false DOREEN GOOD FAMILY MBR TO EILEEN GOOD 69071 WAGES false VICTORIA HAINES FAMILY MBR TO RICK HAINES 107603 WAGES false GOVERNING BODY AND MANAGEMENT AULTMAN HOSPITAL IS A SUBSIDIARY OF AULTMAN HEALTH FOUNDATION (AHF). PART VI, SECTION A, LINE 1B EdWARD J Roth III, Christopher Remark, and Prabhcharan Gill MD are employees of Aultman Hospital. Rick Haines and Milan Dopirak MD are paid employees of a related 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 MANAGEMENT PART VI, SECTION A, LINE 11B AULTMAN 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 PRESENTED AT THE BOARD OF DIRECTORS MEETING PRIOR TO THE FILING DATE, AND A COMPLETE FINAL COPY IS EMAILED TO EACH MEMBER OF THE BAORD OF DIRECTORS FOR ANY ADDITIONAL REVIEW BEFORE FILING. POLICIES PART VI, SECTION B, LINE 12C THE 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. POLICIES PART VI, SECTION B, LINE 15A AND 15B THE 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. DISCLOSURE PART VI, SECTION C, LINE 19 AULTMAN HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART VIII STATEMENT OF REVENUE OTHER REVENUE DETAIL CLINICAL TRIAL AND RESEARCH 1,312,984 PARKING DECK 256,756 SCIENCE LAB CAMPAIGN 150,000 ANSWERING SERVICE 175,354 PART IX STATEMENT OF FUNCTIONAL EXPENSE DETAIL LINE 11G PROFESSIONAL FEES - PHYSICIAN 17,901,718 PROFESSIONAL FEES - NON PHYSICIANS 969,719 SERVICE CONTRACTS 1,301,726 PURCHASED TESTS 1,409,079 PURCHASED SERVICES 2,401,404 OTHER 4,257,876 LINE 24E RECRUITMENT 482,967 MEMBERSHIP FEES 401,500 MISCELLANEOUS 100,537 RECONCILIATION OF NET ASSETS PART XI INTERFUND TRANSFERS ON SEPARATELY REPORTED SUBSIDIARY (77,765,165) UNREALIZED GAIN ON SALE OF ASSETS 2,007 TOTAL (77,763,158) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EDWARD J ROTH III TITLE:CEO AND PRESIDENT - AHF HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MILAN R DOPIRAK MD TITLE:DIRECTOR/PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:PRABHCHARAN P GILL MD TITLE:DIRECTOR/PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICK L HAINES TITLE:DIRECTOR HOURS:54 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK D WRIGHT TITLE:CHIEF FINANCIAL OFFICER - AHF HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CHRISTOPHER E REMARK TITLE:FORMER TREASURER & COO HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EILEEN F GOOD TITLE:CEO of post acute services HOURS:5 ACUTE CARE SPECIATLY HOSPITAL 2600 SIXTH ST SW CANTON OH 44710 134246188 MED SERVICE OH AHF AULTMAN HEALTH FOUNDATION 2600 SIXTH ST SW CANTON OH 44710 341445390 SUPPORT ORG OH 501(c)(3) 11 B NA false AULTMAN COLLEGE OF NURSING AND HEALTH 2600 SIXTH ST SW CANTON OH 47710 201359433 COLLEGE OH 501(c)(3) 2 NA true AULTMAN DEVELOPMENT INSTITUTE 2600 SIXTH STREET SW CANTON OH 44710 341388891 CHARITABLE OH 501(c)(3) 11A NA true THE AULTMAN FOUNDATION 2600 SIXTH ST SW CANTON OH 44710 208090459 FUNDRAISER OH 501(C)(3) 7 AHF true WTPM LLC 2600 SIXTH ST SW CANTON OH 44710 200090246 PROPERTY MGMT OH AHF NORTH CENTRAL MEDICAL RESOURCES INC 2600 SIXTH ST SW CANTON OH 44710 341610344 MED EQUIP RENTAL OH AHF C CORP AULTRA ADMINISTRATIVE GROUP 4845 FULTON DR NW CANTON OH 44718 204951704 ADMIN SERVICE OH AHF C CORP MCKINLEY LIFE INSRUANCE COMPANY 2600 SIXTH ST SW CANTON OH 44710 341624818 INSURANCE OH AHF C CORP MCKINLEY ASSURANCE SPC PO BOX 1051 GEORGE TOWN GRAND CAYMANS CJ 980468384 PORTFOLIO CJ AHF C CORP true false false false false false false false true true false true false true true true false true AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES A 341692 ACTUAL COST AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES P 8488335 ACTUAL COST AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES N 3167717 ACTUAL COST AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES O 1297951 ACTUAL COST AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES P 4461511 ACTUAL COST AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES R 196000 ACTUAL COST AULTMAN DEVELOPMENT INSTITUTE P 3189569 ACTUAL COST AULTMAN DEVELOPMENT INSTITUTE O 99462 ACTUAL COST