2011-11-14T13:21:19-05:00 2010-12-31 BKD LLP 200 E Main St Suite 700 Fort Wayne IN 46802 990 2010-01-01 340714538 AULTMAN HOSPITAL AULT 3303636352 2600 SIXTH STREET SW CANTON OH 44710 MARK WRIGHT 3303636352 2011-11-14 true Joyce A Dulworth 2604604000 2010 2016-03-07 17:11:31Z MARK WRIGHT 2600 SIXTH STREET SW CANTON OH 44710 433241560 false X WWW.AULTMAN.ORG X 1935 OH THE MISSION STATEMENT OF AULTMAN HOSPITAL IS TO "LEAD OUR COMMUNITY TO IMPROVED HEALTH." 40 35 4338 424 1391292 0 1938992 1833045 430207596 420855530 111456 -20986 8414389 8834620 440672433 431502209 260165 108593 0 0 223682596 225071585 0 0 0 213033823 205499544 436976584 430679722 3695849 822487 361851326 372884164 39519682 40697018 322331644 332187146 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 MORE THAN 115 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 HOSPITAL'S 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 313910832 108593 379641984 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. 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 2010, AULTMAN HAS CONTINUED TO CARE FOR UNINSURED PATIENTS. AULTMAN ALSO SERVES THOUSANDS OF PATIENTS COVERED BY PROGRAMS SUCH AS MEDICAID. 12502547 14632689 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. 26763541 32078076 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. 353176920 true true false false false false false false false true true false false true 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 false true true true false false true 457 0 true 4338 true true true false false false false false false false false false X 40 35 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 CHARLES B SCHEURER 1.0 X X 0 0 0 T STEPHEN GREGORY 1.0 X X 0 0 0 JOSEPH R HALTER JR 1.0 X X 0 0 0 CHRISTOPHER E REMARK 50.0 X X 271383 0 25377 EDWARD J ROTH III 50.0 X X 445347 0 31183 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 1.0 X 0 415579 38655 LEO E DOYLE 1.0 X 0 0 0 GLENN A EISENBERG 1.0 X 0 0 0 DAVID M FINDLEY 1.0 X 0 0 0 NORMAN J GAYNOR III 1.0 X 0 0 0 PRABHCHARAN P GILL MD 39.0 X 576518 0 38069 PATRICIA A GRISCHOW 1.0 X 0 0 0 RICK L HAINES 1.0 X 0 320919 28721 MICHAEL E HANKE 1.0 X 0 0 0 JOHN B HUMPHREY JR MD 1.0 X 0 0 0 DOUGLAS A JONES 1.0 X 0 0 0 JAMES E KNISLEY 1.0 X 0 0 0 GEORGE W LEMON 1.0 X 0 0 0 GENE E LITTLE 1.0 X 0 0 0 RONALD R LYONS 1.0 X 0 0 0 HARRY C C MACNEALY 1.0 X 0 0 0 STEVEN OAKLAND 1.0 X 0 0 0 JUDY A SCHEURER 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 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 ROBERT SABOTA MD 1.0 X 0 0 0 TODD SUMMER 1.0 X 0 0 0 LISA WARBURTON GREGORY 1.0 X 0 0 0 MARK D WRIGHT 1.0 X 0 271400 25519 EILEEN F GOOD 52.0 X 250457 0 24288 ANNE M GUNTHER 53.0 X 153035 0 17020 MICHAEL A KREW MD 55.0 X 545804 0 35062 ELETHERIOS P MAMOUNAS MD 55.0 X 459142 0 21716 TIMOTHY E MCDANIEL MD 55.0 X 575032 0 37868 ALLISON M OPRANDI MD 55.0 X 259064 0 17219 MICHAEL P HOPKINS MD 55.0 X 260784 0 13966 3796566 1007898 354663 90 false true false CANTON AULTMAN EMERGENCY PHYSICIANS 2600 6TH STREET SW CANTON OH 447101702 PHYSICIAN SERVICES 3624780 WHISLER PLUMBING HEATING 2521 LINCOLN WAY EAST MASSILLON OH 446465052 CONTRACTING 1944778 ABBOTT ELECTRIC INC 1935 ALLEN AVENUE SOUTHEAST CANTON OH 44707 CONTRACTING 2171927 FRED OLIVERI CONSTRUCTION 6315 PROMWAY AVE NW NORTH CANTON OH 44720 CONTRACTING 1603352 BUCKINGHAM COOLITTLE BORROUGH PO BOX 71-4085 COLUMBUS OH 432714085 LEGAL 1377462 32 10000 1823045 1833045 NET PATIENT REVENUE 621110 385414280 385414280 PREMIUM REVENUE 621110 29938483 29938483 PHARMACY REVENUE 621110 5502767 5502767 420855530 54739 54739 0 0 1946109 1946109 1946109 1946109 1663625 1739351 -75726 -75725 -75725 0 0 0 FOOD SERVICES 621110 2600958 2600958 LAUNDRY INCOME 812300 201197 201197 LABORATORY INCOME 621500 1190095 1190095 2896261 2896261 6888511 431502209 426352749 1391292 1925123 108593 108593 0 0 0 1832677 1502795 329882 366200 300284 65916 165053488 135343860 29709628 5588355 4582451 1005904 39159487 32110779 7048708 13071378 10718530 2352848 0 1595340 1308179 287161 14582 11957 2625 0 0 8540 7003 1537 27710571 22722668 4987903 1593354 1306550 286804 19282877 15811960 3470917 1045313 857157 188156 0 10513429 8621012 1892417 761212 624194 137018 0 105528 86533 18995 0 22280941 18270372 4010569 21160333 17351473 3808860 324733 266281 58452 MEDICAL SUPPLIES 80084134 65668990 14415144 EDUCATION 2166471 1776506 389965 BAD DEBT EXPENSE 11094597 9097570 1997027 FRANCHISE FEE 4175000 3423500 751500 MISCELLANEOUS 1582589 1297723 284866 430679722 353176920 77502802 0 18818 16129 10047687 4574767 44704195 54764391 785603 432986 3711785 3219675 1653326 1921162 450357104 211981415 243665948 238375689 2869443 1911871 2693738 1929106 51700783 65738388 361851326 372884164 35239110 36867730 4280572 3829288 39519682 40697018 X 318375934 328348792 3556909 3558145 398801 280209 322331644 332187146 361851326 372884164 X 822487 9033015 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 668598 100 18235 5508 681425 532238 118967 22208 4815 668598 516342 20632 4736 532238 1.00000 false false 35620988 35620988 141038112 58093846 82944266 242034203 148432783 93601420 31663801 5454786 26209015 238375689 DUE FROM AFFILIATES 64988908 DEFERRED TAX ASSETS 749480 65738388 0 EST. THIRD-PARTY PAYOR SETTLEM 3829288 3829288 431502209 430679722 822487 89057 7666337 7755394 8577881 435205404 89057 3614138 3703195 431502209 431502209 435117737 4438015 4438015 430679722 430679722 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 SEPARATELY REPORTED SUBSIDIARY REVENUE ($823,877) INTERFUND TRANSFERS 9,480,106 INTERFUND TRANSFERS ON SEPARATELY REPORTED SUBSIDIARY (989,891) TOTAL $7,666,338 PART XII, LINE 2D SEPARATELY REPORTED SUBSIDIARY REVENUE $3,614,138 PART XIII, INE 2D SEPARATELY REPORTED SUBSIDIARY EXPENSE $4,438,015 ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IN 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 17625583 4096769 13528814 0.03220 44752544 30285949 14466595 0.03450 62378127 34382718 27995409 0.06670 1268721 10392 1258329 0.00300 8819407 5090401 3729006 0.00890 26343847 22552586 3791261 0.00900 496310 526662 -30352 0.00010 123990 123990 0.00030 37052275 28180041 8872234 0.02110 99430402 62562759 36867643 0.08780 1 434 434 0.00000 1 110 110 0.00000 4 11192 11192 0.00000 1 13910 13910 0.00000 1 463680 463680 0.00110 9329 9329 0.00010 11 498655 498655 0.00120 false 5410835 2017536 97645422 88142394 9503028 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 AULTMAN WOODLAWN 2 AULTMAN WEST 3 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 $11,094,597 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 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 amount of the provision for doubtful accounts, $12,315 and $19,186 for 2010 and 2009, 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 2010 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 HOSPITALS INCLUDE 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. 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 2007, Aultman conducted a community health survey. The goal was to gauge the health status and health habits of Stark County residents and indentify areas where Aultman can improve the health of our community. Nearly 5,000 surveys were completed and returned. The survey showed overweight/obesity is a top area of opportunity, along with ensuring people get proper vaccinations (flu, pneumonia shots) and health screenings (prostate, colonoscopy). The most commonly diagnosed health problems included high blood pressure, high cholesterol, arthritis, heart disease, chronic back pain and diabetes. In 2010, Aultman began a collaboration with local hospitals and area agencies to assess the needs of Stark County. The Community Health Needs Assessment was performed in 2011. 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 2010 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 2010 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 2010. Of the 125,060 self pay cases in our primary service area Aultman provided care for 39%. PROMOTION OF COMMUNITY HEALTH Aultman's board of directors has 36 six 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 2010, 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. More than 11,700 community members have taken the "Aware" risk assessments since HeartAware launched in March 2008. Nearly 2000 high-risk people have taken advantage of the free follow-up education and information. 2010 health screening events included the annual Cancer Screening Day that offers free screenings for breast, colon, lung, cervical, colon and skin cancers - and a free mammogram screening event at Aultman Carrollton for underserved women. Additional outreach efforts included an Educational Health Fair for the Uninsured, Diabetes Health Fair and "Wear Red" events to promote women's heart health and raise awareness about heart disease. 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 2010, Aultman volunteers visited 84 Stark County schools and taught 220 classes. The safety lesson - which reached 5,400 students in 2010 - 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 program's inception in 2005, Safety First has reached about 17,000 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 2010, 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. A total of 35 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. Aultman's Wellness on Wheels (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. During the inaugural year of outreach, the WOW van has reached more than 12,500 at 150 locations. Aultman offers a free tobacco cessation program called "Give It Up!" Hour-long group sessions are held once a week for six weeks. The program covers everything from how to create a quitting "plan" to tips on staying tobacco-free. Participants receive follow-up support such as phone communication at three and six months after program completion and are eligible to attend additional counseling if needed. In 2010, a total of 76 community members completed Aultman's Give It Up program. In 2010, Aultman Health Foundation contributed to the betterment of the Stark County community with the following activities. 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 2010-11 school year, 37 students participated in the Aultman Career Academy. Students and Aultman staff members collectively contributed 5,620 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 disabilities through yearlong internships. The program participants work in areas ranging from Human Resources to Environmental Services to Aultman Weight Management. Each year, Aultman provides work experience for 12-15 Project SEARCH interns. In 2010, approximately 15,600 Aultman staff and intern hours were dedicated to Project SEARCH endeavors. Massillon Sports Medicine Aultman partners with the Massillon High School to allow students interested in health care to explore career options in sports medicine. In 2010, a total of 14 students participated in sports medicine exploration. Staff and student hours totaled 840 hours. GlenOak Hospitality Program Through the hospitality program, GlenOak High School students garner experience in support and service jobs - with the ultimate goal of finding gainful employment upon graduating from high school. In 2010, five students received hands-on experience at Aultman. The total program commitment among the students and Aultman staff was 810 hours. Cedar Elementary School Reading Program Each school year, Aultman provides volunteers to help nearby Cedar Elementary School students improve their reading skills. In 2010, 52 Aultman employees donated 383 hours of time to mentor students and help the children improve their reading skills and confidence. 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. In 2010, a total of 86 women took advantage of the Look Good, Feel Better program at Aultman. ACHIEVE/Live Well ACHIEVE was originally a grant form the Centers for Disease Control and Prevention (CDC) that Stark County received to start a coalition of community stakeholders to help promote wellness policy changes in the different sectors of our community. The coalition morphed into "Live Well Stark County." Live Well Stark County is a group of leaders working together to make Stark County a healthier community through promoting policy and environmental changes that focus on chronic diseases such as obesity, diabetes and heart disease. Plans include: *Improving worksite wellness *Increasing community gardens and farmers' markets *Adding bike lanes and paths *Posting calor true City of Massillon One James Duncan Plaza Massillon OH 446466686 346001829 8000 Support Kent State University 500 E Main St Kent OH 44242 316402079 501(C)(3) 10000 Support Stark Development Board 116 Cleveland Ave Suite 600 Canton OH 44702 341476938 7692 Support National Football Museum Inc 2121 George Halas Dr NW Canton OH 44708 340898576 501(C)(3) 18000 Support Stark Education Partner 400 Market Ave N Canton OH 44702 341625250 501(C)(3) 10000 Support Ohio Foundation of Independent Colleges 250 E Broad St STE 1700 Columbus OH 432153722 314441082 501(C)(3) 25000 Support 6 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 CHRISTOPHER E REMARK 270532 0 0 0 851 0 15600 0 9777 0 296760 0 0 0 EDWARD J ROTH III 443028 0 0 0 2319 0 15600 0 15583 0 476530 0 0 0 MILAN R DOPIRAK MD 0 297148 0 115263 0 3168 0 29084 0 9571 0 454234 0 0 PRABHCHARAN P GILL MD 442660 0 35000 0 98858 0 23850 0 14219 0 614587 0 0 0 RICK L HAINES 0 318700 0 0 0 2219 0 15600 0 13121 0 349640 0 0 EILEEN F GOOD 245640 0 0 0 4817 0 15600 0 8688 0 274745 0 0 0 MARK D WRIGHT 0 271026 0 0 0 374 0 15600 0 9919 0 296919 0 0 MICHAEL A KREW MD 439482 0 35000 0 71322 0 23847 0 11215 0 580866 0 0 0 ELETHERIOS P MAMOUNAS MD 438577 0 0 0 20565 0 19101 0 2615 0 480858 0 0 0 TIMOTHY E MCDANIEL MD 471794 0 30000 0 73238 0 23850 0 14018 0 612900 0 0 0 ALLISON M OPRANDI MD 254626 0 0 0 4438 0 7550 0 9669 0 276283 0 0 0 MICHAEL P HOPKINS MD 247748 0 10000 0 3036 0 12250 0 1716 0 274750 0 0 0 ANNE M GUNTHER 152729 0 0 0 306 0 12842 0 4178 0 170055 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 2010. TIFFANY GOOD-WITMER FAMILY MBR TO EILEEN GOOD 126314 WAGES false ELIZABETH GOOD FAMILY MBR TO EILEEN GOOD 88732 WAGES false DOREEN GOOD FAMILY MBR TO EILEEN GOOD 57551 WAGES false VICTORIA HAINES FAMILY MBR TO RICK HAINES 93603 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 TED BOYD ARE BOARD MEMBERS OF AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. R CLINT ZOLLINGER ESQ AND SHEILA MARKLEY BLACK ESQ ARE BOARD MEMBERS OF AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER. CHARLES B. SCHEURER AND JUDY A. SCHEURER ARE BOARD MEMBERS OF AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A FAMILY RELATIONSHIP. GOVERNING BODY AND MANAGEMENT PART VI, SECTION A, LINE 11B AULTMAN HEALTH FOUNDATIONS 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. 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 AT THE BOARD OF DIRECTORS MEETING PRIOR TO THE FILING DATE. THE 990 IS PRESENTED AT THE BOARD OF DIRECTORES MEETING AND A COMPLETE FINAL COPY IS EMAILED TO EACH MEMBER OF THE BOARD PRIOR TO THE FILING DATE. 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 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 CEO prior to review and approval 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 and Associates, Inc., an independent compensation consulting firm for review of executive compensation practices. Aultman Hospital uses the following reference materials for the development of Physician Compensation: Medical Group Management Association (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 physician 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 16,806,218 PROFESSIONAL FEES - NON PHYSICIANS 992,543 LINE 24E RECRUITMENT 760,980 MEMBERSHIP FEES 231,785 RECONCILIATION OF NET ASSETS PART XI INTERFUND TRANSFERS ON SEPARATELY REPORTED SUBSIDIARY 8,943,958 UNREALIZED GAIN ON SALE OF ASSETS 89,057 TOTAL 9,033,015 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:CHRISTOPHER E REMARK TITLE:TREASURER HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EDWARD J ROTH III TITLE:CEO AND PRESIDENT - AHF HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MILAN R DOPIRAK MD TITLE:DIRECTOR/PHYSICIAN HOURS:54 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:54 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EILEEN F GOOD TITLE:CEO - WOODLAWN HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANNE M GUNTHER TITLE:CHIEF NURSING OFFICER HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL A KREW MD TITLE:PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ELETHERIOS P MAMOUNAS MD TITLE:PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:TIMOTHY E MCDANIEL MD TITLE:PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ALLISON M OPRANDI MD TITLE:PHYSICIAN HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL P HOPKINS MD TITLE:PHYSICIAN HOURS:1 AULTMAN HEALTH FOUNDATION 2600 SIXTH ST SW CANTON OH 44710 341445390 SUPPORT ORG OH 501(C)(3) 11 B NA AULTMAN COLLEGE OF NURSING AND HEALTH 2600 SIXTH ST SW CANTON OH 47710 201359433 COLLEGE OH 501(C)(3) 2 NA AULTMAN DEVELOPMENT INSTITUTE 2600 SIXTH STREET SW CANTON OH 44710 341388891 CHARITABLE OH 501(C)(3) 11A NA true false false true true false false false true true false true false true true true false true AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES A 341692 AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES D 2037949 AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES N 2605181 AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES O 1822053 AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES P 4438015 AULTMAN COLLEGE OF NURSING & HEALTH SCIENCES R 988383 AULTMAN DEVELOPMENT INSTITUTE E 102733 AUTLAMN DEVELOPMENT INSTITUTE O 281976