2026-05-01T09:39:08-05:00 2025-06-30 331498605 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-07-01 200934451 AVITA HEALTH FOUNDATION AVIT 4194684841 269 PORTLAND WAY SOUTH GALION OH 44833 D ERIC DRAIME CFO 4194684841 2026-04-30 1 1 AMY CIMINELLO P00796388 6148493000 2026-04-27 2024 2025-03-06 01:10:19Z JERRY MORASKO 269 PORTLAND WAY SOUTH GALION OH 44833 2798320 0 X HTTPS://AVITAHEALTH.ORG/FOUNDATION/ X 2004 OH INSPIRE PHILANTHROPY AND PROVIDE FINANCIAL SUPPORT TO GALION COMMUNITY HOSPITAL AND AVITA HEALTH SYSTEM IN WAYS THAT HAVE A POSITIVE IMPACT ON PATIENTS, EMPLOYEES, AND THE COMMUNITY. 14 13 0 16 0 0 1149323 2578838 0 0 46923 117753 -46804 -123675 1149442 2572916 432234 1521913 0 0 0 0 0 0 248831 273752 284853 705986 1806766 443456 766150 3892159 5887487 9627 1154591 3882532 4732896 TO INSPIRE PHILANTHROPY AND TO PROVIDE FINANCIAL SUPPORT TO GALION AND BUCYRUS COMMUNITY HOSPITALS IN ORDER TO ENHANCE HEALTHCARE SERVICES AND TO IMPROVE THE WELL BEING OF THE RESIDENTS OF OUR COMMUNITIES. 0 0 1521913 1521913 SUPPORT AVITA HEALTH SYSTEM, GALION, BUCYRUS, AND ONTARIO HOSPITALS AND SUBSIDIARY ORGANIZATIONS THAT PROMOTE HEALTH CARE IN CRAWFORD COUNTY, OHIO AND SURROUNDING COUNTIES. 1521913 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X D ERIC DRAIME 4194680501 269 PORTLAND WAY SOUTH GALION OH 44833 JERRY MORASKO CEO 0.20 40.60 X X 0 1034139 17576 D ERIC DRAIME CFO 0.20 40.60 X X 0 426144 3050 MYLES CREED DIRECTOR 0.20 40.00 X 0 241055 6794 RANDY MCDONALD CHAIR 0.20 0.00 X X 0 0 0 MATT HORN VICE CHAIR 0.20 0.00 X X 0 0 0 LARRY MORRISON SECRETARY/TREASURER 0.20 0.00 X X 0 0 0 DAWN RATLIFF PAST CHAIR 0.20 0.00 X 0 0 0 CALEB ULMER DIRECTOR 0.20 0.00 X 0 0 0 CHANEL HIPP DIRECTOR 0.20 0.00 X 0 0 0 DR DAVID LONG DIRECTOR 0.20 0.00 X 0 320365 6654 DR ERIC HAUS DIRECTOR 0.20 0.00 X 0 488759 10448 DR GWENDOLINE FANG DIRECTOR 0.20 0.00 X 0 384257 11907 MARYLYN STRANG DIRECTOR 0.20 0.00 X 0 0 0 NICHOLAS GESOURAS DIRECTOR 0.20 0.00 X 0 0 0 RICHARD HARER DIRECTOR 0.20 0.00 X 0 0 0 TROY SAPP DIRECTOR 0.20 0.00 X 0 0 0 BOYD EPPERSON HONORARY DIRECTOR 0.20 0.10 X 0 0 0 ERIC GEYER HONORARY DIRECTOR 0.20 0.00 X 0 0 0 0 2894719 56429 0 0 1 0 0 659758 373458 1173710 371912 2578838 117753 117753 101729 659758 225404 -123675 -123675 2572916 0 0 -5922 1495363 1495363 26550 26550 196653 196653 10749 10749 36774 36774 39816 25273 14543 861 861 1806766 1521913 36022 248831 2357463 4215062 19214 9585 16485 1525111 1636726 3892159 5887487 9627 1154591 9627 1154591 X 1987250 2277822 1895282 2455074 3882532 4732896 3892159 5887487 766150 84214 0 X X 0 1 X 1 1 1 X 1237953 1253985 1067540 1149323 2578838 7287639 1237953 1253985 1067540 1149323 2578838 7287639 7287639 28390 33447 38527 46923 117753 265040 13823 50396 180728 140941 101729 487617 8040296 0.90640 0.76220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 HELD FOR FUTURE INVESTMENTS 1636726 1636726 COMPREHENSIVE CAMPAIGN 233394 233394 CORNERSTONE 103097 103097 1 424996 323267 101729 225404 761487 659758 101729 225404 225404 -123675 1 GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 448332399 344451872 501(C)(3) 1150000 0 COMMUNITY IMPROVEMENT GRANT GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 448332399 344451872 501(C)(3) 21821 0 SHIP GRANT GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 448332399 344451872 501(C)(3) 323542 0 GENERAL USE FUNDS 1 0 AVITA EMPLOYEE CRISIS 13 12300 SCHOLARSHIP 23 14250 PART I, LINE 2: GRANTS ARE USED TO SUPPORT THE TAX-EXEMPT PURPOSE OF RELATED ENTITIES. THESE ARE MONITORED INTERNALLY. SCHEDULE I, PART III: GALION COMMUNITY HOSPITAL EMPLOYEES ARE ELIGIBLE FOR REIMBURSEMENT. APPLICATIONS ARE APPROVED BY HUMAN RESOURCES. TUITION INVOICES AND GRADES ARE MONITORED BY THE CONTROLLER TO MAKE SURE THE STUDENT MEETS CERTAIN CRITERIA TO RECEIVE THE FUNDS. 0 0 0 0 0 0 0 0 0 JERRY MORASKO CEO 0 961785 0 72354 0 0 0 0 0 17576 0 1051715 0 0 DR ERIC HAUS DIRECTOR 0 362312 0 126447 0 0 0 0 0 10448 0 499207 0 0 D ERIC DRAIME CFO 0 370796 0 55348 0 0 0 0 0 3050 0 429194 0 0 DR GWENDOLINE FANG DIRECTOR 0 367190 0 17067 0 0 0 0 0 11907 0 396164 0 0 DR DAVID LONG DIRECTOR 0 267193 0 53172 0 0 0 0 0 6654 0 327019 0 0 MYLES CREED DIRECTOR 0 210249 0 30806 0 0 0 0 0 6794 0 247849 0 0 PART I, LINE 3: AVITA HEALTH FOUNDATION RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD -COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION SHALL, AT ALL TIMES, BE GALION COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR DIRECTORS SHALL HAVE THE APPROVAL OF THE BOARD OF DIRECTORS OF GALION COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, SUCH AS APPROVAL OF THE GOVERNING BODY'S ELECTION OR REMOVAL OF MEMBERS. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE SUB-COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS AND SENT TO THE EXECUTIVE COMMITTEE OF GALION COMMUNITY HOSPITAL'S BOARD FOR THEIR REVIEW PRIOR TO FILING. THE BOARD EXECUTIVE COMMITTEE APPROVES THE FORM 990 FOLLOWING REVIEW, AS AUTHORIZED BY THE FULL GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C GALION COMMUNITY HOSPITAL HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL BOARD OF DIRECTORS AND OFFICERS OF THE CORPORATION. CONFLICT OF INTEREST SURVEYS ARE REVIEWED BY BOARD CHAIRMAN AND THE CEO TO ENSURE COMPLIANCE. VARIOUS RESTRICTIONS ARE IMPOSED ON INDIVIDUALS WITH POTENTIAL CONFLICTS OF INTEREST (I.E. INABILITY TO VOTE) UNTIL DECISION HAS BEEN MADE ON POTENTIAL CONFLICT. AVITA HEALTH FOUNDATION HAS ADOPTED THIS POLICY. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC, OTHER THAN THE FINANCIAL STATEMENTS WHICH ARE ATTACHED TO GALION COMMUNITY HOSPITAL'S FORM 990. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS A FINANCE COMMITTEE WHICH OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART XII, LINE 3B: SINGLE AUDIT IS COMPLETED ON A CONSOLIDATED BASIS. GALION COMMUNITY HOSPITAL 269 PORTLAND WAY SOUTH GALION OH 44833 344451872 HOSPITAL SERVICES OH 501(C)(3) LINE 3 AVITA HEALTH SYSTEM 1 COMMUNITY HEALTH ASSOCIATES INC 955 BUCYRUS ROAD GALION OH 44833 341784017 PHYSICIAN OFFICE OH 501(C)(3) LINE 12A, I GALION COMMUNITY HOSPITAL 1 NORTH CENTRAL OHIO FAMILY CARE CENTER INC 269 PORTLAND WAY SOUTH GALION OH 44833 341807906 PHYSICIAN OFFICE OH 501(C)(3) LINE 12A, I GALION COMMUNITY HOSPITAL 1 AVITA HEALTH SYSTEM 269 PORTLAND WAY SOUTH GALION OH 44833 274385692 HEALTHCARE OH 501(C)(3) LINE 12B, II N/A 0 CRAWFORD COUNTY SHARED HEALTH SERVICES INC 1220 NORTH MARKET STREET GALION OH 44833 341484014 HOME HEALTH & HOSPICE OH 501(C)(3) LINE 11 GALION COMMUNITY HOSPITAL 1 GALION COMMUNITY PAIN MANAGEMENT LLC 269 PORTLAND WAY SOUTH GALION OH 44833 300602607 HOSPITAL SUPPORT OH N/A 0 0 GALION COMMUNITY VASCULAR SERVICES LLC 269 PORTLAND WAY SOUTH GALION OH 44833 611613817 HOSPITAL SUPPORT OH N/A 0 0 AMERICAN SURGICAL SPINE SERVICES 629 N SANDUSKY AVE BUCYRUS OH 44820 371786727 HOSPITAL SUPPORT OH N/A 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1