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AULTMAN HEALTH FOUNDATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
AULTMAN HEALTH FOUNDATION (EIN 34-1445390)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-15
IRS object ID
201903199349310445
Schema version
2018v3.1
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)
Return2019-11-15T12:52:46-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14505 STEPHEN CIRCLE NW STE 200AddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44718ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341445390EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AULTMAN HEALTH FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAULTBusinessNameControlTxt
Phone3303636352PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 SIXTH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK D WRIGHTPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone3303636352PhoneNum
Signature2019-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLISA HILLINGPreparerPersonNm
PTINP01624111PTIN
Phone3304972000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-15IPDt
IP Tm10:14:44IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7BE7DF1651D6D8591F67A801A29A6D8D893E2ED2AtSubmissionCreationDeviceId
At Submission Filing Device Id4CEE3F166FC64316C964FDA06B2457A90F5D27ABAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEDWARD J ROTH IIIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 SIXTH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$73,648,364GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.AULTMAN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1975FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTHE MISSION OF AULTMAN HEALTH FOUNDATION IS TO "LEAD OUR COMMUNITY TO IMPROVED HEALTH."ActivityOrMissionDesc
Voting Members Governing Body63VotingMembersGoverningBodyCnt
Voting Members Independent49VotingMembersIndependentCnt
Total Employee342TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$37,112NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$44,136,705PYProgramServiceRevenueAmt
CY Program Service Revenue$47,979,263CYProgramServiceRevenueAmt
PY Investment Income$7,847,548PYInvestmentIncomeAmt
CY Investment Income$7,708,145CYInvestmentIncomeAmt
PY Other Revenue$1,362,022PYOtherRevenueAmt
CY Other Revenue$716,068CYOtherRevenueAmt
PY Total Revenue$53,346,275PYTotalRevenueAmt
CY Total Revenue$56,403,476CYTotalRevenueAmt
PY Grants And Similar Paid$703,823PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,025,804CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$25,145,688PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$27,190,989CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$24,017,116PYOtherExpensesAmt
CY Other Expenses$23,614,716CYOtherExpensesAmt
PY Total Expenses$49,866,627PYTotalExpensesAmt
CY Total Expenses$51,831,509CYTotalExpensesAmt
PY Revenues Less Expenses$3,479,648PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,571,967CYRevenuesLessExpensesAmt
Total Assets BOY$325,101,516TotalAssetsBOYAmt
Total Assets EOY$433,220,948TotalAssetsEOYAmt
Total Liabilities BOY$46,035,183TotalLiabilitiesBOYAmt
Total Liabilities EOY$149,079,203TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$279,066,333NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$284,141,745NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF AULTMAN HEALTH FOUNDATION IS TO "LEAD OUR COMMUNITY TO IMPROVED HEALTH." AULTMAN HEALTH FOUNDATION AND ITS SUBSIDIARIES AND AULTCARE HEALTH PLANS ENABLE AULTMAN TO BE ONE OF THE LOWEST-COST HEALTH CARE PROVIDERS IN NORTHEASTERN OHIO. LOWER COSTS HELP LOCAL BUSINESSES STAY FINANCIALLY HEALTHY AND MAINTAIN GOOD JOBS IN OUR COMMUNITY. IN ADDITION TO PROVIDING HIGH-QUALITY, LOW-COST HEALTH CARE, AULTMAN HEALTH FOUNDATION PROVIDES HEALTH EDUCATION FOR THE COMMUNITY. FOR EXAMPLE, THE WORKING ON WELLNESS MOBILE HEALTH-FAIR UNIT PROVIDES HEALTH SCREENINGS AND WELLNESS EDUCATION FOR OUR COMMUNITY. THE WOW TEAM VISTED MORE THAN 400 SITES IN 2018, RANGING FROM COMMUNITY EVENTS TO SENIOR CITIZEN CENTERS. WOW NURSES HAD PERSONAL INTERACTION WITH MORE THAN 17,000 COMMUNITY MEMBERMissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$20,334,316ExpenseAmt
Grant$0GrantAmt
Revenue$3,658RevenueAmt
DescWITH 120 EMPLOYEES, THE AULTMAN SYSTEMS AND TECHNOLOGY DEPARTMENT PROVIDES THE TECHNICAL INFRASTRUCTURE FOR BUSINESS AND CLINICAL SYSTEMS THROUGHOUT AHF, ITS SATELLITE FACILITIES AND SUBSIDIARIES. THE SYSTEMS AND TECHNOLOGY TEAM HANDLES EVERYTHING RELATED TO INFORMATION TECHNOLOGY AT AULTMAN HEALTH FOUNDATION - INCLUDING HARDWARE, SOFTWARE DATA SECURITY AND INTERNAL CUSTOMER SUPPORT.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$6,568,140ExpenseAmt
Grant$0GrantAmt
Revenue$7,045,429RevenueAmt
DescTHE AULTMAN SPECIALTY HOSPITAL, LOCATED ON THE MAIN AULTMAN CAMPUS, PROVIDES LONG-TERM ACUTE CARE FOR PATIENTS WITH MEDICALLY COMPLEX CONDITIONS. PATIENTS' AVERAGE LENGTH OF STAY IS 25 DAYS, AND THEY ARE TYPICALLY TRANSFERRED FROM AULTMAN ICU OR STEP-DOWN UNITS OR OTHER LOCAL HOSPITALS. IN 2018, 186 PATIENTS WERE CARED FOR AT THE AULTMAN SPECIALTY HOSPITAL. THE FACILITY'S QUALITY PROGRAM HAS BEEN ENHANCED IN THE AREAS OF IMPROVED PREVENTION OF SKIN BREAKDOWN, VENTILATOR-ASSOCIATED PNEUMONIA, LINE SEPSIS AND CLOSTRIDIUM DIFFICILE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$4,351,050ExpenseAmt
Grant$0GrantAmt
Revenue$14,392RevenueAmt
DescTHE 29-MEMBER AULTMAN HEALTH FOUNDATION HUMAN RESOURCES DEPARTMENT PROVIDES SUPPORT SERVICES RELATIVE TO EMPLOYEE BENEFITS, COMPENSATION, EDUCATION AND DEVELOPMENT, EMPLOYEE RECRUITING, NEW-HIRE ORIENTATION, DIVERSITY AND INCLUSION, AND EMPLOYEE EVENTS ACROSS AHF FACILITIES.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$10,924,918ExpenseAmt
Grant$1,025,804GrantAmt
Revenue$40,915,784RevenueAmt
DescAULTMAN HEALTH FOUNDATION (AHF) WAS FORMED AS A SUPPORT ENTITY AULTMAN HOSPITAL (AH) AND AHF'S SUBSIDIARIES. THIS STRUCTURE IS COMMON TO MANY HEALTH CARE SYSTEMS. AHF PERFORMS ACTIVITIES THAT DIRECTLY AND INDIRECTLY IMPACT AH. THERE IS A CLOSE WORKING RELATIONSHIP BETWEEN AHF AND AH AND SUBSTANTIAL RESOURCES OF AHF ARE COMMITTED TO FURTHERING THE AH MISSION.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$10,924,918TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$1,025,804TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$40,915,784TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$42,178,424TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document157IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee342EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial AccountYes (1)ForeignFinancialAccountInd
Foreign CountryCJForeignCountryCd
Foreign CountryEIForeignCountryCd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (1)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members63GoverningBodyVotingMembersCnt
Independent Voting Member49IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MARK D WRIGHTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3303636192PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 SIXTH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (87 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
EDWARD J ROTH III
PRESIDENT/CEO50.005.00Yes (X)Yes (X)$717,657$0$50,471
BARBARA HAMMONTREE BENNETT
PAST CHAIR - AHF6.000.00Yes (X)Yes (X)$0$0$0
DARRYL J DILLENBACK
CHAIR - AHF7.009.00Yes (X)Yes (X)$0$0$0
EMIL ALECUSAN
VICE CHAIR - AHF7.000.00Yes (X)Yes (X)$0$0$0
BRYAN RICE
2ND VICE CHAIR/SECRETARY3.000.00Yes (X)Yes (X)$0$0$0
CHRISTOPHER E REMARK
TREASURER/CEO - AH; DIRECTOR - IHC4.0051.00Yes (X)$0$517,306$45,950
BARBARA ABBOTT
DIRECTOR - AHF2.000.00Yes (X)$0$0$0
DAVID W BARTLEY II
DIRECTOR - AHF2.000.00Yes (X)$0$0$0
BRIAN S BELDEN
DIRECTOR - AHF3.004.00Yes (X)$0$0$0
PAUL R BISHOP
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
PEGGY CLAYTOR
DIRECTOR - AHF2.002.00Yes (X)$0$0$0
NATE J COOKS
DIRECTOR - AHF1.003.00Yes (X)$0$0$0
JACQUELINE DEGARMO
DIRECTOR - ASH2.000.00Yes (X)$0$0$0
STEPHEN G DEUBLE
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
MILAN R DOPIRAK MD
DIRECTOR - AHF1.0054.00Yes (X)$0$422,555$5,928
LEO DOYLE
DIRECTOR - AHF6.002.00Yes (X)$0$0$0
DAVID M FINDLEY
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
RYAN FULMER
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
T STEPHEN GREGORY
DIRECTOR - AHF6.004.00Yes (X)$0$0$0
PATRICIA A GRISCHOW
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
RICK L HAINES
DIRECTOR - AHF; CEO - AULTCARE5.0050.00Yes (X)$0$618,543$44,624
JOSEPH E HALTER JR
DIRECTOR - AHF3.000.00Yes (X)$0$0$0
MICHAEL E HANKE
DIRECTOR - AHF2.000.00Yes (X)$0$0$0
SUE HOSTETLER
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
JOHN B HUMPHREY JR MD
DIRECTOR - AHF5.004.00Yes (X)$0$0$0
BECKY L JEWELL
DIRECTOR - AHF1.002.00Yes (X)$0$0$0
GEOFF KARCHER
DIRECTOR - AHF3.000.00Yes (X)$0$0$0
JOANNE KRIVETZKY MD
DIRECTOR - AHF; MED STAFF PRES-ELECT1.001.00Yes (X)$0$0$0
BRIAN LAYMAN
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
GENE E LITTLE
DIRECTOR - AHF4.000.00Yes (X)$0$0$0
MICHAEL LYNCH MD
DIRECTOR - AHF2.0053.00Yes (X)$0$464,504$46,689
RON LYONS
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
LORI MARTINO
DIRECTOR - AHF; AH WOMEN'S BOARD PRESIDENT1.000.00Yes (X)$0$0$0
LORI L MERTES MD
PRESIDENT OF INNOVATIONS BOARD1.0054.00Yes (X)$0$427,012$27,500
JEFFREY MILLER MD
DIRECTOR - AHF1.005.00Yes (X)$0$0$0
PRABHCHARAN GILL MD
DIRECTOR - AHF1.0054.00Yes (X)$0$692,800$51,251
MICHAEL RICH MD
DIRECTOR - AHF1.0054.00Yes (X)$0$475,424$51,251
JESSE ROPER
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
LOUIS G SHAHEEN MD
DIRECTOR - AHF1.003.00Yes (X)$0$0$0
DOUGLAS J SIBILA
DIRECTOR - AHF4.002.00Yes (X)$0$0$0
JOHN A SIRPILLA
DIRECTOR - AHF4.000.00Yes (X)$0$0$0
TODD M SOMMER
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
RYAN STENGAR
DIRECTOR - AHF1.000.00Yes (X)$0$0$0
GAIL STERLING
DIRECTOR - AHF1.004.00Yes (X)$0$0$0
WILLIAM WALLACE MD
DIRECTOR - AHF2.007.00Yes (X)$0$0$0
R CLINT ZOLLINGER ESQ
DIRECTOR - AHF2.000.00Yes (X)$0$0$0
MARK D WRIGHT
CFO50.005.00Yes (X)$439,693$0$45,251
ELIZABETH A GETZ
CIO50.005.00$326,796$0$49,394Yes (X)
ROBERT C MOLNAR
SVP, REGIONAL DEVELOPMENT50.005.00$250,335$0$44,125Yes (X)
MARK N ROSE
SVP - LEGAL SERVICES50.005.00$352,116$0$51,251Yes (X)
JASON JUSTUS
VP - POMERENE FINANCE55.000.00$211,505$0$31,581Yes (X)
SUSAN E OLIVERA
VP - HUMAN RESOURCES53.002.00$290,765$0$51,251Yes (X)
AKBAR SHAH MD
CHAIR - ASH; PHYSICIAN55.000.00Yes (X)Yes (X)$0$1,006,846$50,471
DANIEL RODRIGUEZ MD
VICE CHAIR - ASH55.000.00Yes (X)Yes (X)$0$289,080$37,751
DIANA BOYD
SECRETARY & TREASURER - ASH1.000.00Yes (X)Yes (X)$0$0$0
EILEEN GOOD SENIOR VP -
CLINIAL ADVOCACY; DIRECTOR - ASH1.000.00Yes (X)Yes (X)$1,050,465$0$2,168
DEANNA HATFIELD
DIRECTOR - ASH1.000.00Yes (X)$0$0$0
DENISE HILL
DIRECTOR - ASH1.001.00Yes (X)$0$0$0
ERIC JOHNSON
DIRECTOR - ASH1.000.00Yes (X)$0$0$0
GEORGE KEFALAS MD
DIRECTOR - ASH2.000.00Yes (X)$0$0$0
ELLEN LINZ
DIRECTOR - ASH1.000.00Yes (X)$0$0$0
DAVID MOTTS
DIRECTOR - ASH1.000.00Yes (X)$0$0$0
CHADI BOU SERHAL MD
DIRECTOR - ASH2.000.00Yes (X)$0$0$0
STEPHANIE BOYD
CEO - ASH (THROUGH 2/18)1.000.00$28,086$140,429$21,006Yes (X)
RYAN KUHARICH
CEO - ASH55.000.00Yes (X)Yes (X)$112,515$0$40,185
MELANIE MIRANDE MD
CHAIR - IHC1.000.00Yes (X)Yes (X)$0$0$0
BRIAN MCCLAIN MD
TREASURER - IHC2.000.00Yes (X)Yes (X)$0$0$0
DOUGLAS BLOCKER MD
DIRECTOR - IHC1.000.00Yes (X)$0$0$0
ANTHONY DEGENHARD DO
DIRECTOR - IHC2.005.00Yes (X)$0$0$0
ANDY R HART MD
DIRECTOR - IHC1.000.00Yes (X)$0$0$0
LEWIS HUMBLE MD
DIRECTOR - IHC1.0054.00Yes (X)$0$312,203$44,430
JAMES JOHNS MD
DIRECTOR - IHC1.000.00Yes (X)$0$0$0
STEVEN KELLY MD
DIRECTOR - IHC1.0054.00Yes (X)$0$989,864$51,170
ROGER MUSA MD
DIRECTOR - IHC1.0054.00Yes (X)$0$254,669$44,724
TIMOTHY O'TOOLE MD
DIRECTOR - IHC2.000.00Yes (X)$0$0$0
JOHN PRODAFIKAS
DIRECTOR - IHC1.0054.00Yes (X)$0$881,417$51,250
ROBERT SABOTA MD
DIRECTOR - IHC1.001.00Yes (X)$0$0$0
JOHN WESTERBECK MD
DIRECTOR - IHC1.000.00Yes (X)$0$0$0
JAMES WILSON MD
DIRECTOR - IHC1.000.00Yes (X)$0$0$0
ANDREW ZURICK MD
MEDICARE BENEFICIARY - IHC1.000.00Yes (X)$0$0$0
ALLISON M OPRANDI MD
CEO - IHC55.000.00$0$416,658$41,409Yes (X)
MATTHEW RITZERT
VP - IHC55.000.00$154,764$0$16,482Yes (X)
KEVIN D PETE
SVP50.005.00$312,162$0$40,501Yes (X)
RONALD RUSNAK MD
DIRECTOR OF CLINICAL INFORMATICS55.000.00$342,830$0$40,632Yes (X)
FRANCIS SNYDER
CEO - POMERENE55.000.00$335,592$0$50,382Yes (X)
TIMOTHY TEYNOR
VP - PUBLIC POLICY50.005.00$232,488$0$38,264Yes (X)
TRACY SABO
VP OF HUMAN RESOURCES55.000.00$195,070$0$27,352Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,352,839TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,909,310TotReportableCompRltdOrgAmt
Total Other Compensation$1,194,694TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K41IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CERNER CORP
2800 ROCKCREEK PWKYKANSAS CITYMO64117SOFTWARE SUPPORT$7,030,323
DELL FINANCIAL SERVICES
ONE DELL WAYROUND ROCKTX78682SOFTWARE SUPPORT$1,389,744
MICROSOFT CORPORATION
ONE MICROSOFT WAYREDMONDWA98052SOFTWARE SUPPORT$1,061,590
CISCO SYSTEMS INC
170 W TASMAN DRIVESAN JOSECA95134SOFTWARE SUPPORT$842,068
HURON CONSULTING GROUP INC
550 W VAN BUREN STREETCHICAGOIL60607MANAGEMENT CONSULTING$140,906
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K39CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HEALTH SYSTEM ADMINISTRATION561000$37,971,620$37,971,620
PATIENT SERVICE REVENUE624100$7,089,970$7,089,970
PROPERTY MANAGEMENT REVENUE561000$1,499,804$1,499,804
OTHER INCOME561000$1,417,869$1,417,869
FieldValueIRS element (for citing)
Total Program Service Revenue$47,979,263TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,662,283TotalRevenueColumnAmt
Exclusion-$1,662,283ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$26,615,316SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$17,243,808SecuritiesAmt
Other$1,080OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$9,371,508SecuritiesAmt
Other-$1,080OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,370,428TotalRevenueColumnAmt
Exclusion$9,370,428ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescSUBPART F INCOME (SEE FORM 5471)Desc
Business900099BusinessCd
Total Revenue Column$716,068TotalRevenueColumnAmt
Exclusion$716,068ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$716,068OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,403,476TotalRevenueColumnAmt
Related Or Exempt Func Income$47,979,263RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$8,424,213ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,025,804TotalAmt
Program Services$1,025,804ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,481,843TotalAmt
Program Services$5,250,293ProgramServicesAmt
Management And General$1,231,550ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$16,633,069TotalAmt
Program Services$13,472,786ProgramServicesAmt
Management And General$3,160,283ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$843,387TotalAmt
Program Services$683,143ProgramServicesAmt
Management And General$160,244ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,622,794TotalAmt
Program Services$1,314,463ProgramServicesAmt
Management And General$308,331ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,609,896TotalAmt
Program Services$1,304,016ProgramServicesAmt
Management And General$305,880ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$54,662TotalAmt
Program Services$44,276ProgramServicesAmt
Management And General$10,386ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$83,415TotalAmt
Program Services$67,566ProgramServicesAmt
Management And General$15,849ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$193,167TotalAmt
Program Services$156,465ProgramServicesAmt
Management And General$36,702ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$5,686TotalAmt
Program Services$4,606ProgramServicesAmt
Management And General$1,080ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,971,977TotalAmt
Program Services$6,457,301ProgramServicesAmt
Management And General$1,514,676ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$16,083TotalAmt
Program Services$13,027ProgramServicesAmt
Management And General$3,056ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total-$184,370TotalAmt
Program Services-$149,340ProgramServicesAmt
Management And General-$35,030ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$10,783,274TotalAmt
Program Services$8,734,452ProgramServicesAmt
Management And General$2,048,822ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,473,419TotalAmt
Program Services$1,193,469ProgramServicesAmt
Management And General$279,950ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$211,420TotalAmt
Program Services$171,250ProgramServicesAmt
Management And General$40,170ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$8,268TotalAmt
Program Services$6,697ProgramServicesAmt
Management And General$1,571ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$71,333TotalAmt
Program Services$57,780ProgramServicesAmt
Management And General$13,553ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$198,398TotalAmt
Program Services$160,702ProgramServicesAmt
Management And General$37,696ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$245,176TotalAmt
Program Services$198,593ProgramServicesAmt
Management And General$46,583ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
EDUCATION$799,697$647,755$151,942
MEDICAL SUPPLIES$523,685$424,185$99,500
MEDICATION$426,064$345,112$80,952
RECRUITMENT$189,715$153,669$36,046

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$543,647TotalAmt
Program Services$440,354ProgramServicesAmt
Management And General$103,293ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$51,831,509TotalAmt
Program Services$42,178,424ProgramServicesAmt
Management And General$9,653,085ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,807,977BOYAmt
EOY$2,190,126EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,305,604BOYAmt
EOY$1,285,722EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$3,143,166BOYAmt
EOY$1,107,916EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,348,440BOYAmt
EOY$1,692,303EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,895,626LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,305,681LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,119,540BOYAmt
EOY$3,589,945EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$51,620,298BOYAmt
EOY$50,090,181EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$241,076,494BOYAmt
EOY$372,029,657EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$18,679,997BOYAmt
EOY$1,235,098EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$325,101,516BOYAmt
EOY$433,220,948EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,670,547BOYAmt
EOY$9,961,737EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$635,246BOYAmt
EOY$613,891EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$131,554,573EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$26,200,615BOYAmt
EOY$6,621,745EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,528,775BOYAmt
EOY$327,257EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$46,035,183BOYAmt
EOY$149,079,203EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$279,066,333BOYAmt
EOY$284,141,745EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$279,066,333BOYAmt
EOY$284,141,745EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$325,101,516BOYAmt
EOY$433,220,948EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$4,571,967ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$3,533,337NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$4,036,782OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1AULTMAN HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN340714538EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$10,924,918SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$10,924,918SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 12G, COLUMN V:FormAndLineReferenceDesc
ExplanationAULTMAN HEALTH FOUNDATION (AHF) WAS FORMED TO HANDLE THE OVERALL MANAGEMENT FOR AULTMAN HOSPITAL (AH) AND AHF'S SUBSIDIARIES. THIS STRUCTURE IS COMMON TO MANY HEALTH CARE SYSTEMS. AHF PERFORMS ACTIVITIES THAT DIRECTLY AND INDIRECTLY IMPACT AH. THERE IS A CLOSE WORKING RELATIONSHIP BETWEEN AHF AND AH AND SUBSTANTIAL RESOURCES OF AHF ARE COMMITTED TO FURTHERING THE AH MISSION.ExplanationTxt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$185,791OtherActivitiesAmt
Total Lobbying Expenditures$185,791TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHIS REPRESENTS PAYMENTS TO VARIOUS PROFESSIONAL ORGANIZATIONS FOR CONDUCTING FEDERAL AND STATE ADVOCACY, GOVERNMENT RELATIONS REPRESENTATION, AND GENERAL LEGISLATIVE COUNSELING AND BUSINESS REGULATIONS ON BEHALF OF THE ORGANIZATION.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,877,417OtherCostOrOtherBasisAmt
Book Value$1,877,417BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,250,535OtherCostOrOtherBasisAmt
Depreciation$2,072,844DepreciationAmt
Book Value$1,177,691BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,656,104OtherCostOrOtherBasisAmt
Depreciation$2,128,399DepreciationAmt
Book Value$527,705BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$111,570OtherCostOrOtherBasisAmt
Depreciation$104,438DepreciationAmt
Book Value$7,132BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,589,945TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (2 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
INVESTMENT IN AFFILIATES$330,987,534C
ASSETS LIMITED AS TO USE$41,042,123C
FieldValueIRS element (for citing)
Total Book Value Program Rltd$372,029,657TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$51,273
INTERCOMPANY PAYABLES$275,984
FieldValueIRS element (for citing)
Total Liability$327,257TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationWHEN 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 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.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,030,960TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,015,166DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,794NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,030,960TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,015,166DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,794NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,030,960TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,015,166DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,794NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$94,595BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$3,351,252ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$2,753,077CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$598,175MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AULTMAN SPECIALTY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 SIXTH ST SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://WWW.AULTMAN.ORGWebsiteAddressTxt
State License1454StateLicenseNum

Subordinate Hospital Name SubordinateHospitalName

FieldValueIRS element (for citing)
Business Name Line1AULTMAN SPECIALTY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Subordinate Hospital EIN134246188SubordinateHospitalEIN
Licensed HospitalYes (X)LicensedHospitalInd
OtherLONG-TERM ACUTE CAREOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1AULTMAN SPECIALTY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION B, LINE 7DOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION B, LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, PAGE 8FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, PAGE 8FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, PAGE 8FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
AULTMAN SPECIALTY HOSPITALPART V, SECTION B, LINE 5: AULTMAN HOSPITAL, AULTMAN ALLIANCE COMMUNITY HOSPITAL AND AULTMAN SPECIALTY HOSPITAL COLLABORATED WITH VARIOUS COMMUNITY ORGANIZATIONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY TO CONDUCT THE STARK COUNTY COMMUNITY HEALTH ASSESSMENT (CHA), THE BASIS FOR THIS JOINT CHNA. THE CHA PROCESS INCLUDED GATHERING PRIMARY AND SECONDARY DATA COLLECTION THROUGH FOUR PHASES: 1) COMMUNITY SURVEY, 2) COMMUNITY HEALTH LEADER SURVEY, 3) SECONDARY DATA AND 4) COMMUNITY FOCUS GROUP. THE PROCESS CULMINATED IN A HEALTH IMPROVEMENT SUMMIT, WHERE HOSPITALS AND COMMUNITY STAKEHOLDER MEMBERS OF THE STARK COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY COMMITTEE (ADVISORY COMMITTEE) COMPLETED THE PROCESS BY IDENTIFYING AND PRIORITIZING THE SIGNIFICANT COMMUNITY HEALTH NEEDS. COMMUNITY SURVEY. THE FIRST PHASE CONSISTED OF A RANDOM SAMPLE TELEPHONE SURVEY OF STARK COUNTY HOUSEHOLDS. TELEPHONE INTERVIEWS ENSURED ADEQUATE SAMPLE SIZE AND REPRESENTATIVENESS OF THE POPULATION. THE FINAL SAMPLE SIZE OF 800 RESULTED IN AN OVERALL SAMPLING ERROR OF +/- 3.5% WITHIN A 95% CONFIDENCE LEVEL. AN OVERSAMPLE OF APPROXIMATELY 160 AFRICAN-AMERICAN RESIDENTS AND 105 CANTON RESIDENTS WAS CONDUCTED IN ADDITION TO THE 800 INTERVIEWS IN ORDER TO ATTAIN ENOUGH CASES OF THIS POPULATION TO BE ABLE TO DRAW STATISTICALLY VALID CONCLUSIONS. DATA COLLECTION BEGAN ON JULY 5, 2018 AND ENDED ON AUGUST 7, 2018. MOST CALLING TOOK PLACE BETWEEN THE EVENING HOURS OF 5:15 P.M. AND 9:15 P.M. SOME INTERVIEWS WERE CONDUCTED DURING THE DAY AND ON SOME WEEKENDS TO ACCOMMODATE RESPONDENT SCHEDULES. THE INTERVIEWS TOOK AN AVERAGE OF 14.4 MINUTES.SECONDARY DATA. THE SECOND PHASE CONSISTED OF REVIEWING AND ANALYZING SECONDARY DATA SOURCES TO IDENTIFY PRIORITY AREAS OF CONCERN WHEN ANALYZED ALONGSIDE SURVEY DATA. CMOR GATHERED AND COMPILED HEALTH AND DEMOGRAPHIC DATA FROM VARIOUS SOURCES. COMMUNITY LEADER SURVEY. THE THIRD PHASE CONSISTED OF A WEB SURVEY OF COMMUNITY LEADERS WHO WERE KNOWLEDGEABLE ABOUT PUBLIC HEALTH. A TOTAL OF 101 COMMUNITY LEADERS COMPLETED THE WEB SURVEY BETWEEN OCTOBER 25 AND NOVEMBER 12, 2018. SEE APPENDIX 2, ORGANIZATIONS RESPONDING TO THE INVITATION TO PARTICIPATE IN THE COMMUNITY LEADER SURVEY.COMMUNITY FOCUS GROUP. TO BE COMPLETED IN 2019.
AULTMAN SPECIALTY HOSPITALPART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING HOSPITAL FACILITIES: AULTMAN HOSPITAL, AULTMAN ALLIANCE COMMUNITY HOSPITAL, AND MERCY MEDICAL CENTER.
AULTMAN SPECIALTY HOSPITALPART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING NON-HOSPITAL FACILITIES: ACCESS HEALTH STARK COUNTY; ALLIANCE CITY HEALTH DEPARTMENT; ALLIANCE FAMILY HEALTH CENTER; BEACON CHARITABLE PHARMACY; CANTON CITY PUBLIC HEALTH; COMMQUEST; MASSILLON CITY HEALTH DEPARTMENT; MY COMMUNITY HEALTH CENTER; OHIO STATE UNIVERSITY EXTENSION; PARAMOUNT ADVANTAGE; PEGASUS FARM; SISTERS OF CHARITY FOUNDATION OF CANTON; STARKFRESH; STARK COUNTY HEALTH DEPARTMENT; STARK COUNTY COMMUNITY ACTION AGENCY; STARK COUNTY FAMILY COUNCIL; STARK COUNTY JOBS AND FAMILY SERVICES; STARK COUNTY DISTRICT LIBRARY; STARK MENTAL HEALTH & ADDICTION RECOVERY; STARK PARKS; STARK COUNTY TASC; UNITED WAY OF GREATER STARK COUNTY; YMCA OF CENTRAL STARK COUNTY.IN ADDITION, THE COLLABORATION CONTRACTED WITH CENTER FOR MARKETING & OPINION RESEARCH TO CONDUCT THE 2018 STARK COUNTY HEALTH NEEDS ASSESSMENT AS THEY DID FOR PREVIOUS CYCLES. CMOR PROVIDES PUBLIC OPINION RESEARCH SERVICES TO COLLEGES AND UNIVERSITIES, HOSPITALS AND HEALTH CARE ORGANIZATIONS, BUSINESSES AND COMMUNITY-BASED ORGANIZATIONS AND GOVERNMENT AGENCIES. THEY HAVE EXPERTISE IN ASKING THE RIGHT QUESTIONS TO THE RIGHT PEOPLE THE RIGHT WAY USING TELEPHONE, WEB AND MAIL SURVEYS, FIELD, INTERCEPT AND KEY INFORMANT INTERVIEWS AND FOCUS GROUP ADMINISTRATION, AS WELL AS A WIDE RANGE OF CONSULTING SERVICES.
AULTMAN SPECIALTY HOSPITALPART V, SECTION B, LINE 7D: THE CHNA AND CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:AULTMAN.ORG/HOME/ABOUT/AULTMAN-HOSPITAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
AULTMAN SPECIALTY HOSPITALPART V, SECTION B, LINE 11: THE 2018 CHNA IDENTIFIED ACCESS TO HEALTH CARE, MENTAL HEALTH SERVICES (SPECIFICALLY ACCESS, YOUTH SUICIDE, AND HEROIN/OPIOID USE); INFANT MORTALITY, AND OBESITY AND HEALTHY LIFESTYLE AS THE FOUR MOST SIGNIFICANT COMMUNITY HEALTH NEEDS. THE FOLLOWING IDENTIFIES THE NEED, ACTIONS TAKEN TO ADDRESS THE NEED, AND IMPACT OF THE ACTION IN ADDRESSING THE NEED.NEED 1: ACCESS TO HIGH-QUALITY, AFFORDABLE, HOLISTIC, AND CULTURALLY RELEVANT CAREAULTMAN IS COMMITTED TO A VARIETY OF STRATEGIES TO ADDRESS THE NEED FOR ACCESSIBLE CARE. AULTMAN ALIGNS SERVICES TO PROVIDE RESIDENTS OF STARK COUNTY, AND SURROUNDING AREAS, WITH EQUITABLE ACCESS TO HEALTHCARE SERVICES BY REDUCING BARRIERS TO CARE FOR VULNERABLE POPULATIONS AND DECREASING THE PERCENTAGE OF RESPONDENTS FROM VULNERABLE POPULATIONS WHO REPORT NOT HAVING A PRIMARY CARE PROVIDER. AULTMAN SPECIALTY HOSPITAL PROVIDES LONG-TERM ACUTE CARE SERVICES TO MEDICALLY COMPLEX PATIENTS IN A SAFE AND PATIENT-CENTERED ENVIRONMENT. PATIENTS CAN RECEIVE CARE IN THEIR LOCAL COMMUNITY FOR COMPLEX WOUNDS, COMPLEX RESPIRATORY DISEASES OR VENTILATOR WEANING BEYOND A SHORT-TERM ACUTE CARE HOSPITAL STAY. PRIOR TO DISCHARGE, AULTMAN SPECIALTY HOSPITAL ARRANGES NECESSARY SERVICES (E.G., FOLLOW-UP APPOINTMENTS, THERAPY SERVICES, HOME HEALTH CARE OR CARE AT ANOTHER NURSING FACILITY AND TRANSPORTATION SERVICES AVAILABLE AT FREE OR REDUCED COST). A FULL-TIME REGISTERED NURSE DISCHARGE PLANNER FACILITATES THE PLAN OF CARE FOR THE PATIENT UPON DISCHARGE. AULTMAN SPECIALTY HOSPITAL COLLABORATES WITH AREA TRANSITIONAL CARE UNITS, SKILLED NURSING FACILITIES AND HOME HEALTH AGENCIES FOR COORDINATION OF CARE TO ASSURE APPROPRIATE HANDOFF COMMUNICATION AND SAFE PATIENT TRANSFERS TO MEET COMMUNITY HEALTH NEEDS. AULTMAN SPECIALTY HOSPITAL EXPANDED THIRD-PARTY PAYER COVERAGE TO INCLUDE MANY COMMERCIAL PAYERS AS IN-NETWORK PROVIDERS TO INCREASE COMMUNITY ACCESS TO AFFORDABLE, QUALITY LONG-TERM ACUTE CARE SERVICES. A HOSPITAL REPRESENTATIVE COLLABORATES WITH AREA HOSPITALS WITH OUTREACH TO INCREASE AWARENESS OF LONG-TERM ACUTE CARE SERVICES. A FULL-TIME AND PART-TIME REGISTERED NURSE ADMISSIONS COORDINATOR EVALUATES ALL REFERRALS FOR ADMISSION TO AULTMAN SPECIALTY HOSPITAL TO ENSURE CARE COORDINATION. ADDITIONAL NEEDS: MENTAL HEALTH, OPIOID MISUSE AND ADDICTION, INFANT MORTALITY, AND OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICES AULTMAN SPECIALTY HOSPITAL CHOSE NOT TO ADDRESS MENTAL HEALTH, HEROIN/OPIATE USE, INFANT MORTALITY, AND OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICES. A LONG-TERM ACUTE CARE HOSPITAL, AULTMAN SPECIALTY HOSPITAL DOES NOT POSSESS THE EXPERTISE TO ADDRESS THESE NEEDS. AULTMAN SPECIALTY HOSPITAL WILL RELY ON THE EXPERTISE OF OTHER ORGANIZATIONS, INCLUDING AULTMAN HOSPITAL, TO ADDRESS THESE NEEDS. SIGNIFICANT PROGRAMS, FACILITIES AND ORGANIZATIONS EXIST WITHIN THE COMMUNITY, AS IDENTIFIED IN THE 2016 AULTMAN CHNA REPORT, TO ADDRESS THIS NEED.
AULTMAN SPECIALTY HOSPITALPART V, SECTION B, LINE 13H: AULTMAN HEALTH FOUNDATION IS THE PARENT COMPANY OF AULTMAN SPECIALTY HOSPITAL (ASH). ASH HAS A FINANCIAL ASSISTANCE POLICY (FAP) WHICH HAS THE SAME PROVISIONS AS THE POLICY FOR AULTMAN HOSPITAL AND OTHER FACILITIES WITHIN AULTMAN HEALTH FOUNDATION. ACCORDING TO THE POLICY 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 HEALTH AND HUMAN SERVICES DEPARTMENT. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% - 100% OF FPG RECEIVES A 100% DISCOUNT, 101% - 150% OF FPG RECEIVES A 90% DISCOUNT, 151% - 200% OF FPG RECEIVES A 80% DISCOUNT, 201% - 300% OF FPG RECEIVES A 65% DISCOUNT, 301% AND ABOVE IS DISCOUNTED AT 58%.
AULTMAN SPECIALTY HOSPITALPART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE INFORMATION CAN BE FOUND AT THE FOLLOWING URL:AULTMAN.ORG/HOME/PATIENTS-AND-VISITORS/INSURANCE-AND-BILLING/ FINANCIAL-ASSISTANCE/
PART V, SECTION B, LINE 13A:ALL MEDICALLY NECESSARY SELF-PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS 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% - 100% OF FPG RECEIVES A 100% DISCOUNT, 101% - 150% OF FPG RECEIVES A 90% DISCOUNT, 151% - 200% OF FPG RECEIVES A 80% DISCOUNT, 201% - 300% OF FPG RECEIVES A 65% DISCOUNT, 301% AND ABOVE IS DISCOUNTED AT 58%.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

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PART I, LINE 3C:AULTMAN HEALTH FOUNDATION IS THE PARENT COMPANY OF AULTMAN SPECIALTY HOSPITAL (ASH). ASH HAS A FINANCIAL ASSISTANCE POLICY (FAP) WHICH HAS THE SAME PROVISIONS AS THE POLICY FOR AULTMAN HOSPITAL AND OTHER FACILITIES WITHIN AULTMAN HEALTH FOUNDATION. ACCORDING TO THE POLICY 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 HEALTH AND HUMAN SERVICES DEPARTMENT. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% - 100% OF FPG RECEIVES A 100% DISCOUNT, 101% - 150% OF FPG RECEIVES A 90% DISCOUNT, 151% - 200% OF FPG RECEIVES A 80% DISCOUNT, 201% - 300% OF FPG RECEIVES A 65% DISCOUNT, 301% AND ABOVE IS DISCOUNTED AT 58%.
PART I, LINE 7:THE ORGANIZATION USED THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 94,595.
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 (SEE AULTMAN.ORG/HOME/ABOUT/AULTMAN-HOSPITAL/ANNUAL-REPORT/).
PART III, LINE 2:BAD DEBT EXPENSE CONSISTS OF AMOUNTS DEEMED UNCOLLECTIBLE AND REFERRED TO COLLECTION AGENCY, PER THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY.
PART III, LINE 3:METHODOLOGY FOR BAD DEBT RELATED TO CHARITY CARE:PATIENTS REFERRED TO THE ASH ARE REFERRED HERE BECAUSE THEIR ILLNESSES ARE COMPLEX AND WILL REQUIRE LONG-TERM ACUTE CARE SERVICES. MOST OF THE PATIENTS WITH SUCH MEDICALLY COMPLEX ILLNESSES ARE ELDERLY AND HAVE CHRONIC AS WELL AS ACUTE ILLNESS AND ARE ABLE TO QUALIFY FOR MEDICARE OR MEDICAID. IF THE PATIENT MEETS THE HEALTH CRITERIA FOR ADMISSIONS INTO A LONG TERM ACUTE CARE FACILITY, ASH ACCEPTS THE PATIENT REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS ARE OFTEN CONSIDERED SELF-PAY PATIENTS AT THE TIME OF ADMISSION AND THEN THROUGH OUR OUTREACH PROGRAM THESE PATIENTS ARE USUALLY ABLE TO QUALIFY FOR MEDICAID OR SOME OTHER FORM OF ASSISTANCE. BECAUSE OF THIS, ASH HAD NO BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE IN 2018. THE ORGANIZATION DOES HAVE A FINANCIAL ASSISTANCE POLICY WHICH HAS THE SAME PROVISIONS AS THE POLICY FOR ANY OTHER FACILITY WITHIN THE AULTMAN HEALTH FOUNDATION.
PART III, LINE 4:SEE THE "RECEIVABLES AND PROVISION FOR BAD DEBTS" PARAGRAPHS IN NOTE 1 ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 9B:ASH FOLLOWS THE SAME COLLECTION PROCEDURES OUTLINED IN THE PARENT COMPANY'S COLLECTION POLICY. FOR THOSE PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAY AND AFTER AS WELL AS WITH EACH BILLING NOTICE. BILLS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT DECLINE TO DO SO; WHEN PATIENTS DECLINE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; OR WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL.
PART VI, LINE 2:COMMUNITY HEALTH NEEDS ASSESSMENT:AULTMAN SPECIALTY HOSPITAL (ASH) ASSESSES THE COMMUNITY'S HEALTH CARE NEEDS IN A VARIETY OF WAYS. IT STUDIES PROTOCOL VOLUME AND PATIENT SATISFACTION SURVEYS. IN 2016, ASH 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 1,276 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. THE HOSPITAL IS CURRENTLY IN THE PROCESS OF DEVELOPING ITS IMPLEMENTATION PLAN.
PART VI, LINE 3:PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:IF ABLE, 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 FORMS. 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. ASH STAFF ASSISTS SELF-PAY INPATIENTS WITH THE MEDICAID PROCESS AND OTHER PROGRAMS UNDER WHICH THEY ARE ELIGIBLE FOR ASSISTANCE. PATIENTS WHO ARE UNABLE TO BE SCREENED DURING THEIR STAY RECEIVE FOLLOW UP ASSISTANCE WITH QUALIFYING FOR THE ASSISTANCE PROGRAM THAT MOST APPROPRIATELY FITS THEIR FINANCIAL NEEDS. THE APPLICATION AND CONTACT INFORMATION FOR THE OUTREACH DEPARTMENT IS PRINTED ON THE BACK OF EVERY STATEMENT.
PART VI, LINE 4:COMMUNITY INFORMATION:ASH ENCOURAGES ITS EMPLOYEES AND BOARD MEMBERS TO BE ACTIVELY INVOLVED IN THE COMMUNITY.THE ORGANIZATION HAS ELEVEN BOARD MEMBERS WHO ARE ACTIVELY INVOLVED IN THE COMMUNITY TO BE REPRESENTATIVES OF THE COMMUNITY'S INTERESTS IN HEALTH CARE SERVICES.THE MEDICAL STAFF IS COMPRISED OF 202 PHYSICIANS. ANY PHYSICIAN IN GOOD STANDING WITHIN AULTMAN HOSPITAL'S MEDICAL STAFF AND WITH AN APPROPRIATE SPECIALTY TO CARE FOR MEDICALLY COMPLEX PATIENTS MAY APPLY FOR PRIVILEGES AT ASH.ASH'S SERVICE AREA INCLUDES STARK, WAYNE, HOLMES, CARROLL AND TUSCARAWAS COUNTIES. THE CORE MARKET FOR THE HOSPITAL IS STARK COUNTY. THE UNITED STATES CENSUS BUREAU ESTIMATED THE 2018 POPULATION OF OUR FIVE COUNTY AREAS TO BE OVER 650,690. THE ORGANIZATION IS ONE OF ONLY 2 FACILITIES WITHIN THE 5 COUNTY AREAS WHO ARE CONSIDERED LONG-TERM ACUTE CARE FACILITIES AND WHO PROVIDE THE SPECIALIZATION NEEDED TO CARE FOR PATIENTS WITH SUCH COMPLEX MEDICAL CONDITIONS.
PART VI, LINE 5:AULTMAN SPECIALTY HOSPITAL (ASH) IS A WHOLLY OWNED SUBSIDIARY OF AULTMAN HEALTH FOUNDATION. AULTMAN HEALTH FOUNDATION SUPPORTS AND PROMOTES THE HEALTH OF ITS COMMUNITY MEMBERS IN A VARIETY OF WAYS. 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 AULTMAN WEBSITE HAS ADDITIONAL HEALTH CARE RESOURCES, INCLUDING A HEALTH LIBRARY, SYMPTOM CHECKER, VIDEOS AND RISK ASSESSMENTS.AULTMAN'S 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 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 2018, THE WOW STAFF REACHED MORE THAN 17,000 PEOPLE.ADDITIONAL OUTREACH EFFORTS INCLUDED AULTMAN REPRESENTATIVES ATTENDING HEALTH FAIRS THROUGHOUT THE YEAR. THESE EVENTS INCLUDE SENIOR DAY AT THE PRO FOOTBALL HALL OF FAME, THE CANTON FARMERS' MARKET AND HEALTH FAIRS AT LOCAL SCHOOLS.2018 MARKED THE ELEVENTH YEAR AULTMAN HOSTED THE CAREERS IN HEALTH CARE SUMMER PROGRAM FOR HIGH SCHOOL SENIORS AND COLLEGE STUDENTS INTERESTED IN HEALTH CARE CAREERS. SYMPOSIUM PRESENTERS INCLUDED AULTMAN DOCTORS, NURSES, STAFF AND ADMINISTRATORS WHO SHARED INSIGHT ON THE CHALLENGES AND OPPORTUNITIES OF WORKING IN HEALTH CARE. THE EVENT ALSO INCLUDED A HEALTH CARE CAREER FAIR WITH MORE THAN A DOZEN DEPARTMENTS AND SERVICES REPRESENTED. JOB SHADOWING EXPERIENCES WITH DOCTORS, NURSES AND OTHER HEALTH CARE PROFESSIONALS WERE AVAILABLE.AULTMAN'S LEVEL III NEONATAL INTENSIVE CARE UNIT, DESIGNATED BY THE OHIO DEPARTMENT OF HEALTH, IS A TRANSFER HOSPITAL FOR SMALLER FACILITIES IN COUNTIES INCLUDING TUSCARAWAS, HOLMES, COSHOCTON AND COLUMBIANA. 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 2018, AULTMAN HEALTH FOUNDATION CONTRIBUTED TO THE BETTERMENT OF THE STARK COUNTY COMMUNITY WITH THE FOLLOWING ACTIVITIES.THROUGH THE SAFETY FIRST PROGRAM, AULTMAN STRIVES TO KEEP OUR COMMUNITY'S KIDS SAFE BY PREVENTING HEAD TRAUMA AND OTHER BIKE-RELATED INJURIES. IN 2018, HUNDREDS OF AULTMAN EMPLOYEES VOLUNTEERED TO TEACH MORE THAN 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 PROGRAM'S INCEPTION IN 2005, SAFETY FIRST HAS REACHED ABOUT 30,000 STUDENTS WITH THE IMPORTANT MESSAGE OF BICYCLE SAFETY.THE WOW TEAM VISITED MORE THAN 400 SITES IN 2018, RANGING FROM COMMUNITY EVENTS TO SENIOR CITIZEN CENTERS. WOW NURSES HAD PERSONAL INTERACTION WITH MORE THAN 17,000 COMMUNITY MEMBERS.THE AULTMAN CANCER PROGRAM CONTINUES TO PLACE A HIGH PRIORITY ON COMMUNITY OUTREACH. IN 2018, 4 FREE CANCER SCREENING EVENTS WERE OFFERED IN CANTON, CARROLLTON, AND TUSCARAWAS PROVIDING 294 CANCER SCREENINGS TO OVER 150 UNINSURED OR UNDERINSURED INDIVIDUALS. THE CANCER TEAM ALSO PARTICIPATED IN MORE THAN 20 COMMUNITY EVENTS THAT FOCUSED ON CANCER PREVENTION, EDUCATION, AND AWARENESS. THE HEALTHY U PROGRAM, A COLLABORATION BETWEEN AULTMAN CANCER CENTER AND STARK COUNTY SCHOOLS, EDUCATED 128 6TH GRADE STUDENTS ON CANCER BASICS AND HOW LIFETIME CANCER RISK CAN BE REDUCED THROUGH HEALTHY LIFESTYLE HABITS. FOOD INSECURITY IS A CRITICAL ISSUE IN NORTHEASTERN OHIO, AND AULTMAN TEAM MEMBERS GIVE GENEROUSLY TO THE ANNUAL HARVEST FOR HUNGER CAMPAIGN. IN 2018, AULTMAN EMPLOYEES PROVIDED 7,526 POUNDS OF NONPERISHABLE FOOD DONATIONS AND NEARLY $11,900 IN MONETARY GIFTS THAT HELPED THOUSANDS OF FAMILIES AND INDIVIDUALS IN NEED.AULTMAN MEDICAL EDUCATION HOSTED THE ANNUAL CAREERS IN HEALTH CARE PROGRAM, DESIGNED FOR STUDENTS 18 AND OLDER WITH INTERESTS IN HEALTH CARE CAREERS. THE PROGRAM INCLUDED PRESENTATIONS FROM DOCTORS, NURSES AND HOSPITAL ADMINISTRATORS, PROVIDING A GLIMPSE AT HOW A HOSPITAL RUNS. THE SYMPOSIUM ALSO FEATURED A CAREER FAIR THAT ENABLE THE STUDENTS TO TALK WITH EMPLOYEES FROM MORE THAN A DOZEN AULTMAN DEPARTMENTS. SUMMER JOB SHADOWING EXPERIENCES WERE ALSO AVAILABLE FOR SYMPOSIUM PARTICIPANTS.FOR WOMEN WHO CANNOT AFFORD BASIC CLOTHING ITEMS SUCH AS BRAS, EACH DAY PRESENTS EMOTIONAL AND UNCOMFORTABLE SITUATIONS. AULTMAN EMPLOYEES CONTINUE TO DONATE TOWARDS THIS BASIC NEED, AND DONATIONS HAVE BEEN DISTRIBUTED TO LOCAL BATTERED WOMEN AND HOMELESS SHELTERS AS WELL AS THE STARK COUNTY YWCA.AULTMAN HEALTH FOUNDATION TEAM MEMBERS AND THEIR LOVED ONES SUPPORT ANNUAL FUNDRAISING WALKS FOR ORGANIZATIONS INCLUDING THE MARCH OF DIMES AND JUVENILE DIABETES RESEARCH FOUNDATION. AULTMAN NOT ONLY PARTICIPATES IN THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE AND MAKING STRIDES AGAINST BREAST CANCER WALK - ALONG WITH THE AMERICAN HEART ASSOCIATION'S HEART WALK - BUT CLINICIANS ARE ON HAND TO PROVIDE EDUCATIONAL INFORMATION ABOUT REDUCING RISKS OF CANCER AND HEART DISEASE.EVERY YEAR, AULTMAN ORGANIZES A FUNDRAISING CAMPAIGN TO BENEFIT UNITED WAY. IN 2018, AULTMAN EMPLOYEES AND PHYSICIANS GENEROUSLY DONATED $483,724 TO FUND PROGRAMS TO BENEFIT COMMUNITY MEMBERS OF ALL AGES AND FROM ALL WALKS OF LIFE.AS PART OF AULTMAN HEALTH FOUNDATION'S MISSION TO LEAD OUR COMMUNITY TO IMPROVED HEALTH, THE AULTMAN AMBASSADOR PROGRAM (AAP) PROVIDES AN OPPORTUNITY TO EMPOWER HIGH SCHOOL STUDENTS TO BE "AULTMAN AMBASSADORS" TO ENGAGE THEIR PEERS, FAMILIES AND COMMUNITIES IN PROMOTING HEALTHY LIFESTYLES AIMED AT REDUCING OBESITY AND INCREASING PHYSICAL ACTIVITY. THE PROGRAM IS A COLLABORATIVE EFFORT AMONG AULTMAN HEALTH FOUNDATION, AULTMAN COLLEGE, LOUISVILLE HIGH SCHOOL AND CANTON SOUTH HIGH SCHOOL. LOUISVILLE HAS PARTICIPATED IN THE PROGRAM FOR SIX YEARS, WHILE CANTON SOUTH HAS BEEN ON BOARD FOR FOUR YEARS. THE PROGRAM WILL EXPAND TO THE FOLLOWING SCHOOLS: UNIVERSITY OF MOUNT UNION, KENT STATE - STARK, WALSH UNIVERSITY, LAKE HIGH SCHOOL, ALLIANCE HIGH SCHOOL, NORTH CANTON HOOVER HIGH SCHOOL AND PERRY HIGH SCHOOL IN THE FALL OF 2018. A TOTAL OF 16 STUDENT AMBASSADORS PARTICIPATED IN THE PROGRAM FOR THE 2018-2019 SCHOOL YEAR. 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.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.
PART VI, LINE 6:AULTMAN'S BOARD OF DIRECTORS HAS 38 NON-EMPLOYED MEMBERS. A TOTAL OF 64 OF THE 70 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.
PART VI, LINE 7, REPORTS FILED WITH STATESOH

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (19 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
UNITED WAY OF GREATER STARK COUNTY INC
401 MARKET AVENUE N STE 300CANTONOH44702134254191501(C)(3)$245,2772018 CAMPAIGN/COMMUNITY INVOLVEMENT
THE AULTMAN FOUNDATION
2600 SIXTH ST SWCANTONOH44710208090459501(C)(3)$100,000TO SUPPORT VARIOUS ORGANIZATIONS IN THE COMMUNITY
ARTS IN STARK
1001 MARKET AVE NCANTONOH44702346609771501(C)(3)$71,000SUPPORT ARTS PROGRAMS IN STARK COUNTY SCHOOLS AND COMMUNITIES
CANTON REGIONAL CHAMBER OF COMMERCE
222 MARKET AVE NCANTONOH44702340129930501(C)(6)$64,136SUPPORT VARIOUS EVENTS IN THE COMMUNITY SUCH AS LIGHT UP DOWNTOWN, HOF EVENTS, LEADERSHIP STARK COUNTY
JACKSON TOWNSHIP BOARD OF TRUSTEES
5737 WALES AVE NWMASSILLONOH44646346001495JACKSON TOWNSHIP$55,752CONTRIBUTION TOWARDS THE COST TO REPLACE 6 STRYKER AMBULANCE COTS
YMCA OF CENTRAL STARK
1201 30TH STREET NWCANTONOH44709340714392501(C)(3)$52,000TO SUPPORT THE YMCA CAPITAL PROJECT FOR THE CANAL FULTON YMCA, THE MEYER'S LAKE YMCA CAMPAIGN, & THE NORTH CANTON YMCA CAMPAIGN.
ACCESS HEALTH STARK COUNTY
408 NINTH STREET SWCANTONOH44707462949527501(C)(3)$40,000GRANT TO ACCESS HEALTH STARK COUNTY TO CONTINUE TO PROVIDE SERVICES FOR 2019
ALLIANCE AREA DEVELOPMENT FOUNDATION
2500 W STATE STREET SUITE E11ALLIANCEOH44601311652174501(C)(3)$20,0002019 AAD CHARITABLE CONTRIBUTION
AMERICAN HEART ASSOCIATION
4682 DOUGLAS COURT NWCANTONOH44718135613797501(C)(3)$18,000CANTON GO RED LUNCHEON, BILL PHILLIPS MEMORIAL GOLF CLASSIC. GF CANTON HW & GRFW 18
J BABE STERN COMMUNITY CENTER
2628 13TH STREET SWCANTONOH44710340828418501(C)(3)$15,000BABES KIDS LEARNING TODAY CAPITAL CAMPAIGN 2018
VOTE NO PROTECT OHIO
196 E STATE STREET SUITE 200COLUMBUSOH43215831738909527$15,000SUPPORT OHIO BALLOT INITIATIVE ISSUE 1 - TO REDUCE PENALTIES FOR CRIMES OF OBTAINING, POSSESSING, OR USING ILLEGAL DRUGS.
LEADER'S EDGE
3950 STATE ROUTE 39 NWDOVEROH44622462200863501(C)(3)$12,717ANTI-VIRUS PROGRAM
KEEP KIDS SAFE
6951 MEADOWLANDS AVE NWNORTH CANTONOH44720341868289501(C)(3)$12,500SUPPORT KEEP KIDS SAFE CAMPAIGN
CHILD & ADOLESCENT BEHAVIORAL HEALTH
919 SECOND STREET NECANTONOH44704341191950501(C)(3)$10,000EDUCATION AND TRAINING PURPOSES
TEAM NEO FOUNDATION
1111 SUPERIOR AVE SUITE 1600CLEVELANDOH44114341885407501(C)(3)$10,000SUPPORT 2018 TEAM NEO CLEVELAND PLUS
AULTMAN COLLEGE OF NURSING AND HEALTH
2600 SIXTH ST SWCANTONOH44710340943665501(C)(3)$10,000SCHOLARSHIPS
AMERICAN CANCER SOCIETY
525 NORTH BROAD STREETCANFIELDOH44406240726080501(C)(3)$9,000RELAY FOR LIFE, AND MAKING STRIDES AGAINST BREAST CANCER
MASSILLON CHAMBER OF COMMERCE
137 LINCOLN WAY EMASSILLONOH44646340383260501(C)(6)$6,151MEMBERSHIP INVESTMENT
ALLIANCE COMMUNITY HOSPITAL FOUNDATION
200 EAST STATE STREETALLIANCEOH44601341531817501(C)(3)$6,0002018 ANNUAL CHARITY GOLF CLASSIC
FieldValueIRS element (for citing)
Total501c3 Org16Total501c3OrgCnt
Total Other Org3TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationAULTMAN HEALTH FOUNDATION'S (AHF) COMMUNITY SUPPORT POLICY/PROCEDURE PROVIDES GUIDANCE IN RESPONSE TO COMMUNITY ORGANIZATION REQUESTS FOR SUPPORT. AHF 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. A SPONSORSHIP COMMITTEE MEETS REGULARLY TO REVIEW REQUESTS FOR SUPPORT FROM VARIOUS COMMUNITY ORGANIZATIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (30 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
EDWARD J ROTH III
PRESIDENT/CEO$656,479$0$48,000$0$13,178$0$32,750$0$17,721$0$768,128$0$0$0
CHRISTOPHER E REMARK
TREASURER/CEO - AH; DIRECTOR - IHC$0$469,244$0$46,814$0$1,248$0$26,750$0$19,200$0$563,256$0$0
MILAN R DOPIRAK MD
DIRECTOR - AHF$0$396,285$0$24,409$0$1,861$0$5,928$0$0$0$428,483$0$0
RICK L HAINES
DIRECTOR - AHF; CEO - AULTCARE$0$465,779$0$147,490$0$5,274$0$32,750$0$11,874$0$663,167$0$0
MICHAEL LYNCH MD
DIRECTOR - AHF$0$413,025$0$49,878$0$1,601$0$32,750$0$13,939$0$511,193$0$0
LORI L MERTES MD
PRESIDENT OF INNOVATIONS BOARD$0$386,930$0$38,598$0$1,484$0$27,500$0$0$0$454,512$0$0
PRABHCHARAN GILL MD
DIRECTOR - AHF$0$620,849$0$65,000$0$6,951$0$32,750$0$18,501$0$744,051$0$0
MICHAEL RICH MD
DIRECTOR - AHF$0$226,306$0$205,196$0$43,922$0$32,750$0$18,501$0$526,675$0$0
MARK D WRIGHT
CFO$398,379$0$40,261$0$1,053$0$26,750$0$18,501$0$484,944$0$0$0
ELIZABETH A GETZ
CIO$293,608$0$32,060$0$1,128$0$30,893$0$18,501$0$376,190$0$0$0
ROBERT C MOLNAR
SVP, REGIONAL DEVELOPMENT$232,586$0$17,347$0$402$0$25,624$0$18,501$0$294,460$0$0$0
MARK N ROSE
SVP - LEGAL SERVICES$313,077$0$36,900$0$2,139$0$32,750$0$18,501$0$403,367$0$0$0
JASON JUSTUS
VP - POMERENE FINANCE$191,440$0$19,600$0$465$0$13,737$0$17,844$0$243,086$0$0$0
SUSAN E OLIVERA
VP - HUMAN RESOURCES$265,581$0$24,170$0$1,014$0$32,750$0$18,501$0$342,016$0$0$0
AKBAR SHAH MD
CHAIR - ASH; PHYSICIAN$0$501,886$0$406,987$0$97,973$0$32,750$0$17,721$0$1,057,317$0$0
DANIEL RODRIGUEZ MD
VICE CHAIR - ASH$0$260,775$0$26,500$0$1,805$0$19,250$0$18,501$0$326,831$0$0
EILEEN GOOD SENIOR VP -
CLINIAL ADVOCACY; DIRECTOR - ASH$0$0$0$0$1,050,465$0$1,827$0$341$0$1,052,633$0$0$0
STEPHANIE BOYD
CEO - ASH (THROUGH 2/18)$24,864$124,320$3,185$15,925$37$184$1,806$9,030$1,695$8,475$31,587$157,934$0$0
RYAN KUHARICH
CEO - ASH$107,158$0$5,139$0$218$0$20,985$0$19,200$0$152,700$0$0$0
LEWIS HUMBLE MD
DIRECTOR - IHC$0$250,761$0$60,517$0$925$0$32,750$0$11,680$0$356,633$0$0
STEVEN KELLY MD
DIRECTOR - IHC$0$620,510$0$268,704$0$100,650$0$32,750$0$18,420$0$1,041,034$0$0
ROGER MUSA MD
DIRECTOR - IHC$0$215,796$0$38,473$0$400$0$26,223$0$18,501$0$299,393$0$0
JOHN PRODAFIKAS
DIRECTOR - IHC$0$477,114$0$386,154$0$18,149$0$32,750$0$18,500$0$932,667$0$0
ALLISON M OPRANDI MD
CEO - IHC$0$359,886$0$54,230$0$2,542$0$32,100$0$9,309$0$458,067$0$0
MATTHEW RITZERT
VP - IHC$146,150$0$8,381$0$233$0$16,482$0$0$0$171,246$0$0$0
KEVIN D PETE
SVP$265,275$0$45,886$0$1,001$0$22,000$0$18,501$0$352,663$0$0$0
RONALD RUSNAK MD
DIRECTOR OF CLINICAL INFORMATICS$324,254$0$16,163$0$2,413$0$30,250$0$10,382$0$383,462$0$0$0
FRANCIS SNYDER
CEO - POMERENE$290,830$0$41,850$0$2,912$0$31,881$0$18,501$0$385,974$0$0$0
TIMOTHY TEYNOR
VP - PUBLIC POLICY$219,203$0$5,000$0$8,285$0$30,911$0$7,353$0$270,752$0$0$0
TRACY SABO
VP OF HUMAN RESOURCES$182,211$0$12,400$0$459$0$21,601$0$5,751$0$222,422$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AALL EMPLOYEES ARE ELIGIBLE TO RECEIVE REIMBURSEMENT FOR HEALTH CLUB COSTS UP TO $120 ANNUALLY AS PART OF THE ORGANIZATION'S EFFORT TO PROMOTE HEALTHY LIFESTYLES. THIS AMOUNT WAS INCLUDED AS TAXABLE COMPENSATION FOR ALL EMPLOYEES THAT RECEIVED THE BENEFIT.
PART I, LINE 3SEE SCHEDULE O FOR THE NARRATIVE RELATED TO FORM 990, PART VI, LINE 15 FOR AN EXPLANATION OF EXECUTIVE COMPENSATION REVIEW.
PART I, LINE 4BMARK ROSE, EILEEN GOOD, RICK HAINES, ED ROTH, CHRIS REMARK, MARK WRIGHT, FRANCIS SNYDER, AND TIM TEYNOR ARE PARTICIPANTS IN THE ORGANIZATION'S 457(F) PLAN. EILEEN GOOD RECEIVED A DISTRIBUTION OF $1,050,465 IN 2018. THERE WERE NO OTHER CONTRIBUTIONS TO OR DISTRIBUTIONS FROM THE PLAN IN 2018.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1OHIO HIGHER EDUCATIONAL FACILITY COMMISSIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN346849674BondIssuerEIN
CUSIP67756CDM7CUSIPNum
Bond Issued2018-11-02BondIssuedDt
Issue Price$135,145,347IssuePriceAmt
PurposeTO REFUND SERIES 2017 BONDS, REFINANCE PRIOR DEBTS AND NEW MONEYPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$135,145,347TotalProceedsAmt
In Reserve Fund$5,147,239InReserveFundAmt
Other Spent Proceeds$87,220,531OtherSpentProceedsAmt
Unspent$42,777,577UnspentAmt
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable BondsYes (1)RefundingTaxableBondsInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease ArrangementsYes (1)AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropYes (1)MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts0EngageBondCounselContractsInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.02290PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00190PrivateBusConcerningUBIPct
Total Private Business Use0.02480TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonRICE'S NURSERYPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionBRYAN RICE, AHF BOARD MEMBER,OWNS RICE'S NURSERYRelationshipDescriptionTxt
Transaction$258,321TransactionAmt
TransactionLANDSCAPING SERVICES FOR AULTMAN HEALTH FOUNDATIONTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 2B:AULTMAN HEALTH FOUNDATION'S EMPLOYEES ARE PAID BY A COMMON PAYMASTER. AULTMAN HEALTH FOUNDATION IS A PARENT COMPANY WITH THE FOLLOWING SUBSIDIARIES: - AULTMAN SPECIALTY HOSPITAL LLC - AULTMAN NORTH CANTON MEDICAL GROUP - MICKINLEY ASSURANCE SEGREGATED PORTFOLIO CO. - AULTMAN HOSPITAL AND SUBSIDIARIES - THE AULTMAN FOUNDATION - THE ORRVILLE HOSPITAL FOUNDATION DBA AULTMAN ORRVILLE HOSPITAL - AULTCARE CORPORATION - INTEGRATED HEALTH COLLABORATIVE LLC - AULTMAN INNOVATIONS LLC - ALLIANCE COMMUNITY HOSPITAL AND SUBSIDIARIES - AULTCARE HOLDING COMPANY
FORM 990, PART VI, SECTION A, LINE 1THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE THAT CONSISTS OF THE CHAIR, VICE CHAIR, PRESIDENT/CEO, SECRETARY, TREASURER, PRESIDENT OF THE MEDICAL STAFF AT AULTMAN HOSPITAL, AND THE PAST CHAIR. THE EXECUTIVE COMMITTEE MEETS ONLY AS NECESSARY BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND HAS AND EXERCISES THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE ORGANIZATION, EXCEPT IN MATTERS IN WHICH THE BOARD IS REQUIRED TO ACT BY LAW, BY THE ARTICLES OF INCORPORATION, OR BY THE CODE OF REGULATIONS.
FORM 990, PART VI, SECTION A, LINE 2GEOFF KARCHER AND BRYAN RICE ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. JOSEPH HALTER AND GEOFF KARCHER ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. GENE LITTLE AND HARRY MACNEALY ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. EDWARD ROTH AND HARRY MACNEALY ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 7AONE AHF BOARD MEMBER IS APPOINTED BY ALLIANCE COMMUNITY HOSPITAL, ONE BOARD MEMBER IS APPOINTED BY AULTMAN ORRVILLE HOSPITAL. IN ADDITION, THE AULTMAN HOSPITAL MEDICAL STAFF PRESIDENT, THE AULTMAN HOSPITAL MEDICAL STAFF PRESIDENT-ELECT, AND THE PHYSICIAN CHAIRMAN OF THE BOARD OF AULTCARE CORPORATION ARE EX -OFFICIO VOTING MEMBERS OF THE AHF BOARD.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY AULTMAN HEALTH FOUNDATION'S FINANCE DEPARTMENT. AHF'S FINANCE DEPARTMENT CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN. THE DEPARTMENT RECONCILED THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARED THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. IN ADDITION, THE FINANCE DEPARTMENT DID A COMPARATIVE ANALYSIS TO THE PRIOR YEAR RETURN. THE ANALYSIS AND RECONCILIATION SCHEDULES, ALONG WITH A COMPLETE COPY OF THE 990, WERE PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. A COMPLETE COPY OF THE 990 WAS THEN MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH A SECURED INTERNET PORTAL PRIOR TO THE FILING DATE.
FORM 990, PART VI, SECTION B, LINE 12CTHE AULTMAN HEALTH FOUNDATION'S BOARD OF DIRECTORS HAS A CONFLICT OF INTEREST POLICY. AS A RESULT OF THIS POLICY, EACH YEAR BOARD MEMEBERS, 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.
FORM 990, PART VI, SECTION B, LINE 15THE AULTMAN HEALTH FOUNDATION AND ITS AFFILIATED ENTITIES USE 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 CEO'S COMPENSATION IS ALSO REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE. 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 HEALTH FOUNDATION AND ITS AFFILIATED ENTITIES USE 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.
FORM 990, PART VI, SECTION C, LINE 19AULTMAN HEALTH FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
PART VI, SECTION A, LINE 1BEDWARD ROTH III IS A PAID EMPLOYEE OF THE ORGANIZATION. CHRISTOPHER REMARK, RICK HAINES, MILAN DOPIRAK MD, MICHAEL LYNCH MD, AND MICHAEL RICH MD ARE PAID EMPLOYEES OF A RELATED ORGANIZATION.
FORM 990, PART IX, LINE 11GCONSULTING FEES: PROGRAM SERVICE EXPENSES 1,083,493. MANAGEMENT AND GENERAL EXPENSES 254,153. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,337,646. PURCHASED MAINTENANCE: PROGRAM SERVICE EXPENSES 1,255,775. MANAGEMENT AND GENERAL EXPENSES 294,565. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,550,340. ASH PATIENT SERVICES: PROGRAM SERVICE EXPENSES 1,089,298. MANAGEMENT AND GENERAL EXPENSES 255,514. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,344,812. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,710,275. MANAGEMENT AND GENERAL EXPENSES 635,744. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,346,019. PROFESSIONAL FEES - PHYSICIAN: PROGRAM SERVICE EXPENSES 187,234. MANAGEMENT AND GENERAL EXPENSES 43,919. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 231,153. PROFESSIONAL FEES - NONPHYSICIAN: PROGRAM SERVICE EXPENSES 56,785. MANAGEMENT AND GENERAL EXPENSES 13,320. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 70,105. HOSPITAL FRANCHISE FEE: PROGRAM SERVICE EXPENSES 74,441. MANAGEMENT AND GENERAL EXPENSES 17,461. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,902.
FORM 990, PART XI, LINE 9:INTERFUND TRANSFERS -663,945. SUBPART F INCOME -716,068. CHANGE IN VALUE OF INVESTMENT IN IHC 5,416,795.
FEDERAL ELECTIONSSECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION AULTMAN HEALTH FOUNDATION 2600 SIXTH STREET SW CANTON, OH 44710 EMPLOYER IDENTIFICATION NUMBER: 34-1445390 FOR THE YEAR ENDING DECEMBER 31, 2018 AULTMAN HEALTH FOUNDATION IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER REG. SEC. 1.263(A)-1(F).

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
AULTMAN SPECIALTY HOSPITAL
2600 SIXTH ST SWCANTONOH44710134246188LONG-TERM ACUTE CAREOH$7,045,596$3,615,199AULTMAN HEALTH FOUNDATION
INTEGRATED HEALTH COLLABORATIVE LLC
2600 SIXTH ST SWCANTONOH44710454325320HEALTH COLLABORATIVEOH$633,266$93,502AULTMAN HEALTH FOUNDATION
AULTMAN INNOVATIONS LLC
2600 SIXTH ST SWCANTONOH44710810847842IP HOLDING AND MARKETINGOH$3,080$1,877AULTMAN HEALTH FOUNDATION

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
AULTMAN HOSPITAL
2600 SIXTH ST SWCANTONOH44710340714538HOSPITALOH501(C)(3)LINE 3AULTMAN HEALTH FOUNDATIONYes (1)
THE AULTMAN FOUNDATION
2600 SIXTH ST SWCANTONOH44710208090459FUNDRAISINGOH501(C)(3)LINE 7AULTMAN HEALTH FOUNDATIONYes (1)
ORRVILLE HOSPITAL FOUNDATION (DBA AULTMAN ORRVILLE HOSPITAL)
832 S MAIN STORRVILLEOH44667340733138HOSPITALOH501(C)(3)LINE 3AULTMAN HEALTH FOUNDATIONYes (1)
AULTMAN COLLEGE OF NURSING AND HEALTH
2600 SIXTH ST SWCANTONOH44710201359433COLLEGEOH501(C)(3)LINE 2AULTMAN HOSPITAL0
AULTMAN NORTH CANTON MEDICAL GROUP
2600 SIXTH ST SWCANTONOH44710341088530HEALTHCAREOH501(C)(3)LINE 10AULTMAN HEALTH FOUNDATIONYes (1)
TUSCARAWAS VALLEY REGIONAL CANCER CENTER
300 MEDICAL PARK DRIVEDOVEROH44622311689698MEDICAL SERVICEOH501(C)(3)LINE 30N/A
DARTMOUTH CHILD CARE CENTER CONTRACTING SERVICES INC
125 DARTMOUTH AVE SWCANTONOH44710341652364SUPPORT ORGANIZATIONOH501(C)(3)LINE 12C, III-FIAULTMAN HOSPITALYes (1)
AULTMAN RADIATION ONCOLOGY OF ALLIANCE COMMUNITY HOSPITAL
885 S SAWBURG AVEALLIANCEOH44601814224503MEDICAL SERVICEOH501(C)(3)LINE 3AULTMAN HOSPTIALYes (1)
ALLIANCE COMMUNITY HOSPITAL
200 E STATE STREETALLIANCEOH44601340714581HOSPITALOH501(C)(3)LINE 3AULTMAN HEALTH FOUNDATIONYes (1)
CARING HANDS INC
885 S SAWBURG AVEALLIANCEOH44601341505340PRIVATE DUTY NURSINGOH501(C)(3)LINE 10ALLIANCE COMMUNITY HOSPITALYes (1)
ALLIANCE COMMUNITY HOSPITAL AUXILIARY
200 E STATE STREETALLIANCEOH44601340777659SUPPORT ORGANIZATIONOH501(C)(3)LINE 12C, III-FIALLIANCE COMMUNITY HOSPITALYes (1)
IHN SOURCING GROUP
2600 SIXTH ST SWCANTONOH44710451731318SUPPORT ORGANIZATIONOH501(C)(3)LINE 12C, III-FIAULTMAN HOSPITALYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
WEST TUSCARAWAS PROPERTY MANAGEMENT LLC
2600 SIXTH ST SWCANTONOH44710200090246PROPERTY MGMTOHAULTCARE INSURANCE COMPANYEXCLUDED-$196,032$20,559,001001.00000
AULTMAN ONCOLOGY CENTER OF EXCELLENCE LLC
2600 SIXTH ST SWCANTONOH44710454215510HEALTHCAREOHAULTMAN HOSPITALRELATED-$90,781$3,993000.72900
IHN POST-ACUTE NETWORK LLC
2821 WOODLAWN AVE NWCANTONOH44708813136598HEALTHCAREOHAULTMAN HOSPITALRELATED-$68,575$102,887000.73400

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (16 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
MCKINLEY ASSURANCE SPC
PO BOX 1051GEORGE TOWNGRAND CAYMANSCJ980468384PORTFOLIOCJAULTMAN HEALTH FOUNDATIONC$5,569,013$25,161,6321.00000Yes (1)
AULTCARE CORPORATION
341488123PREF. PROVIDER ORG.C02600 SIXTH ST SWCANTONOH44710OHN/A
AULTCARE HOLDING COMPANY
471165287HOLDING COMPANYAULTMAN HEALTH FOUNDATIONC1.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
NORTH CENTRAL MEDICAL RESOURCES INC
341610344MEDICAL EQUIPMENT RENTALAULTCARE HOLDING COMPANYC$3,884,117$227,087,6791.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
OHIO SPECIALTY PHYSICIANS CORPORATION
341853300HEALTH SERVICESAULTCARE HOLDING COMPANYC$2,281,064$279,7871.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
OHIO HOSPITAL BASED PHYSICIANS CORP
341871647HEALTH SERVICESAULTCARE HOLDING COMPANYC$15,678,064$1,414,6051.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
OHIO PHYSICIANS PROFESSIONAL CORP
311509897HEALTH SERVICESAULTCARE HOLDING COMPANYC$27,286,017$2,287,8871.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
AULTMAN MSO
311509904ADMIN SERVICESAULTCARE HOLDING COMPANYC$2,308,950$574,1231.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
AULTCARE HEALTH INSURING CORPORATION
463305099INSURANCEAULTCARE HOLDING COMPANYC$243,651,193$105,811,3971.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
AULTCARE INSURANCE COMPANY
341624818INSURANCEAULTCARE HOLDING COMPANYC$283,284,343$94,473,1411.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
AULTRA ADMINISTRATIVE GROUP
204951704ADMIN SERVICEAULTCARE HOLDING COMPANYC$2,936,968$487,3391.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
AULTCOMP MCO INC
274379962HEALTH SERVICESAULTCARE HOLDING COMPANYC$2,541,355$82,6461.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
WAYNE HEALTH SERVICES & SUPPLIES
341501390MEDICAL SUPPLIESAULTCARE HOLDING COMPANYC$1,060,447$503,9321.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
AULTMAN MEDICAL GROUP
453166014HEALTH SERVICESAULTCARE HOLDING COMPANYC$19,071,740$2,936,9891.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
MAINSIGHT ASO LLC
473587655HEALTH SERVICESAULTCARE HOLDING COMPANYC$27,2621.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
HEALTH ALLIANCE INC
341531993HEALTH SERVICESAULTCARE HOLDING COMPANYC$1,135,880$323,4711.00000Yes (1)2600 SIXTH ST SWCANTONOH44710OH
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other OrgYes (1)AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
THE AULTMAN FOUNDATION
B$100,000FMV
AULTMAN HOSPITAL
K$312,348FMV
AULTMAN HOSPITAL
P$1,284,198FMV
AULTCARE INSURANCE COMPANY
Q$1,260,588FMV
AULTMAN HOSPITAL
Q$36,216,005FMV
ORRVILLE HOSPITAL FOUNDATION (DBA AULTMAN ORRVILLE HOSPITAL)
Q$222,162FMV
AULTCARE CORPORATION
D$9,420,926FMV
WEST TUSCARAWAS PROPERTY MANAGEMENT
G$11,273,215FMV