TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) EDWARD J ROTH III...................................................................... PRESIDENT / CEO - AHF	5.00 ................. 50.00	X	X	0	616,011	23,436
(2) JEFFREY MILLER MD...................................................................... CHAIR - AH; DIRECTOR - AOH	2.00 ................. 1.00	X	X	0	0	0
(3) BRIAN S BELDEN...................................................................... VICE CHAIR - AH ; CHAIR - TAF	1.00 ................. 1.00	X	X	0	0	0
(4) WILLIAM WALLACE MD...................................................................... SECRETARY AND TREASURER - AH	4.00 ................. 1.00	X	X	5,000	0	0
(5) T STEPHEN GREGORY...................................................................... DIRECTOR - AH & ANCMG; AOH TREAS.	1.00 ................. 2.00	X	X	0	0	0
(6) CHRISTOPHER E REMARK...................................................................... CEO - AH; DIRECTOR - AH,ACON & ANCMG	50.00 ................. 5.00	X	X	404,894	0	24,101
(7) ANNE GUNTHER...................................................................... CNO - AH; DIRECTOR - AH & ACON	55.00 ................. 0.00	X		242,484	0	15,270
(8) BARBARA HAMMONTREE BENNETT...................................................................... DIRECTOR - AH	1.00 ................. 1.00	X		0	0	0
(9) PEGGY CLAYTOR...................................................................... DIRECTOR - AH	1.00 ................. 1.00	X		0	0	0
(10) NATE J COOKS...................................................................... DIRECTOR - AH	1.00 ................. 1.00	X		0	0	0
(11) MILAN R DOPIRAK MD...................................................................... DIRECTOR - AH	54.00 ................. 1.00	X		0	426,826	17,125
(12) RICK L HAINES...................................................................... DIRECTOR - AH; CEO - AULTCARE	5.00 ................. 50.00	X		0	430,887	17,515
(13) VICKY STERLING...................................................................... DIRECTOR - AH & TAF	1.00 ................. 1.00	X		0	0	0
(14) JOHN B HUMPHREY JR MD...................................................................... DIRECTOR - AH	4.00 ................. 1.00	X		0	0	0
(15) HARRY CC MACNEALY...................................................................... DIRECTOR - AH	1.00 ................. 1.00	X		0	0	0
(16) TIMOTHY O'TOOLE MD...................................................................... DIRECTOR - AH	2.00 ................. 1.00	X		47,600	0	0
(17) ROBERT W SABOTA MD...................................................................... DIRECTOR - AH	1.00 ................. 1.00	X		0	2,550	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) LOUIS G SHAHEEN MD........................................................................ DIRECTOR - AH	1.00 .......................1.00	X				0	0	0
(19) FATHER ROBERT KAYLOR........................................................................ CHAIR - ACON	1.00 .......................0.00	X	X			0	0	0
(20) JOHN MCGRATH........................................................................ VICE CHAIR - ACON	1.00 .......................0.00	X	X			0	0	0
(21) REBECCA J CROWL........................................................................ PRESIDENT - ACON	55.00 .......................0.00	X	X			0	207,795	21,312
(22) ADAM LUNTZ........................................................................ TREASURER - ACON; CFO - AH	55.00 .......................0.00	X	X			0	177,443	19,840
(23) JANET B BAKER........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(24) SHEILA MARKLEY BLACK ESQ........................................................................ DIRECTOR - ACON	1.00 .......................1.00	X				0	0	0
(25) PATRICIA H DRAVES PHD........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(26) EILEEN F GOOD........................................................................ DIRECTOR - ACON / SENIOR VP-CLINICAL ADVOCACY	50.00 .......................5.00	X				0	215,056	6,126
(27) MARILYN THOMAS JONES........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(28) KAREN SOEHNLEN MCQUEEN........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(29) ROSLYN E MESSERLY........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(30) TERESA J PURSES........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(31) JEFFREY L SUSMAN MD........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(32) VINCE WATTS........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(33) PATRICK WILLOUGHBY........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	0	0
(34) LISA M ZELLERS........................................................................ DIRECTOR - ACON	1.00 .......................0.00	X				0	64,325	2,385
(35) GEORGE W LEMON........................................................................ VICE CHAIR - TAF; DIRECTOR - AOH	1.00 .......................1.00	X	X			0	0	0
(36) BRIAN LAYMAN........................................................................ VICE CHAIR - TAF	1.00 .......................0.00	X	X			0	0	0
(37) VICTORIA L HAINES........................................................................ DIRECTOR - TAF / VP-FOUNDATION SERVICES	5.00 .......................50.00	X	X			0	184,758	14,828
(38) TERESA L WURST MD........................................................................ DIRECTOR - TAF	55.00 .......................0.00	X				184,090	0	19,700
(39) MICHAEL R GALLINA........................................................................ DIRECTOR - TAF	1.00 .......................54.00	X				0	113,166	12,132
(40) JEANEEN MCDANIELS........................................................................ DIRECTOR - TAF	1.00 .......................0.00	X				0	0	0
(41) REVEREND DOUGLAS A PATTON........................................................................ DIRECTOR - TAF	1.00 .......................0.00	X				0	0	0
(42) FRANK G PROVO........................................................................ DIRECTOR - TAF	1.00 .......................0.00	X				0	0	0
(43) CHARLES B SCHEURER........................................................................ DIRECTOR - TAF & ANCMG	1.00 .......................1.00	X				0	0	0
(44) MARK A AUBLE........................................................................ CHAIRPERSON - AOH	1.00 .......................0.00	X	X			0	0	0
(45) ANDREW NAUMOFF MD........................................................................ VICE CHAIR - AOH	1.00 .......................54.00	X	X			0	297,272	18,182
(46) DOUGLAS J SIBILA........................................................................ SECRETARY - AOH	1.00 .......................1.00	X	X			0	0	0
(47) MARCHELLE L SUPPAN DPM........................................................................ DIRECTOR/CEO - AOH	55.00 .......................0.00	X	X			202,985	0	10,481
(48) BECKY L JEWELL........................................................................ DIRECTOR - AOH	1.00 .......................0.00	X				0	0	0
(49) ROSS CAMPENSA MD........................................................................ DIRECTOR - AOH	1.00 .......................0.00	X				0	0	0
(50) TODD M SOMMER........................................................................ DIRECTOR - AOH	1.00 .......................1.00	X				0	0	0
(51) ALFRED A SCHLABACH........................................................................ DIRECTOR - AOH	1.00 .......................0.00	X				0	0	0
(52) CLIFORD G JOHNSON MD........................................................................ MEDICAL DIRECTOR - ANCMG	40.00 .......................0.00	X	X			418,741	0	23,436
(53) LEO DOYLE........................................................................ DIRECTOR - ANCMG	1.00 .......................1.00	X				0	0	0
(54) JULIA FIORENTINO MD........................................................................ DIRECTOR - ANCMG	40.00 .......................0.00	X				272,461	0	15,539
(55) MATTHEW HIESTAND MD........................................................................ DIRECTOR - ANCMG	40.00 .......................0.00	X				333,682	0	23,436
(56) MARIA YOUNG MD........................................................................ DIRECTOR - ANCMG	40.00 .......................0.00	X				280,249	0	24,101
(57) SHRUTI TREHAN MD........................................................................ DIRECTOR - ANCMG	40.00 .......................0.00	X				1,739,621	0	23,436
(58) ROBERT C MOLNAR........................................................................ VP-PHYSICIAN SERVICES;DIRECTOR-ANCMG	5.00 .......................50.00	X				0	204,907	20,851
(59) MARK D WRIGHT........................................................................ CFO - AHF	5.00 .......................50.00		X			0	358,752	23,675
(60) JEANNINE SHAMBAUGH........................................................................ VP-CHIEF INTERNAL AFFAIRS - ACON	55.00 .......................0.00		X			0	137,141	19,132
(61) JEAN PADDOCK........................................................................ CHIEF ACADEMIC OFFICER - ACON	55.00 .......................0.00		X			0	139,949	13,940
(62) VIVIAN LEGGETT........................................................................ CHIEF EXTERNAL AFFAIRS OFFICER-ACON	55.00 .......................0.00		X			0	158,705	14,551
(63) MATTHEW A STEWART........................................................................ CFO - AOH	55.00 .......................0.00		X			0	123,507	18,035
(64) AMY BUDD........................................................................ VICE PRESIDENT - ANCMG	40.00 .......................0.00		X			149,762	0	13,517
(65) ALLISON M OPRANDI MD........................................................................ PHYSICIAN	55.00 .......................0.00			X		357,670	0	23,310
(66) SUSAN E MERCER MD........................................................................ VP-MEDICAL EDUCATION - AH	55.00 .......................0.00			X		310,783	0	14,084
(67) LORI L MERTES MD........................................................................ PHYSICIAN/CHIEF QUALITY OFFICER - AH	55.00 .......................0.00			X		305,821	0	7,950
(68) WILLIAM FAYEN MD........................................................................ DIRECTOR - ANCMG	40.00 .......................0.00			X		245,772	0	15,597
(69) RAZA A KHAN MD........................................................................ DIRECTOR - ANCMG	40.00 .......................0.00			X		963,352	0	23,977
(70) PRABHCHARAN GILL MD........................................................................ PHYSICIAN - AH	55.00 .......................0.00				X	638,090	0	20,415
(71) MICHAEL A KREW MD........................................................................ PHYSICIAN - AH	55.00 .......................0.00				X	635,156	0	24,101
(72) STEVEN M WEAVER MD........................................................................ PHYSICIAN - ANCMG	55.00 .......................0.00				X	576,938	0	24,101
(73) TIMOTHY E MCDANIEL MD........................................................................ PHYSICIAN - AH	55.00 .......................0.00				X	557,934	0	21,623
(74) OSAMA MITRI MD........................................................................ PHYSICIAN - AH	55.00 .......................0.00				X	476,444	0	24,817

(A) Name and business address	(B) Description of services	(C) Compensation
CANTON AULTMAN EMERGENCY PHYSICIANS INC 2600 SIXTH ST SW CANTON,OH44710	PHYSICIAN SERVICES	5,602,798
CANTON MEDICAL EDUCATION FOUNDATION 2600 SIXTH ST SW CANTON,OH44710	PHYSICIAN SERVICES	2,403,362
PULMONARY PHYSICIANS INC 2600 TUSCARAWAS ST W STE 100 CANTON,OH44708	PHYSICIAN SERVICES	1,587,352
MILLIGAN PUSATERI CO LPA 4684 DOUGLAS CIR NW CANTON,OH44735	LEGAL	1,554,086
HILSCHER-CLARKE ELECTRIC CO 519 FOURTH ST NW CANTON,OH44703	ELECTRICAL CONTRACTOR	1,330,616
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 279

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
PART I, PUBLIC CHARITY STATUS	PURSUANT TO THE INSTRUCTIONS FOR GROUP FILINGS, PART I PUBLIC CHARITY STATUS HAS BEEN COMPLETED BASED ON THE LARGEST NUMBER OF SUBORDINATES IN THE GROUP. AULTMAN HOSPITAL (34-0714538) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS A HOSPITAL OR A COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) (BOX 3) ORRVILLE HOSPITAL FOUNDATION DBA AULTMAN ORRVILLE HOSPITAL (34-0733138) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS A HOSPITAL OR A COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) (BOX 3) AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES (20-1359433) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS A SCHOOL DESCRIBED IN SECTION 170(B)(1)(A)(II) (BOX 2) THE AULTMAN FOUNDATION (20-8090459) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS AN ORGANIZATION THAT NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(A)(VI) (BOX 7) AULTMAN NORTH CANTON MEDICAL GROUP (34-1088530) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS AN ORGANIZATION THAT NORMALLY RECEIVES: (1) MORE THAN 33 1/3% OF ITS SUPPORT FROM CONTRIBUTIONS, MEMBERSHIP FEES, AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS - SUBJECT TO CERTAIN EXCEPTIONS, AND (2) NO MORE THAN 33 1/3% OF ITS SUPPORT FROM GROSS INVESTMENT INCOME AND UNRELATED BUSINESS TAXABLE INCOME (LESS SECTION 511 TAX) FROM BUSINESSES ACQUIRED BY THE ORGANIZATION AFTER JUNE 30, 1975. SEE SECTION 509(A)(2) (BOX 9)

Return Reference

Explanation

PART I, PUBLIC CHARITY STATUS

PURSUANT TO THE INSTRUCTIONS FOR GROUP FILINGS, PART I PUBLIC CHARITY STATUS HAS BEEN COMPLETED BASED ON THE LARGEST NUMBER OF SUBORDINATES IN THE GROUP. AULTMAN HOSPITAL (34-0714538) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS A HOSPITAL OR A COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) (BOX 3) ORRVILLE HOSPITAL FOUNDATION DBA AULTMAN ORRVILLE HOSPITAL (34-0733138) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS A HOSPITAL OR A COOPERATIVE HOSPITAL SERVICE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) (BOX 3) AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES (20-1359433) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS A SCHOOL DESCRIBED IN SECTION 170(B)(1)(A)(II) (BOX 2) THE AULTMAN FOUNDATION (20-8090459) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS AN ORGANIZATION THAT NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(A)(VI) (BOX 7) AULTMAN NORTH CANTON MEDICAL GROUP (34-1088530) IS NOT A PRIVATE FOUNDATION BECAUSE IT IS AN ORGANIZATION THAT NORMALLY RECEIVES: (1) MORE THAN 33 1/3% OF ITS SUPPORT FROM CONTRIBUTIONS, MEMBERSHIP FEES, AND GROSS RECEIPTS FROM ACTIVITIES RELATED TO ITS EXEMPT FUNCTIONS - SUBJECT TO CERTAIN EXCEPTIONS, AND (2) NO MORE THAN 33 1/3% OF ITS SUPPORT FROM GROSS INVESTMENT INCOME AND UNRELATED BUSINESS TAXABLE INCOME (LESS SECTION 511 TAX) FROM BUSINESSES ACQUIRED BY THE ORGANIZATION AFTER JUNE 30, 1975. SEE SECTION 509(A)(2) (BOX 9)

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization AULTMAN HEALTH FOUNDATION GROUP RETURN

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization AULTMAN HEALTH FOUNDATION GROUP RETURN		Employer identification number 32-0483994

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization AULTMAN HEALTH FOUNDATION GROUP RETURN			Employer identification number 32-0483994
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

4,055

Total. Add lines 1c through 1i ....................................................................................................

4,055

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	TOTAL DUES OF $102,275 WERE PAID TO THE OHIO HOSPITAL ASSOCIATION BY AH, OF WHICH 3.4% WERE RELATED TO LOBBYING ACTIVITIES. TOTAL DUES OF $16,975 WERE PAID TO THE OHIO HOSPITAL ASSOCIATION BY AOH, OF WHICH 3.4% WERE RELATED TO LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	719,326	712,855	722,979	696,799	681,425
b	Contributions ...
c	Net investment earnings, gains, and losses	5,815	12,313	-4,282	31,857	20,946
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	6,870	5,842	5,842	5,677	5,572
g	End of year balance ......	718,271	719,326	712,855	722,979	696,799

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	31,808,314		31,808,314
b	Buildings	186,862,915	84,814,196	102,048,719
c	Leasehold improvements	162,315	88,910	73,405
d	Equipment ...	322,447,313	227,842,821	94,604,492
e	Other ...	22,081,769	9,456,936	12,624,833
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				241,159,763

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
ACCRUED PENSION	505,996
DUE TO AFFLIATES	8,089,451
INTEREST RATE SWAP	22,283
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	8,617,730
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO SUPPORT THE CHAPLAINCY PROGRAM.

PART X, LINE 2:

WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. IN ACCORDANCE WITH THE INCOME TAXES TOPIC OF THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION, THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENT 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.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE E(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Schools

Complete if the organization answered "Yes" on Form 990,
Part IV, line 13, or Form 990-EZ, Part VI, line 48.
Right pointing arrow large image

Attach to Form 990 or Form 990-EZ.
Right pointing arrow large image

Information about Schedule E (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047 2015Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

YES

Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws,

other governing instrument, or in a resolution of its governing body? . . . . . . . . . . . . . . . . . . .

Yes

Does the organization include a statement of its racially nondiscriminatory policy toward students in all its

brochures, catalogues, and other written communications with the public dealing with student admissions,

programs, and scholarships? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during

the period of solicitation for students, or during the registration period if it has no solicitation program, in a way

that makes the policy known to all parts of the general community it serves? If "Yes," please describe. If "No,"

please explain. If you need more space use Part II. . . . . . . . . . . . . . . . . . . . . . . . .

Yes

Does the organization maintain the following?

Records indicating the racial composition of the student body, faculty, and administrative staff? . . . . . . . . .

Yes

Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory

basis? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

Copies of all catalogues, brochures, announcements, and other written communications to the public dealing

with student admissions, programs, and scholarships? . . . . . . . . . . . . . . . . . . . . . . .

Yes

Copies of all material used by the organization or on its behalf to solicit contributions? . . . . . . . . . . . .

Yes

If you answered "No" to any of the above, please explain. If you need more space, use Part II.

Does the organization discriminate by race in any way with respect to:

Students' rights or privileges? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Admissions policies? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Employment of faculty or administrative staff? . . . . . . . . . . . . . . . . . . . . . . . . .

Scholarships or other financial assistance? . . . . . . . . . . . . . . . . . . . . . . . . . .

Educational policies? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Use of facilities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Athletic programs? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Other extracurricular activities? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If you answered "Yes" to any of the above, please explain. If you need more space, use Part II.

Does the organization receive any financial aid or assistance from a governmental agency? . . . . . . . . . .

Yes

Has the organization's right to such aid ever been revoked or suspended? . . . . . . . . . . . . . . . .

If you answered "Yes" to either line 6a or line 6b, explain on Part II.

Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05

of Rev. Proc. 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If "No," explain on Part II. . . . . . . . .

Yes

Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.

Cat. No. 50085D

Schedule E (Form 990 or 990-EZ) (2015)

Schedule E (Form 990 or 990EZ) (2015)

Page 2

Part II

Supplemental Information. Provide the explanations required by Part I, lines 3, 4d, 5h, 6b, and 7, as applicable. Also provide
any other additional information (see instructions).

Return Reference	Explanation
SCHEDULE E, PART I, LINE 3	AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES HAS MADE ITS NONDISCRIMINATORY POLICY KNOWN TO ALL SEGMENTS OF THE GENERAL COMMUNITY THAT THE COLLEGE SERVES BY POSTING A COPY ON ITS WEBSITE AND IN SEVERAL CANTON AREA NEWSPAPERS.
SCHEDULE E, PART I, LINE 6	AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES RECEIVES FEDERAL FUNDS IN THE FORMS OF THE FEDERAL PELL GRANT PROGRAM, FEDERAL WORK-STUDY PROGRAM AND FEDERAL DIRECT STAFFORD LOANS.

Schedule E (Form 990 or 990-EZ) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 ANGEL AUCTION (event type)	(b) Event #2 FASHION SHOW (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	1,013,981	42,855	1,056,836
2	Less: Contributions . . . .	774,665	42,855	817,520
3	Gross income (line 1 minus line 2) . . . . . .	239,316		239,316

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	151,971	151,971
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		151,971
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		87,345

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	151,971	151,971

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 40100.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	5,783,612	5,365,415	418,197	0.080 %
b	Medicaid (from Worksheet 3, column a) . . . . .	79,581,673	46,248,029	33,333,644	6.420 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	85,365,285	51,613,444	33,751,841	6.500 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	388,231	24,038	364,193	0.070 %
f	Health professions education (from Worksheet 5) . . .	9,702,827	100,022	9,602,805	1.850 %
g	Subsidized health services (from Worksheet 6) . . . .	88,985,573	72,631,176	16,354,397	3.150 %
h	Research (from Worksheet 7) .	776,638	996,448	-219,810	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	463,118	0	463,118	0.090 %
j	Total. Other Benefits . .	100,316,387	73,751,684	26,564,703	5.160 %
k	Total. Add lines 7d and 7j .	185,681,672	125,365,128	60,316,544	11.660 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	36,946	36,946	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	644,664	644,664	0.120 %
8	Workforce development
9	Other
10	Total	681,610	681,610	0.130 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

8,655,438

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

2,229,202

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

86,505,239

Enter Medicare allowable costs of care relating to payments on line 5.....

85,962,278

Subtract line 6 from line 5. This is the surplus (or shortfall)........

542,961

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 AULTMAN ONCOLOGY CENTER OF EXCELLENCE LLC	ONCOLOGY SERVICES	72.900 %	0 %	27.100 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?4 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)								Other (Describe)	Facility reporting group
1	AULTMAN HOSPITAL 2600 SIXTH ST SW CANTON,OH44708 HTTP://WWW.AULTMAN.ORG 1270 AULTMAN HOSPITAL 340714538	X	X	X		X	X	MAIN HOSPITAL	A
2	AULTMAN WOODLAWN 2821 WOODLAWN AVE NW CANTON,OH44708 HTTP://WWW.AULTMAN.ORG AULTMAN HOSPITAL 340714538	X						SKILLED NURSING REHABILITATION CTR HOME CARE & HOSPICE	A
3	AULTMAN WEST 2051 WALES AVE NW MASSILLON,OH44708 HTTP://WWW.AULTMAN.ORG 1443 AULTMAN HOSPITAL 340714538	X	X					IMMEDIATE CARE, DIAGNOSTICS, THERAPY AND SURGERY	A
4	AULTMAN ORRVILLE HOSPITAL 832 S MAIN STREET ORRVILLE,OH44667 HTTP://WWW.AULTMANORRVILLE.ORG/ 1291 AULTMAN ORRVILLE HOSPITAL 340733138	X	X		X		X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTPS://AULTMAN.ORG/HOME/ABOUT/AULTMAN-HOSPITAL/COMMUNITY-HEALTH-NEEDS-ASSE

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTPS://AULTMAN.ORG/HOME/ABOUT/AULTMAN-HOSPITAL/COMMUNITY-HEALTH-NEEDS-ASSE

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.000000000000% and FPG family income limit for eligibility for discounted care of 401.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://AULTMAN.ORG/HOME/PATIENTS-AND-VISITORS/INSURANCE-AND-BILLING/FINANC

The FAP application form was widely available on a website (list url):

HTTPS://AULTMAN.ORG/HOME/PATIENTS-AND-VISITORS/INSURANCE-AND-BILLING/FINANC

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://AULTMAN.ORG/HOME/PATIENTS-AND-VISITORS/INSURANCE-AND-BILLING/FINANC

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	AULTMAN ORRVILLE HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTP://WWW.AULTMANORRVILLE.ORG/AULTMAN-HOSPITAL-INFORMATION/ABOUT-US/COMMUN

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTP://WWW.AULTMANORRVILLE.ORG/AULTMAN-HOSPITAL-INFORMATION/ABOUT-US/COMMUN

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	AULTMAN ORRVILLE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTP://WWW.AULTMANORRVILLE.ORG/PATIENT-INFORMATION/RESOURCES/BILLING

The FAP application form was widely available on a website (list url):

HTTP://WWW.AULTMANORRVILLE.ORG/PATIENT-INFORMATION/RESOURCES/BILLING

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.AULTMANORRVILLE.ORG/PATIENT-INFORMATION/RESOURCES/BILLING

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	AULTMAN ORRVILLE HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
AULTMAN ORRVILLE HOSPITAL	PART V, SECTION B, LINE 5: IN CONDUCTING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT; AULTMAN ORRVILLE HOSPITAL TOOK INTO ACCOUNT THE BROAD INTERESTS OF OUR COMMUNITY BY SOLICITING INPUT FROM LOCAL NOT-FOR-PROFIT AND COMMUNITY MEMBERS. THE HOSPITAL CONDUCTED A COMMUNITY FOCUS GROUP SESSION ON JULY 10, 2013 TO SOLICIT INPUT FROM COMMUNITY MEMBERS AND EXPLORE BETTER WAYS TO MEET HEALTH CARE NEEDS. OVER 20 COMMUNITY SUPPORT AGENCIES WERE REPRESENTED AT OUR MEETING, CONDUCTED BY AN INDEPENDENT CONSULTANT FROM THE CENTERS FOR MARKETING AND OPINION RESEARCH (CMOR). AGENCIES INCLUDED THE CITY OF ORRVILLE, ORRVILLE CHAMBER OF COMMERCE, UNIVERSITY OF AKRON WAYNE COLLEGE, SALVATION ARMY, WAYNE COUNTY CHILDREN SERVICES, AN AMISH COMMUNITY MEMBER, WAYNE COUNTY JOB AND FAMILY SERVICES, VIOLA STARTZMAN FREE CLINIC, YOUR HUMAN RESOURCE CENTER, ORRVILLE MINISTERIAL ASSOCIATION, GROWING HEALTHY HABITS, COMMUNITY BIRTH CIRCLE, COUNSELING CENTER OF WAYNE AND HOLMES, WAYNE COUNTY EMA, WAYNE/HOLMES MENTAL HEALTH RECOVERY BOARD, ORRVILLE PUBLIC LIBRARY, HEARTLAND COMMUNITY EDUCATION, STEPS AT LIBERTY CENTER, AND WAYNE COUNTY EMERGENCY MANAGEMENT. DISCUSSION TOPICS INCLUDED STRENGTHS OF THE HOSPITAL IN THE COMMUNITY, ISSUES AND BARRIERS RELATED TO SERVICES, AND EMERGING COMMUNITY NEEDS. IT WAS DETERMINED THE TOP THREE ISSUES WERE: LIMITED ACCESS TO HEALTHCARE, HIGH OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICES, AND LACK OF SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES. IT WAS DISCUSSED THAT THE AREAS IN WHICH AULTMAN ORRVILLE HOSPITAL COULD HAVE THE MOST IMPACT WAS ON IMPROVED ACCESS TO HEALTHCARE SERVICES, SHIFTING THE MENTALITY OF AREA RESIDENTS TOWARD MORE HEALTHY BEHAVIORS, AND IMPROVING HEALTHCARE COST
AULTMAN ORRVILLE HOSPITAL	PART V, SECTION B, LINE 7D: THE CHNA AND CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING HTTP://WWW.AULTMANORRVILLE.ORG/AULTMAN-HOSPITAL-INFORMATION/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
AULTMAN ORRVILLE HOSPITAL	PART V, SECTION B, LINE 11: AULTMAN ORRVILLE HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT BY:#1 - IMPROVING ACCESS TO HEALTH INSURANCE AND HEALTHCARE SERVICES- ACCEPTING ALL PAYERS AND MOST INSURANCE CONTRACTS- PROVIDING DISCOUNTS AND PACKAGE PRICING TO THE AMISH AND PATIENTS WITHOUT INSURANCE- REMAINING PART OF THE INDEPENDENT HOSPITAL NETWORK, ONE OF THE LOWEST COST NETWORKS IN THE STATE OF OHIO- PROVIDING FREE TRANSPORTATION SERVICES WITHIN A 25 MILE RADIUS- PROVIDING FREE OVERNIGHT ACCOMODATIONS FOR THE AMIHS THROUGH OUR AMISH HOUSE AND BUGGY BARN- PROMOTING OUR FINANCIAL ASSISTANCE POLICY FOR PATIENTS WITHOUT INSURANCE UP TO 400% FEDERAL POVERTY LEVEL- PROMOTING AN INTERNAL HEALTH PLAN, AULTCARE AND PRIMETIME MEDICARE, INCLUDING WELLNESS PROGRAMS- OFFERING A SKILLED NURSING CARE PROGRAM WITHIN THE HOSPITAL- ONE OF ONLY A HANDFUL OF CRITICAL ACCESS HOSPITALS IN THE STATE OF OHIO TO PROVIDE A FULL SERVICE WOMEN'S HEALTH/OB PROGRAM- EMPLOY PRIMARY CARE PHYSICIANS THROUGH THE AULTMAN HEALTH FOUNDATION RELATIONSHIP- OFFER EXTENDED AND WEEKEND HOURS IN THE EMPLOYED PRIMARY CARE SETTINGS- PROVIDE LAB AND X-RAY SERVICES TO THE VIOLA STARTZMAN FREE CLINIC AT NO COST- OFFER FREE BREAST FEEDING CLASSES- OFFER SAFE SITTER CLASSES- PROVIDE COMMUNITY EDUCATION PROGRAMMING THROUGH THE WORKING ON WELLNESS PROGRAM, SUCH AS HEALTH TALKS, FREE SCREENINGSADDITIONAL PROGRESS IN #1 SINCE SURVEY- INTEGRATION OF DUNLAP FAMILY PHYSICIANS AND DR RICK JONES TO AULTMAN MEDICAL GROUP (PRIMARY CARE PROVIDERS), WORKING TO RECRUIT ONE ADDITIONAL PCP TO GROUP- PROMOTE PRIMETIME HEALTH PLAN - INCREASE OF APPROXIMATELY 100 MEMBERS OR 2% MARKET SHARE IN 2015- EXPLORING HEALTHCARE EXCHANGE CONTRACTS, HOSPITAL CURRENTLY HAS FOUR AND WILL ADD AULTCARE IN 2016- WORKING TO EXPAND 340B DRUG COVERAGE AND SERVICES TO KEEP PHARMECUTICAL COSTS LOW IN THE COMMUNITY, BUT STILL TRYING TO DETERMINE WHICH PROGRAM WOULD HELP DO THIS BEST- ADDED SPECIALISTS TO THE MEDICAL STAFF IN THE AREAS OF INTERNAL MEDICINE, OB/GYN, PATHOLOGY, EMERGENCY MEDICINE, OCCUPATIONAL MEDICINE, ENDOCRINOLOGY, AND NEWBORN CARE#2 - OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICES- OFFER MYPLATE PROGRAM- FREE HEALTH TALKS TO COMMUNITY ON MONTHLY BASIS- PRIMETIME SENIORS PROGRAM- BEE HEALTHY EMPLOYEE WELLNESS PROGRAM- COLLABORATE WITH GROWING HEALTHY HABITS PROGRAM- SILVERSNEAKERS AND SILVER AND FIT EXERCISE FITNESS PROGRAMS- DIABETES SELF MANAGEMENT TRAINING AND SUPPORT PROGRAMS- SPORTS AND WELLNESS, EXERCISE AS MEDICINE PROGRAMS- GIVE IT UP! SMOKING CESSATION PROGRAMS- WORKING ON WELLNESS COMMUNITY OUTREACH MOBILE VANADDITIONAL PROGRESS IN #2 SINCE SURVEY- IMPLEMENTED MEDICALLY SUPERVISED AULTMAN WEIGHT MANAGEMENT PROGRAM- PROVIDED OFFICE LOCATION SPACE FOR AULTMAN ENDOCRINOLOGIST ON ROTATION- OBTAINED $40,000 WELLNESS GRANT TO BE USED FOR WORKING ON WELLNESS PROGRAM FROM THE WAYNE COUNTY COMMUNITY FOUNDATION- OBTAINED $17,500 GRANT USED TO PURCHASE MOBILE VEHICLE FOR WORKING ON WELLNESS PROGRAM- OFFERING SMOKING CESSATION PROGRAMS TO HIGH SCHOOL STUDENTS IN THE EASTERN WAYNE COUNTY SERVICE AREA, WITH INCREASED FOCUS TO THE RITTMAN AREA#3 - SUBSTANCE ABUSE AND MENTAL HEALTH- COLLABORATE WITH MENTAL HEALTH AND RECOVERY BOARD OF WAYNE AND HOLMES COUNTY- PROMOTE EMPLOYEE CARE FUND- PACE-SETTER LEVEL CONTRIBUTOR TO ORRVILLE UNITED WAY FUND- HEALTH TALK SERIES ON DEPRESSION AND HEALTHY EATING HABITSADDITIONAL PROGRESS IN #3 SINCE SURVEY- AULTMAN ORRVILLE HAS NOT MADE SIGNIFICANT PROGRESS WITH THIS INITIATIVE THUS FAR, BUT WE HAVE EXPLORED OFFERING OFFICE SPACE TO THE MENTAL HEALTH AND RECOVERY BOARD OF WAYNE AND HOLMES COUNTY- AULTMAN ORRVILLE HOSPITAL IS COLLABORATING WITH WAYNE COUNTY
AULTMAN ORRVILLE HOSPITAL	PART V, SECTION B, LINE 22D: MAXIMUM AMOUNTS THAT CAN BE CHARGED ARE DETERMINED BASED ON 2015 POVERTY GUIDELINES TIMES 150% UP TO 400% OF THE ANNUAL GROSS INCOME OR MONTHLY INCOME. IN ADDITION, THE ORGANIZATION FOLLOWS THE FINANCIAL ASSISTANCE POLICY AND PROCEDURES. THE PATIENTS COMPLETE THE HCAP APPLICATION PLUS THE FINANCIAL ASSISTANCE APPLICATION. THE DISCOUNT PROVIDED TO THE SELF-PAY INDIVIDUALS UNDER THE FAP POLICY IS GREATER THAN 22A, 22B AND 22C.A 30% DISCOUNT IS OFFERED FOR PROFESSIONAL FEES. A DISCOUNT OF 20%-70% IS OFFERED TO SELF-PAY PATIENTS FOR FACILITY CHARGES.
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: AULTMAN HOSPITAL, - FACILITY 2: AULTMAN WOODLAWN, - FACILITY 3: AULTMAN WEST
GROUP A-FACILITY 1 -- AULTMAN HOSPITAL PART V, SECTION B, LINE 5:	COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ADVISORY COMMITTEE. THE CHNA ADVISORY COMMITTEE IS MADE UP OF A VARIETY OF HEALTH AND SOCIAL SERVICES AGENCIES AND VOLUNTEERS IN THE COMMUNITY. THE FOLLOWING AGENCIES HAVE BEEN INVOLVED IN THE COMMITTEE: ACCESS HEALTH STARK COUNTY; AFFINITY MEDICAL CENTER; ALLIANCE COMMUNITY HOSPITAL; ALLIANCE CITY HEALTH DEPARTMENT; AULTMAN HEALTH FOUNDATION; CANTON CITY HEALTH DEPARTMENT; CANTON COMMUNITY CLINIC; MERCY MEDICAL CENTER; PRESCRIPTION ASSISTANCE NETWORK OF STARK COUNTY; STARK COUNTY FAMILY COUNCIL; STARK COUNTY HEALTH DEPARTMENT; STARK COUNTY JOBS & FAMILY SERVICES; STARK COUNTY MEDICAL SOCIETY; STARK COUNTY MENTAL HEALTH & RECOVERY BOARD; UNITED WAY OF GREATER STARK COUNTY; AND WESTERN STARK CLINIC. TO COLLECT INFORMATION FROM THE CHNA ADVISORY COMMITTEE AULTMAN HOSPITAL PARTICIPATED IN TWO HEALTH IMPROVEMENT SUMMITS. DURING THE FIRST SUMMIT NEARLY 70 HEALTH AND SOCIAL SERVICE AGENCIES AND COMMUNITY VOLUNTEERS CAME TOGETHER TO REVIEW THE NEWLY RELEASED 2011 STARK COUNTY HEALTH NEEDS ASSESSMENT REPORT. THE REPORT INCLUDES SURVEY DATA COLLECTED FROM COMMUNITY RESIDENTS THROUGH A RANDOMIZED TELEPHONE POLL, SECONDARY HEALTH INDICATORS DATA AND YOUTH DATA OBTAINED FROM A SURVEY ADMINISTERED THROUGH STARK COUNTY SCHOOLS. THE DATA WAS ANALYZED AND FIVE LEADING HEALTH ISSUES WERE IDENTIFIED. PARTICIPANTS WERE ASKED TO DISCUSS THE RESULTS AND VOTE ON THREE HEALTH ISSUES FOR THE COMMUNITY TO ADDRESS. USING THE CONNECTING POINT VOTING SYSTEM, THE RESULTS WERE AVAILABLE IMMEDIATELY FOR VIEW. THE PARTICIPANTS WERE THEN ASKED TO BREAK INTO GROUPS AND BRAINSTORM IDEAS FOR ADDRESSING EACH HEALTH NEED. THESE IDEAS WERE USED TO CONSTRUCT A FRAMEWORK FOR A HEALTH IMPROVEMENT PLAN. PARTICIPANTS WERE ASKED TO CONTINUE THEIR COMMITMENT TO THIS PROCESS OVER THE NEXT FOUR MONTHS TO FURTHER DEVELOP THE PLAN. DURING THE SECOND SUMMIT OVER 60 COMMUNITY LEADERS FROM PUBLIC HEALTH, HEALTH CARE ORGANIZATIONS, FOUNDATIONS, AND OTHER GOVERNMENTAL AND SOCIAL SERVICES ORGANIZATION ATTENDED. THE SUMMIT WAS ORGANIZED TO BRING TOGETHER COMMUNITY ORGANIZATIONS THROUGHOUT STARK COUNTY WHOSE EFFORTS AND INITIATIVES ADDRESS ONE OR MORE OF THE THREE HEALTH PRIORITIES. THE ATTENDEES WERE ENCOURAGED TO COMMIT TO IMPLEMENTING GOALS AND STRATEGIES IN THE HEALTH IMPROVEMENT PLAN AND ASSIST IN EVALUATION EFFORTS. THE PURPOSE OF THE SUMMIT WAS ALSO TO MOTIVATE ATTENDEES TO MAKE SUSTAINABLE CHANGES AND TO SHOWCASE THE COUNTY'S COLLABORATION TO MAKE STARK COUNTY A HEALTHIER COMMUNITY.STARK COUNTY CHNA ADVISORY COMMITTEE ORIGINAL COMMITTEE MEMBERS: LES ABLE, COMMUNITY VOLUNTEER, RETIRED, STARK COUNTY MENTAL HEALTH BOARD JIM ADAMS, HEALTH COMMISSIONER, CANTON CITY HEALTH DEPARTMENT SHARON ANDREANI, DIRECTOR OF NURSING, ALLIANCE CITY HEALTH DEPARTMENT BARB BLEVINS, DIRECTOR, ACCESS HEALTH STARK COUNTY EMILY CANIFORD, DIRECTOR OF ADMINISTRATION AND SUPPORT SERVICES, STARK COUNTY HEALTH DEPARTMENT KAY CONLEY, COMMITTEE CHAIR, GRANTS COORDINATOR, STARK COUNTY HEALTH DEPARTMENT LYNNE DRAGOMIER, VP PUBLIC RELATIONS AND MARKETING, MERCY MEDICAL CENTER GARY FEAGLES, EXECUTIVE DIRECTOR, WESTERN STARK CLINIC BILL FRANKS, HEALTH COMMISSIONER, STARK COUNTY HEALTH DEPARTMENT DANA HALE, RN, BSN, CANTON CITY HEALTH DEPARTMENT WENDY HUNTER-VAUGHN, MANAGER OF PROGRAMS/EVALUATIONS, MENTAL HEALTH AND RECOVERY SERVICES BOARD OF STARK COUNTY BILL JAMES, DIRECTOR OF INDUSTRIAL ENGINEERING, ALLIANCE COMMUNITY HOSPITAL CAROL LICHTENWALTER, DIRECTOR, STARK COUNTY FAMILY COUNCIL KEVIN METZ, EXECUTIVE DIRECTOR, STARK COUNTY MEDICAL SOCIETY KRISTEN MIDAY, FINANCIAL ANALYST, AULTMAN HEALTH FOUNDATION MICHELLE MILLER, PROJECT LEADER OF RESEARCH AND DEVELOPMENT, ALLIANCE COMMUNITY HOSPITAL LIZ PRUITT, VP OF OPERATIONS, AFFINITY MEDICAL CENTER KELLY RICHENDOLLAR, HEALTH EDUCATOR, STARK COUNTY HEALTH DEPARTMENT CAROL RISALITI, EXECUTIVE DIRECTOR, PRESCRIPTION ASSISTANCE NETWORK OF STARK COUNTY LORIE TRAVAGLINO, DIRECTOR, UNITED WAY OF GREATER STARK COUNTY.
GROUP A-FACILITY 1 -- AULTMAN HOSPITAL PART V, SECTION B, LINE 6A:	THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES:- AFFINITY MEDICAL CENTER- ALLIANCE COMMUNITY HOSPITAL- CANTON COMMUNITY CLINIC- MERCY MEDICAL CENTER- WESTERN STARK CLINIC
GROUP A-FACILITY 1 -- AULTMAN HOSPITAL PART V, SECTION B, LINE 11:	AS A RESULT OF THE CHNA AND SUBSEQUENT ANALYSIS, THE FOLLOWING WERE IDENTIFIED AS THE PRIORITY AREAS IN WHICH THE HOSPITAL WILL FOCUS: ACCESS TO HEALTH CARE, OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICES, LARGE NEED FOR MENTAL HEALTH SERVICESACCESS TO HEALTH CARE - CURRENT PROGRAMS AND SERVICES THAT ADDRESS THIS NEED: AH OFFERS SEVERAL SERVICES TO COMBAT LACK OF ACCESS TO HEALTH INSURANCE AND HEALTH CARE: THREE OUTPATIENT CENTERS, STAFFED BY RESIDENT PHYSICIANS AND TEACHING ATTENDING PHYSICIANS, THAT PROVIDE FAMILY MEDICINE, INTERNAL MEDICINE AND OBSTETRICS SERVICES TO UNDERINSURED AND UNINSURED MEMBERS OF THE COMMUNITY. MORE THAN 40,000 PATIENT VISITS ARE MADE TO THE OUTPATIENT CENTERS EACH YEAR. THE WOW PROGRAM, WHICH 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 2012, THE WOW VAN REACHED MORE THAN 20,000 PEOPLE. THE AULTMAN CANCER CENTER'S ANNUAL CANCER SCREENING DAY PROVIDES A VARIETY OF FREE SCREENINGS TO HELP UNDERINSURED PEOPLE IN OUR COMMUNITY. AT THE APRIL 2012 CANCER SCREENING DAY, 161 PATIENTS WERE SCREENED. MOST OF THE PARTICIPANTS RECEIVED MULTIPLE SCREENINGS, FOR A TOTAL OF 353 SCREENINGS THROUGHOUT THE EVENT. THE CENTER ALSO OFFERED A BREAST SCREENING DAY IN 2012 TO UNDERSERVED WOMEN IN THE CARROLLTON, OHIO AREA. THE AULTMAN INFUSION THERAPY DEPARTMENT BEGAN A MEDICATION REIMBURSEMENT PROGRAM FOR UNINSURED PATIENTS IN 2007. LED BY AN ONCOLOGY-CERTIFIED REGISTERED NURSE, THE PROGRAM WAS SUCCESSFUL IN RECOVERING $450,000 IN DRUG COSTS IN 2012 FROM VARIOUS ASSISTANCE PROGRAMS. FREE HEALTH TALK PRESENTATIONS PROVIDE COMMUNITY MEMBERS WITH GENERAL HEALTH INFORMATION AND THE OPPORTUNITY TO INTERACT WITH LOCAL HEALTH CARE PROFESSIONALS. TOPICS RANGE FROM MANAGING DIABETES TO HEART ATTACK SIGNS TO CANCER PREVENTION. THE AH PATIENT OUTREACH DEPARTMENT OFFERS CHARITY CARE ASSISTANCE TO THE UNINSURED OR UNDERINSURED, ALONG WITH PROVIDING PATIENT RIGHTS NOTIFICATION TO ALL MEDICARE BENEFICIARIES IN THE HOSPITAL. PATIENTS RECEIVE FINANCIAL COUNSELING, ASSISTANCE IN APPLYING FOR MEDICAID AND THE STATE-FUNDED HOSPITAL CARE ASSURANCE PROGRAM (HCAP) AS WELL AS GUIDANCE ON AULTMAN'S OWN FINANCIAL ASSISTANCE PROGRAM (FAP). THE DEPART. PROCESSED MORE THAN 15,000 CHARITY CARE APPLICATIONS IN 2012 AND DELIVERED NEARLY 17,000 PATIENTS' RIGHTS DOCUMENTS TO MEDICARE PATIENTS. AH PROVIDES HIGH-QUALITY HEALTH CARE PROGRAMS AND SERVICES TO ANYONE IN NEED, REGARDLESS OF THEIR ABILITY TO PAY. AH IS DEDICATED TO YOUR HEALTH, OFFERING EVERYTHING FROM MEDICAL CARE DISCOUNTS TO EDUCATIONAL PROGRAMS. AULTCARE OFFERS INDIVIDUAL AULTONE, EMPLOYER GROUP, AND PRIMETIME HEALTH PLAN MEDICARE ADVANTAGE PLANS. NETWORK PROVIDERS SPAN THE SPECTRUM OF HEALTH CARE SPECIALTIES TO MEET THE NEEDS OF ENROLLEES AND KEEP CARE LOCALLY BASED. CARE COORDINATION SERVICES ARE OFFERED WHEN IT IS NECESSARY FOR MEMBERS TO SEEK AND RECEIVE CARE OUTSIDE OF THE AULTCARE OR PRIMETIME HEALTH PLANS' NETWORK OF PROVIDERS. TELE-MONITORING SERVICES ARE OFFERED FOR HEART FAILURE AND DIABETES CHRONIC STATES. EMPLOYER GROUPS MAY CHOOSE TO ADD ON WELLNESS PROGRAMS DESIGNED SPECIFICALLY TO THE NEEDS OF THE GROUP WITH ONSITE HEALTH COACHING AND EDUCATION PROVIDED BY LICENSED PROFESSIONAL STAFF. TRANSITION PROGRAMS PROVIDE MEMBERS WHO ARE CONFINED IN AN ACUTE CARE SETTINGS EASE IN THEIR MOVING FROM THE ACUTE PHASE OF THEIR CARE TO THE NEXT LEVEL WITHIN THE HEALTH CARE CONTINUUM WITH THE GOAL OF REDUCING READMISSION. THE WEBSITE (WWW.AULTMAN.ORG) IS A COMMUNITY RESOURCE FOR HEALTH AND WELLNESS INFORMATION; HOSPITAL SERVICES AND A CALENDAR OF EVENTS; AN ONLINE PHYSICIAN DIRECTORY AND MORE. AH ALSO HAS A RELATIONSHIP WITH A HEALTH INFORMATION CONTENT PROVIDER CALLED EMMI. EMMI IS AN ANIMATED, WEB BASED EDUCATIONAL PRODUCT WITH AN EXTENSIVE LIBRARY OF SPECIFIC PROGRAMS DESIGNED TO HELP VIEWERS LEARN ABOUT THEIR MEDICAL CONDITION, WELLNESS, DIAGNOSTIC AND SURGICAL PROCEDURES. EMMI PROGRAMS CAN BE VIEWED IN THE HOME AT THE VIEWER'S OWN PACE. THE VIEWER MAY ALSO SHARE PROGRAMS WITH FRIENDS AND FAMILY. THESE PROGRAMS OFFER CURRENT, ACCURATE, SOUND AND UNBIASED MEDICAL INFORMATION. THEY ARE DESIGNED TO NOT ONLY EDUCATE THE VIEWER, BUT TO PROVIDE A BASE ON WHICH THE VIEWER CAN BUILD THEIR KNOWLEDGE AND BE AN INFORMED CONSUMER OF HEALTH CARE SERVICES.OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICES - CURRENT PROGRAMS AND SERVICES THAT ADDRESS THIS NEED: AH SERVICES AND INITIATIVES TO TARGET OBESITY AND UNHEALTHY LIFESTYLE CHOICES INCLUDED: THE HEALTH VISION 2020 INITIATIVE, AIMED AT MAKING STARK COUNTY HEALTHIER BY THE YEAR 2020. THE AULTMAN HEALTH VISION 2020 COMMITTEE TARGETED TOBACCO USE AND OBESITY 2012, OFFERING FREE EDUCATIONAL PROGRAMS, HEALTH SCREENINGS AND THE "GIVE IT UP!" TOBACCO CESSATION PROGRAM TO EQUIP LOCAL RESIDENTS WITH THE TOOLS THEY NEED TO MAKE HEALTHIER LIFESTYLE CHOICES. AULTMAN WEIGHT MANAGEMENT (AWM) PROGRAMS TO HELP CLIENTS LOSE WEIGHT AND IMPROVE THEIR HEALTH. AH OFFERS THREE MEDICALLY SUPERVISED WEIGHT-LOSS PROGRAMS FOR ADULTS; ALONG WITH THE FUN 2B FIT FAMILY-CENTERED PROGRAM FOR CHILDREN 8-15 AND THEIR PARENTS. AWM RELOCATED IN 2012 FROM AN OFFICE BUILDING TO AN AH FACILITY PACKED WITH FITNESS EQUIPMENT, TO MAKE THE EXERCISE COMPONENT OF THE PROGRAM MORE CONVENIENT FOR CLIENTS. NOW, CLIENTS CAN ATTEND THEIR WEEKLY MEETINGS AND EXERCISE AT THE SAME FACILITY. FREE COMMUNITY HEALTH TALK PRESENTATIONS THAT PROVIDE ATTENDEES WITH INFORMATION ON HOW TO EAT HEALTHIER, EXERCISE AND IMPROVE THEIR HEALTH. PRIMETIME PROGRAM THAT HELPS COMMUNITY MEMBERS 50 AND OLDER STAY ACTIVE BY OFFERING A VARIETY OF EXERCISE CLASSES, ALONG WITH GOLF AND BOWLING LEAGUES. THE PRIMETIME PROGRAM EXPANDED TO THE AULTMAN ORRVILLE HOSPITAL LOCATION IN 2012, TO MEET THE NEEDS OF ORRVILLE AND WAYNE COUNTY RESIDENTS. THE CANTON PROJECT, A VEGAN DIET SUPPORT GROUP, LED BY AN AULTMAN CARDIAC REHAB NURSE AND CARDIOLOGIST. THE MONTHLY SUPPORT GROUP IS FREE TO ATTEND, AND ABOUT 100 PEOPLE ARE ON THE SUPPORT GROUP ROSTER. THE GROUP OFFERS INFORMATION AND ENCOURAGEMENT TO PEOPLE ON VEGAN OR PLANT-BASED DIETS. ACTIVITIES RANGE FROM FOOD LABEL-READING SESSIONS TO POT-LUCK SUPPERS TO TIPS ON HOW TO ORDER AT RESTAURANTS. THE CARDIOLOGIST ALSO ATTENDS REGULARLY TO SHARE THE LATEST MEDICAL RESEARCH WITH THE GROUP. THE SHARON LANE HEALTH INFORMATION CENTER, LOCATED AT AH, WHICH OFFERS MANY RESOURCES FOR HEALTHY LIFESTYLES INCLUDING A FULL LENDING LIBRARY, VIDEOS, COOKBOOKS, LITERATURE AND ANATOMICAL MODELS. HEALTH EDUCATION SPECIALISTS ARE ON HAND TO HELP VISITORS WITH CUSTOMIZED RESEARCH. THE WORKING ON WELLNESS (WOW) VAN, WHICH PROVIDES FREE HEALTH SCREENINGS AND EDUCATION THROUGHOUT THE COMMUNITY. THE WOW VAN VISITS AREA SCHOOLS, COMMUNITY/OUTREACH CENTERS, CHURCHES, SENIOR CENTERS; BLOCK PARTIES, ETC. TO PROVIDE AGE-APPROPRIATE HEALTH INFORMATION. IN 2012, THE WOW PROGRAM PROMOTED HEALTHY EATING TO LOCAL SCHOOL CHILDREN BY PROVIDING COLORFUL MYPLATE PLACEMATS TO TEACH KIDS ABOUT FOOD GROUPS AND CREATING "SMART" PLATES OF FOOD. THE WOW VAN ALSO PROVIDES NONINVASIVE HEALTH SCREENINGS INCLUDING BLOOD PRESSURE CHECKS, HEIGHT, WEIGHT AND BODY MASS INDEX/PERCENTAGE OF BODY FAT ARE PROVIDED. EDUCATIONAL PROGRAMS INCLUDING OUTPATIENT COUNSELING WITH A DIETITIAN AND A DIABETES MANAGEMENT PROGRAM, LED BY CERTIFIED DIABETES EDUCATORS. THE AULTMAN AMBASSADOR PROGRAM IS AN INITIATIVE TO REDUCE OBESITY AMONG HIGH SCHOOL STUDENTS, BY WORKING INTENSIVELY WITH A SPECIFIC HIGH SCHOOL OVER SEVERAL YEARS. IN OUR MODEL, AH PARTNERS WITH CARDIOVASCULAR CONSULTANTS (HEART SURGEONS), AN AREA COLLEGE/ UNIVERSITY AND A LOCAL HIGH SCHOOL. OBESITY IS REDUCED THROUGH ACTIVITIES IN BOTH THE SCHOOL AND COMMUNITY. RIGHT NOW, WE ARE ACTIVE IN LOUISVILLE HIGH SCHOOL WITH MALONE UNIVERSITY AS OUR COLLEGIATE PARTNER. A COLLABORATIVE WELLNESS COUNCIL CONSISTING OF AH EMPLOYEES; MALONE FACULTY; AND LOUISVILLE HIGH SCHOOL ADMINISTRATORS, TEACHERS, PARENTS AND STUDENTS HELPS TO DECIDE THE SPECIFIC ACTIONS THAT WE TAKE. THE WELLNESS COUNCIL MEETS MONTHLY DURING THE SCHOOL YEAR.NEED FOR ADDITIONAL MENTAL HEALTH SERVICES - CURRENT PROGRAMS AND SERVICES THAT ADDRESS THIS NEED: AH OFFERS A VARIETY OF SERVICES TO HELP PATIENTS WITH MENTAL HEALTH ISSUES INCLUDING: AN INPATIENT PSYCHIATRIC UNIT THAT PROVIDES GROUP AND FAMILY THERAPY, MEDICATION ADJUSTMENTS, ART THERAPY, SOCIAL SERVICES AND DISCHARGE PLANNING. THE UNIT FEATURES 24/7 NURSING CARE AND SECURITY COVERAGE. THE OUTPATIENT PARTIAL HOSPITALIZATION PROGRAM AND INTENSIVE OUTPATIENT PROGRAM THAT PROVIDE SHORT-TERM, DAILY PROGRAMMING FOR PATIENTS WITHOUT HAVING TO STAY OVERNIGHT IN THE HOSPITAL. THE AULTMAN BEHAVIORAL HEALTH CENTER, WHICH OPENED IN 2012, OFFERS OUTPATIENT GROUP THERAPY, INDIVIDUAL MENTAL HEALTH ASSESSMENTS, MEDICATION MANAGEMENT AND MORE.
GROUP A-FACILITY 1 -- AULTMAN HOSPITAL PART V, SECTION B, LINE 16I:	THE FINANCIAL ASSISTANCE INFORMATION CAN BE FOUND AT THE FOLLOWING URL:HTTPS://AULTMAN.ORG/HOME/PATIENTS-AND-VISITORS/INSURANCE-AND-BILLING/FINANCIAL-ASSISTANCE/#/
GROUP A-FACILITY 1 -- AULTMAN HOSPITAL PART V, SECTION B, LINE 22D:	THE AMOUNTS GENERALLY BILLED (AGB) IS CALCULATED BY THE LOOK BACK METHOD. UNDER THE LOOK BACK METHOD THE AGB PERCENTAGE IS CALCULATED BY DIVIDING THE SUM OF ALL CLAIMS OVER A PRIOR 12-MONTH PERIOD FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED BY THE HEALTH INSURERS (PERMITTED TO BE USED IN THE AGB CALCULATION) BY THE SUM OF THE HOSPITAL'S GROSS CHARGES FOR THOSE CLAIMS. THE RESULTING AGB PERCENTAGE IS THEN MULTIPLIED BY THE GROSS CHARGES FOR THE CARE PROVIDED TO AN INDIVIDUAL THAT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) TO DETERMINE THE MAXIMUM AMOUNT THAT INDIVIDUAL MAY BE "CHARGED" FOR THAT CARE. FOR THE PURPOSE OF DETERMINING WHAT A FAP-ELIGIBLE INDIVIDUAL MAY BE "CHARGED" FOR EMERGENCY OR MEDICALLY NECESSARY CARE, ONLY THE AMOUNT HE OR SHE IS PERSONALLY RESPONSIBLE FOR PAYING AFTER ALL DEDUCTIONS, DISCOUNTS (INCLUDING DISCOUNTS AVAILABLE UNDER THE FAP) AND INSURANCE REIMBURSEMENTS HAVE BEEN APPLIED IS CONSIDERED.
GROUP A-FACILITY 2 -- AULTMAN WOODLAWN PART V, SECTION B, LINE 5:	SEE GROUP A - FACILITY 1 -- AULTMAN HOSPITAL DISCLOSURE
GROUP A-FACILITY 2 -- AULTMAN WOODLAWN PART V, SECTION B, LINE 6A:	SEE GROUP A - FACILITY 1 -- AULTMAN HOSPITAL DISCLOSURE
GROUP A-FACILITY 2 -- AULTMAN WOODLAWN PART V, SECTION B, LINE 22D:	SEE GROUP A - FACILITY 1 -- AULTMAN HOSPITAL DISCLOSURE
GROUP A-FACILITY 3 -- AULTMAN WEST PART V, SECTION B, LINE 5:	SEE GROUP A - FACILITY 1 -- AULTMAN HOSPITAL DISCLOSURE
GROUP A-FACILITY 3 -- AULTMAN WEST PART V, SECTION B, LINE 6A:	SEE GROUP A - FACILITY 1 -- AULTMAN HOSPITAL DISCLOSURE
GROUP A-FACILITY 3 -- AULTMAN WEST PART V, SECTION B, LINE 22D:	SEE GROUP A - FACILITY 1 -- AULTMAN HOSPITAL DISCLOSURE

Schedule H (Form 990) 2015

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?12
Name and address		Type of Facility (describe)
1	1 - AULTMAN NORTH 6100 WHIPPLE AVE NW NORTH CANTON,OH44720	IMMEDIATE CARE, DIAGNOSTICS THERAPY AND SURGERY
2	2 - AULTMAN CENTER FOR DIALYSIS 2912 W TUSCARAWAS ST CANTON,OH44710	DIALYSIS CENTER
3	3 - AULTMAN CENTER FOR PAIN MANAGEMENT 2302 FULTON DR NW CANTON,OH44718	GENERAL MEDICAL & SURGICAL
4	4 - HOME MEDICAL SUPPLY EQUIPMENT 5200 TUSCARAWAS ST CANTON,OH44708	MEDICAL SUPPLY CO
5	5 - AULTWORKS 4650 HILLS DALES RD NW CANTON,OH44708	BWC CERTIFIED TREATMENT FACILITY
6	6 - AULTMAN CARROLTOWN 1020 TRUMP RD CARROLTOWN,OH44615	IMMEDIATE CARE, DIAGNOSTICS THERAPY AND SURGERY
7	7 - AULTMAN TUSCARAWAS 2615 TUSCARAWAS ST W CANTON,OH44708	THERAPY CLINIC
8	8 - AULTMAN WEIGHT MANAGEMENT 2615 TUSCARAWAS ST W CANTON,OH44708	WEIGHT MANAGEMENT PROGRAM
9	9 - AULTMAN FAMILY MEDICINE CENTER 4319 HILLS DALES RD NW CANTON,OH44708	OUTPATIENT PHYSICIAN CLINIC
10	10 - AULTMAN FAMILY MEDICINE CENTER 8320 WAYNESBURG DR SE WAYNESBURG,OH44688	OUTPATIENT PHYSICIAN CLINIC
11	11 - AULTMAN FAMILY MEDICINE CENTER 2600 7TH STREET SW CANTON,OH44710	OUTPATIENT PHYSICIAN CLINIC
12	12 - AULTMAN LOUISVILLE 1925 WILLIAMSBURG WAY LOUISVILLE,OH44641	THERAPY CLINIC

Schedule H (Form 990) 2015

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	ACCORDING TO AULTMAN HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), ALL MEDICALLY NECESSARY SELF PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE UPDATES PUBLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% TO 100% OF FPG RECEIVES 100% DISCOUNT, 101% TO 150% OF FPG IS DISCOUNTED 90%, 151% TO 200% IS DISCOUNTED 80%, 201% TO 250% IS DISCOUNTED 65%, 251% TO 300% IS DISCOUNTED 55%, 301% TO 350% IS DISCOUNTED 40%, 351% TO 400% IS DISCOUNTED 35%, AND 401% AND ABOVE IS DISCOUNTED 30%.
PART I, LINE 7:	AULTMAN HOSPITAL (AH) USED THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H.AULTMAN ORRVILLE HOSPITAL (AOH) USES A COMBINATION OF THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H AND DIRECT COSTING METHOD OF CERTAIN PROGRAMS.PART I, LINE 7G:AOH ASSISTED AREA EMS UNITS BY STOCKING SUPPLIES AND MEDICATIONS TO THE UNITS AT NO CHARGE.PART I, LINE 7F:AOH PROVIDES EDUCATION TO THE COMMUNITY THROUGH HEALTH TALKS BY QUALIFIED PHYSICIANS AND PROFESSIONALS, SUPPORT GROUPS FOR DIABETICS AND CELIAC DISORDERS, EDUCATION FOR RADIOLOGIC TECHNOLOGY AND PHYSICIAL THERAPY STUDENTS, SMOKING CESSATION CLASSES, COUNTY HEALTH FAIRS AND BUSINESS SHOWCASES, AND BICYCLE SAFETY TO ELEMENTARY CHILDREN THROUGH THE AULTMAN SAFETY FIRST PROGRAM.
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 $ 15,978,140.
PART I, LINE 6A	AULTMAN HEALTH FOUNDATION, THE PARENT COMPANY, PUBLISHES ANNUALLY ITS ANNUAL REPORT WHICH INCLUDES ALL RELATED ORGANIZATIONS' PROGRAMS AND SERVICES DESIGNED TO LEAD THE COMMUNITY TO IMPROVED HEALTH AND PROMOTE HEALTHY LIFESTYLES. THIS REPORT IS AVAILABLE ON AULTMAN'S WEBSITE.
PART III, LINE 2:	EXPLANATION OF METHODOLOGY FOR AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE - AH & AOHBAD DEBT EXPENSE REPORTED IS CALCULATED BY TAKING THE PROVISION FOR DOUBTFUL PATIENT ACCOUNTS REPORTED ON THE AUDITED FINANCIAL STATEMENTS AND THEN MULTIPLYING THIS AMOUNT BY THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2.
PART III, LINE 3:	METHODOLOGY FOR BAD DEBT RELATED TO CHARITY CARE - AH & AOHACCORDING TO THE FINANCIAL ASSISTANCE POLICY (FAP), ALL MEDICALLY NECESSARY SELF-PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE FEDERAL POVERTY GUIDELINES AND ARE UPDATED ANNUALLY BASED ON THE UPDATES PUBLISHED BY THE UNITED STATES OF HEALTH AND HUMAN SERVICES. THE FAP DISCOUNT IS BASED ON INCOME AND FAMILY SIZE. SELF-PAY BALANCES WILL RECEIVE A MINIMUM OF 30% DISCOUNT AND UP TO 100% AS LONG AS THE NECESSARY FINANCIAL ASSISTANCE APPLICATION IS COMPLETE. PATIENTS MUST COOPERATE WITH THE FACILITY TO PROVIDE THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY.TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE THAT POTENTIALLY COULD HAVE BEEN ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATIONS CHARITY CARE POLICY THE ORGANIZATION LOOKED AT ALL BAD DEBT BALANCES THAT WERE SELF-PAY. FROM THIS POPULATION THE ORGANIZATION IDENTIFIED THOSE SELF-PAY BALANCES THAT DID NOT RECEIVE ANY FORM OF FAP OR HCAP DISCOUNT. BECAUSE ALL SELF-PAY PATIENTS RECEIVE AT LEAST A MINIMUM OF 30% REGARDLESS OF INCOME, THE ASSUMPTION WAS MADE THAT IF THE ACCOUNT HAD NO DISCOUNT THE PROPER PAPER WORK WAS NOT TURNED IN TO DETERMINE ELIGIBILITY CRITERIA. FROM THIS REMAINING POPULATION THE ESTIMATED DISCOUNT AT COST THAT WOULD HAVE BEEN PROVIDED IF DOCUMENTATION HAD BEEN RECEIVED WAS CALCULATED BY APPLYING THE ACTUAL FAP DISTRIBUTION OF PATIENTS WHO RECEIVED DISCOUNTS IN 2015 AND THEN MULTIPLYING THIS AMOUNT BY THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2. TO BE CONSIDERED FOR FINANCIAL ASSISTANCE, THE PATIENT MUST COOPERATE WITH THE FACILITY TO PROVIDE THE INFORMATION AND DOCUMENTATION NECESSARY TO APPLY FOR OTHER EXISTING FINANCIAL RESOURCES THAT MAY BE AVAILABLE TO PAY FOR HIS OR HER HEATH CARE, SUCH AS MEDICAID.
PART III, LINE 4:	PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE. PREMIUM RECEIVABLES ARE CARRIED AT ORIGINAL BILLED AMOUNT LESS AN ESTIMATE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. PREMIUM RECEIVABLES ARE CONSIDERED PAST DUE TO THE EXTENT THAT THERE IS NO RELATED UNEARNED PREMIUM.ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR DOUBTFUL ACCOUNTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE FOUNDATION HAS DETERMINED, BASED ON AN ASSESSMENT AT THE CONSOLIDATED ENTITY LEVEL, THAT PATIENT SERVICE REVENUE IS PRIMARILY RECORDED PRIOR TO ASSESSING THE PATIENT'S ABILITY TO PAY AND AS SUCH, THE ENTIRE PROVISION FOR DOUBTFUL ACCOUNTS RELATED TO PATIENT REVENUE IS RECORDED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS.
PART III, LINE 8:	AH - THE HOSPITAL DOES NOT HAVE A SHORTFALL WITH THEIR MEDICARE PATIENTS. THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS MEDICARE COST REPORT.AOH - AS A CRITICAL ACCESS HOSPITAL, MEDICARE PAYS AT 101% COST, THUS THERE IS NO SHORTFALL. HOWEVER, IT SHOULD BE NOTED CMS HAS INSTITUTED A SEQUESTRATION PAYMENT REDUCTION OF 2% THROUGH THE AFFORDABLE CARE ACT. ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORT WERE DETERMINED USING THE MEDICARE COST-TO-CHARGE RATIO CALCULATED AS REQUIRED BY MEDICARE.
PART III, LINE 9B:	AH & AOH - THE COLLECTIONS DEPARTMENT WILL ATTEMPT TO CONTACT THE PATIENT; BY PHONE, LETTER OR A COMBINATION OF THE TWO, TO SETTLE A DEBT WITH PAYMENT IN FULL OR MONTHLY INSTALLMENTS. IF IT HAS BEEN DETERMINED AN ACCOUNT IS APPROVED FOR HCAP THE ACCOUNT IS REMOVED FROM BAD DEBT AND THE ADJUSTMENT IS APPLIED. ALSO, IF AN ACCOUNT IS APPROVED FOR FAP, THE ACCOUNT IS REMOVED FROM BAD DEBT AND THE ADJUSTMENT IS APPLIED. AFTER THE GUIDELINE ADJUSTMENT HAS BEEN MADE THE REMAINING BALANCE IS SENT BACK TO RESUME COLLECTIONS. ONCE IT HAS BEEN DETERMINED THAT INTERNAL COLLECTION EFFORTS WILL CEASE, THE COLLECTOR WILL REQUEST THE ACCOUNT TO BE CANCELLED. THESE ACCOUNTS WILL THEN BE REFERRED TO A SECONDARY OUTSIDE COLLECTION AGENCY.
PART V, FACILITY INFORMATION	AULTMAN HOSPITAL INCLUDES ONE DURABLE MEDICAL EQUIPMENT COMPANY, ONE PAIN MANAGEMENT CENTER, ONE SKILLED NURSING FACILITY, ONE HOME CARE, ONE HOSPICE, TWO BUREAU OF WORKMAN'S COMPENSATION CERTIFIED TREATMENT FACILITIES, ONE DIALYSIS CENTER, TWO FAMILY PRACTICES, ONE WEIGHT MANAGEMENT FACILITY, SIX THERAPY CLINICS, THREE DIAGNOSTIC CENTERS, TWO SAME DAY SURGERY CENTERS, ONE INPATIENT SURGERY CENTER, AND THREE IMMEDIATE CARE CENTERS.
PART VI, LINE 2:	NEEDS ASSESSMENT - AHAULTMAN HOSPITAL ASSESSES THE COMMUNITY'S HEALTH CARE NEEDS A VARIETY OF WAYS. WE STUDY PROTOCOL VOLUME AND PATIENT SATISFACTION SURVEYS. WE DOCUMENT THE MEDICAL CONDITIONS THOUSANDS OF COMMUNITY MEMBERS AND MEDICAL STAFF MEMBERS INQUIRE ABOUT IN OUR SHARON LANE HEALTH CENTER HEALTH LIBRARY. WE TRACK ATTENDANCE AT THE MORE THAN 100 "HEALTH TALK" PRESENTATIONS HELD EACH YEAR TO DETERMINE WHAT TOPICS ARE OF MOST INTEREST TO THE COMMUNITY. BETWEEN 2011 - 2013, AULTMAN COLLABORATED WITH AREA HOSPITALS AND HEALTH CARE FACILITIES TO CONDUCT A COMMUNITY HEALTH SURVEY. THE GOAL WAS TO GAUGE THE HEALTH STATUS AND HEALTH HABITS OF STARK COUNTY RESIDENTS - AND IDENTIFY AREAS WHERE AULTMAN CAN IMPROVE THE HEALTH OF OUR COMMUNITY. FIFTEEN QUESTIONS WERE INCLUDED ON THE POLL OF 1,067 STARK COUNTY HOUSEHOLDS. THE SURVEY SHOWED ACCESS TO HEALTH INSURANCE COVERAGE AND HEALTH CARE AS THE TOP PRIORITY; ALONG WITH OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICE; OTHER AREAS OF CONCERN WERE PRESCRIPTION DRUG MISUSE, LARGER NEED FOR MENTAL HEALTH SERVICES, AND GREATER ACCESS TO DENTAL CARE.NEEDS ASSESSMENT - AOHEVERY THREE YEARS, THE ORGANIZATION IS REQUIRED TO PERFORM A COMMUNITY HEALTH NEEDS ASSESSMENT. WE LAST CONDUCTED OUR SURVEY AND ASSESSMENT DURING 2013 AND HAVE POSTED BOTH THE REPORT AND IMPLEMENTATION STRATEGY TO OUR WEBSITE. THE AULTMAN ORRVILLE HOSPITAL CEO AND CFO ALSO CONDUCT COMMUNITY AWARENESS PRESENTATIONS OF THE REPORT AND STRATEGY WITH VARIOUS LOCAL NON-PROFIT INTEREST GROUPS TO GENERATE AWARENESS.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - AH & AOHTHE APPLICATION AND GUIDELINES ARE PROVIDED ON THE BACK OF EVERY PATIENT STATEMENT. AT THE TIME OF REGISTRATION PATIENTS ARE ASKED TO FILL OUT THE HOSPITAL CARE ASSURANCE PROGRAM APPLICATION WHICH INCLUDES CONTACT INFORMATION FOR QUESTIONS AND ASSISTANCE IN COMPLETING THE FORM. SIGNS AND APPLICATIONS ARE POSTED AT ALL POINTS OF ADMISSIONS INFORMING PATIENTS OF THE FREE CARE PROGRAMS WHICH ARE AVAILABLE. IN 2010, THE APPLICATION WAS ADDED TO THE INTERNET FOR EASY PATIENT ACCESS. AULTMAN'S OUTREACH DEPARTMENT ASSISTS SELF-PAY INPATIENTS WITH THE INITIAL MEDICAID APPLICATION PROCESS AND OTHER CHARITY CARE PROGRAMS UNDER WHICH THEY ARE ELIGIBLE FOR ASSISTANCE. PATIENTS WHO ARE UNABLE TO BE SCREENED DURING THEIR ADMISSION OR OUTPATIENT VISIT ARE SENT AN APPLICATION, UPON REQUEST, AFTER THEY HAVE BEEN DISCHARGED. IMPROVEMENT PROCESSES FOR 2011 INCLUDED FORMAL PATIENT OUTREACH STAFF TRAINING IN HCAP PROGRAM REQUIREMENTS AND CUSTOMER SERVICE SKILLS.
PART VI, LINE 4:	COMMUNITY INFORMATION - AHAULTMAN'S SERVICE AREA INCLUDES STARK, WAYNE, HOLMES, CARROLL AND TUSCARAWAS COUNTIES. THE CORE MARKET FOR AULTMAN HOSPITAL IS STARK COUNTY. THE U.S. CENSUS BUREAU ESTIMATED THE 2015 POPULATION OF OUR FIVE COUNTY AREAS TO BE OVER 655,864. THERE ARE TEN REGISTERED HOSPITALS IN THE FIVE COUNTY AREAS. TWO OF THESE ARE AULTMAN FACILITIES. AULTMAN PROVIDED CARE FOR 20.6% OF THE TOTAL 395,279 MEDICAID CASES IN THE PRIMARY SERVICE AREA FOR 2015. OF THE 60,583 SELF-PAY CASES IN OUR PRIMARY SERVICE AREA AULTMAN PROVIDED CARE FOR 21.8%.COMMUNITY INFORMATION - AOHTHE ORGANIZATION SERVES EASTERN WAYNE COUNTY AS THE PRIMARY SERVICE AREA, AS WELL AS THE SURROUNDING COUNTIES (STARK, MEDINA, AND HOLMES) AS THE SECONDARY SERVICE AREA. THE HOSPITAL SERVES ALL RESIDENTS WITH VARIOUS DEMOGRAPHICS, INCLUDING A HIGH POPULATION OF AMISH.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTH - AH & AOHTHE BOARD OF DIRECTORS IS COMPOSED OF AREA RESIDENTS INCLUDING BUSINESS AND COMMUNITY LEADERS AS WELL AS PHYSICIANS. THESE VOLUNTEERS WORK COUNTLESS HOURS IN THEIR OVERSIGHT ROLE. THEY ARE INVOLVED IN FUNDRAISING, COMMUNITY NEEDS, AND IN GENERAL STEWARDSHIP.COMMUNITY PHYSICIANS REQUESTING AND ULTIMATELY QUALIFYING FOR MEDICAL STAFF PRIVILEGES WOULD BE GRANTED PRIVILEGES IN THEIR RESPECTIVE MEDICAL DEPARTMENTS. AULTMAN HAS MORE THAN 535 PHYSICIANS ON ACTIVE STAFF IN MORE THAN 40 MEDICAL SPECIALTIES. FROM BICYCLE SAFETY PROGRAMS TO THE ANNUAL UNITED WAY FUNDRAISING CAMPAIGN, AULTMAN'S COMMITMENT TO THE COMMUNITY EXTENDS FAR BEYOND THE WALLS OF ITS HEALTH CARE FACILITIES. EDUCATIONAL PROGRAMS INCLUDE MORE THAN 100 FREE HEALTH TALK PRESENTATIONS EACH YEAR, FEATURING LOCAL PHYSICIANS AND HEALTH CARE PROFESSIONALS. THE SHARON LANE COMMUNITY CENTER OFFERS A COMPREHENSIVE COLLECTION OF HEALTH CARE AND CONSUMER-HEALTH MATERIALS RANGING FROM BOOKS AND DVDS AVAILABLE FOR LENDING TO ANATOMICAL MODELS. THE CENTER IS OPEN TO PATIENTS AND THEIR FAMILY MEMBERS, STUDENTS, PHYSICIANS AND THE GENERAL PUBLIC. ADDITIONAL RESOURCES INCLUDE AN ILLUSTRATED HEALTH ENCYCLOPEDIA, SYMPTOM CHECKER, VIDEOS, RISK ASSESSMENTS AND A WELLNESS CENTER ON THE AULTMAN WEBSITE.AULTMAN OFFERS THE ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT FROM CANTON TO COLUMBUS, PROVIDING SPECIALIZED CARE FOR MOTHERS WITH HIGH-RISK PREGNANCIES AND PREMATURE BABIES, UNDER ONE ROOF. AULTMAN ALSO PROVIDES A LEVEL II TRAUMA PROGRAM, VERIFIED BY THE AMERICAN COLLEGE OF SURGEONS' COMMITTEE ON TRAUMA, THE ONLY LEVEL II CENTER FOR ADULT AND PEDIATRIC PATIENTS IN ITS FIVE-COUNTY SERVICE AREA.IN 2015, AULTMAN HEALTH FOUNDATION CONTRIBUTED TO THE BETTERMENT OF THE STARK COUNTY COMMUNITY WITH THE FOLLOWING ACTIVITIES. SAFETY FIRST AULTMAN'S SAFETY FIRST PROGRAM BRINGS A MESSAGE OF BIKE SAFETY TO ALL STARK COUNTY FIRST-GRADE CLASSES, ALONG WITH SOME LOCATIONS IN WAYNE AND CARROLL COUNTIES. NEARLY 450 AULTMAN EMPLOYEES VOLUNTEERED IN 2015 TO SHARE THE BIKE SAFETY LESSON AND GIVE FREE HELMETS TO APPROXIMATELY 5,000 FIRST-GRADERS.WORKING ON WELLNESS (WOW)THE WOW TEAM VISITED MORE THAN 400 SITES IN 2015, RANGING FROM COMMUNITY EVENTS TO SENIOR CITIZEN CENTERS. WOW NURSES HAD PERSONAL INTERACTION WITH MORE THAN 26,000 COMMUNITY MEMBERS. CANCER OUTREACHCOMMUNITY OUTREACH EFFORTS EXPANDED IN 2015 WITH PARTICIPATION IN 17 HEALTH FAIRS AND COMMUNITY EVENTS. THE TEAM ORGANIZED FREE BREAST SCREENING EVENTS IN CARROLLTON AND MASSILLON THAT REACHED 80 UNDERSERVED WOMEN. THE ANNUAL CANCER SCREENING DAY AT AULTMAN HOSPITAL PROVIDED 80 UNDERINSURED PATIENTS WITH A TOTAL OF 195 FREE SCREENINGS FOR BREAST, CERVICAL, COLON, LUNG, PROSTATE, SKIN AND ORAL CANCERS. THE CANCER PROGRAM BEGAN WORKING ON THE HEALTHY U PROGRAM IN 2015, A PARTNERSHIP WITH LOCAL SCHOOLS TO TEACH STUDENTS AND FAMILIES ABOUT HEALTHY LIFESTYLES THAT REDUCE CANCER RISK.HARVEST FOR HUNGERFOOD INSECURITY IS A CRITICAL ISSUE IN NORTHEASTERN OHIO, AND AULTMAN TEAM MEMBERS GIVE GENEROUSLY TO THE ANNUAL HARVEST FOR HUNGER CAMPAIGN. IN 2015, AULTMAN EMPLOYEES PROVIDED 9,673 POUNDS OF NONPERISHABLE FOOD DONATIONS AND $15,217 IN MONETARY GIFTS THAT HELPED THOUSANDS OF FAMILIES AND INDIVIDUALS IN NEED.CAREERS IN HEALTH CARE SUMMER LEARNING PROGRAMAULTMAN MEDICAL EDUCATION HOSTED THE EIGHTH 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. NATIONAL WALKING DAY FOR NATIONAL WALKING DAY IN APRIL, AULTMAN ENCOURAGED THE COMMUNITY TO "GET OUT AND MOVING." THE EVENT STARTED WITH AN EMPLOYEE WALK AROUND THE MAIN AULTMAN HOSPITAL CAMPUS. WALKERS THROUGHOUT THE COMMUNITY COULD PARTICIPATE IN AULTMAN'S SOCIAL MEDIA PHOTO CONTEST TO WIN AN IPAD MINI AND OTHER PRIZES. THE FESTIVITIES CONCLUDED WITH A COMMUNITY WALK HELD IN CONJUNCTION WITH STARK PARKS THAT INCLUDED FREE HEALTH SCREENINGS, GIVEAWAYS, PHOTO OPPORTUNITIES WITH LOCAL MASCOTS AND VENDOR DISCOUNTS.BREAST OASISFOR WOMEN WHO CANNOT AFFORD BASIC CLOTHING ITEMS SUCH AS BRAS, EACH DAY PRESENTS EMOTIONAL AND UNCOMFORTABLE SITUATIONS. IN 2015, AULTMAN TEAM MEMBERS HELPED LOCAL WOMEN IN NEED BY DONATING 2,018 NEW AND GENTLY USED BRAS - ALONG WITH $220 IN CASH AND GIFT CARDS.WALKING TO RAISE FUNDS AND IMPROVE THE COMMUNITY'S HEALTHAULTMAN 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. UNITED WAYEVERY YEAR, AULTMAN ORGANIZES A FUNDRAISING CAMPAIGN TO BENEFIT UNITED WAY. IN 2015, AULTMAN EMPLOYEES AND PHYSICIANS GENEROUSLY DONATED $477,272 TO FUND PROGRAMS TO BENEFIT COMMUNITY MEMBERS OF ALL AGES AND FROM ALL WALKS OF LIFE.AULTMAN AMBASSADOR PROGRAM THE AULTMAN AMBASSADOR PROGRAM ARMS LOCAL HIGH SCHOOL STUDENTS WITH THE INFORMATION AND CONFIDENCE THEY NEED TO PROMOTE HEALTHY HABITS IN THEIR SCHOOLS SUCH AS ENCOURAGING CLASSMATES TO DRINK WATER INSTEAD OF SODA AND SUGARY DRINKS. THE PROGRAM IS A COLLABORATIVE EFFORT AMONG AULTMAN HEALTH FOUNDATION, AULTMAN COLLEGE, MALONE UNIVERSITY, LOUISVILLE HIGH SCHOOL AND CANTON SOUTH HIGH SCHOOL. LOUISVILLE HAS PARTICIPATED IN THE PROGRAM FOR FIVE YEARS, WHILE CANTON SOUTH HAS BEEN ON BOARD FOR THREE YEARS. A TOTAL OF 15 STUDENT AMBASSADORS PARTICIPATED IN THE PROGRAM FOR THE 2015-16 SCHOOL YEAR.SENIOR CELEBRATION DAYTHE 2015 SENIOR CELEBRATION DAY AT THE PRO FOOTBALL HALL OF FAME DREW MORE THAN 1,300 ATTENDEES WHO ENJOYED A DAY OF HEALTH INFORMATION AND DEMONSTRATIONS, GIVEAWAYS AND REFRESHMENTS, AND FREE ADMISSION TO THE HALL. A TOTAL OF 20 AULTMAN DEPARTMENTS PARTICIPATED, INCLUDING DIABETES EDUCATION, THERAPY SERVICES, PAIN MANAGEMENT AND HOME CARE.ADDITIONAL COMMUNITY BENEFITIN ADDITION TO PROVIDING CARE FOR PATIENTS WITH NO INSURANCE, AULTMAN ALSO SERVES THOUSANDS OF PATIENTS COVERED BY PROGRAMS SUCH AS MEDICAID. PAYMENTS FROM THESE FEDERALLY FUNDED PROGRAMS DO NOT ALWAYS COVER THE TOTAL COST OF SERVICE. IN 2014, AULTMAN PROVIDED SERVICES TO MEDICAID PATIENTS RESULTING IN MORE THAN $2.8 MILLION IN UNREIMBURSED COST.THROUGH ITS RESIDENT TEACHING PROGRAMS, AULTMAN DELIVERS A SIGNIFICANT LEVEL OF QUALITY OUTPATIENT AND INPATIENT HEALTH CARE TO INSURED, UNDERINSURED AND UNINSURED INDIVIDUALS IN OUR MARKET. FOR MEMBERS OF THE AMISH COMMUNITY, AULTMAN OFFERS FREE TRANSPORTATION TO AND FROM DOCTORS' APPOINTMENTS AND AULTMAN HOSPITAL. AN AMISH HOUSE IS ALSO LOCATED ADJACENT TO THE AULTMAN CAMPUS, GIVING VISITORS A FREE PLACE TO STAY WHEN LOVED ONES ARE HOSPITALIZED.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number
32-0483994

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) ADAPTIVE SPORTS PROGRAM OF OHIO 2829 CLEVELAND ROAD WOOSTER,OH44691	27-1144442	501(C)(3)	5,000	TO SUPPORT BI-MONTHLY PROGRAMS IN STARK COUNTY FOR INDIVIDUALS WITH PHYSICAL DISABILITIES
(2) ARC OF OHIO-STARK COUNTY 6900 MARKET AVENUE NORTH CANTON,OH44721	31-0642964	501(C)(3)	5,000	TO PROVIDE WEEKLY SCHOLARSHIPS FOR SCHOOL AGED CHILDREN WITH DEVELOPMENTAL AND INTELLECTUAL DISABILITIES WHILE ALSO PROVIDING RESPITE FOR FAMILIES.
(3) CHILDREACH MINISTRIES FBO FUTURE PROMISE AT THE MARTIN CENTER 1253 THIRD ST SE CANTON,OH44707	27-0112034	501(C)(3)	5,500	TO FUND A SUMMER CAMP FOR AT RISK YOUTH.
(4) COLEMAN PROFESSIONAL SERVICES 400 WEST TUSCARAWAS STREET CANTON,OH44702	34-1240178	501(C)(3)	5,000	TO PREVENT AND REDUCE HOMELESSNESS BY FINDING STABLE HOUSING SITUATIONS FOR CHRONICALLY HOMELESS AND FOR PEOPLE WHO ARE HOMELESS AFTER HOSPITAL OR JAIL RELEASE.
(5) COMMUNITY BIRTH CIRCLE PO BOX 315 ORRVILLE,OH44667	80-0746833	501(C)(3)	6,000	TO PROVIDE CHILDBIRTH EDUCATION AND DOULA LABOR SUPPORT TO LOW INCOME WOMEN.
(6) DOMESTIC VIOLENCE PROJECT PO BOX 9459 CANTON,OH44711	34-1263226	501(C)(3)	5,000	TO PROMOTE LITERACY AND POSITIVE ATTITUDES ABOUT WELLNESS FOR CHILDREN RESIDING IN THE DOMESTIC VIOLENCE PROJECT'S SHELTERS.
(7) GLENBEIGH OUTPATIENT CENTER OF CANTON PO BOX 298 ROCK CREEK,OH44084	34-1789783	501(C)(3)	5,000	TO PROVIDE WORKSHOPS FOR VETERANS SUFFERING FROM PTSD AND THEIR FAMILIES.
(8) MEALS ON WHEELS OF STARK & WAYNE COUNTIES 2363 NAVE ROAD SE CANTON,OH44646	34-1681952	501(C)(3)	5,000	TO PURCHASE EQUIPMENT THAT WILL INCREASE THE EFFICIENCIES OF THE ORGANIZATION.
(9) ORRVILLE YMCA 1801 SMUCKER ROAD ORRVILLE,OH44667	34-1491294	501(C)(3)	6,000	TO HELP PROMOTE HEALTHY LIFESTYLES AND YOUTH DEVELOPMENT THROUGH ACCESS TO TRAINED STAFF AND EQUIPMENT BEST SUITED FOR THE AGE GROUP.
(10) PERSONAL AND FAMILY COUNSELING SERVICES 1433 FIFTH STREET NW NEW PHILADELPHIA,OH44663	34-0720558	501(C)(3)	5,000	TO EDUCATE 20 YOUTH LEADERS TO IMPLEMENT A DRUG PREVENTION AND HEALTHY LIFESTYLES PROGRAM IN THEIR SCHOOLS.
(11) QUOTA INTERNATIONAL OF MASSILLON PO BOX 81 MASSILLON,OH44648	91-2080144	501(C)(3)	9,000	TO PROVIDE CHILDREN WITH AUDITORY NEEDS SPECIAL HEARING ASSISTANCE TECHNOLOGY.
(12) STARK COUNTY HUNGER TASK FORCE 408 9TH STREET SW CANTON,OH44707	34-1374549	501(C)(3)	9,000	TO SUPPORT THE FOOD PURCHASE PROGRAM THROUGH THE AKRON CANTON REGIONAL FOODBANK TO HUNGRY CITIZENS IN OUR COUNTY.
(13) STARK SOCIAL WORKERS NETWORK PO BOX 8223 CANTON,OH44711	34-1652871	501(C)(3)	5,500	TO PURCHASE SUPPLIES AND EQUIPMENT NEEDED TO TEACH HEALTHY COOKING, GOOD EATING HABITS, AND TO ENCOURAGE EXERCISING AND OTHER HEALTHY HABITS.
(14) YMCA OF WESTERN STARK COUNTY 131 TREMONT SE MASSILLON,OH44646	34-0719180	501(C)(3)	5,000	TO PROVIDE NUTRITION AND WELLNESS EDUCATION TO LOW INCOME RESIDENTS, TO HELP PREVENT DIABETES AND OTHER OBESITY RELATED DISEASES.
(15) STARK DEVELOPMENT BOARD INC 116 CLEVELAND AVE CANTON,OH44702	34-1476938	501(C)(3)	96,667	SUPPORT
(16) CITY OF MASSILLON 100 LINCOLN WAY E MASSILLON,OH44646	34-6001829	CITY OF MASSILLON	50,000	SUPPORT
(17) PRO FOOTBALL HALL OF FAME 2121 GEORGE HALAS DR NW CANTON,OH44708	34-0898576	501(C)(3)	46,140	SUPPORT
(18) GOODWILL IND OF GREATER 408 NINTH ST SW CANTON,OH44707	34-0909974	501(C)(3)	40,000	SUPPORT
(19) ACCESS HEALTH STARK COUNTY 408 9TH ST SW CANTON,OH44707	46-2949527	501(C)(3)	40,000	SUPPORT
(20) YMCA OF CENTRAL STARK COUNTY 1201 30TH ST NW STE 200 CANTON,OH44709	34-0714392	501(C)(3)	26,667	SUPPORT
(21) CANTON CITY HEALTH DEPARTMENT 218 S CLEVELAND AVE CANTON,OH44702	34-6000504	CITY OF CANTON	24,000	SUPPORT
(22) KENT STATE UNIVERSITY 232 SCHEARTZ CENTER KENT,OH44240	31-6402079	KENT STATE UNIVERSIT	20,000	SUPPORT
(23) WALSH UNIVERSITY 2020 EAST MAPLE N CANTON,OH44720	34-0868798	501(C)(3)	20,000	SUPPORT
(24) YMCA OF CENTRAL STARK COUNTY 1201 30TH ST NW STE 200 CANTON,OH44709	34-0714392	501(C)(3)	16,666	SUPPORT
(25) STARK EDUCATION PARTNERSHIP 400 MARKET AVE N SUITE B CANTON,OH44702	34-1625250	501(C)(3)	15,000	SUPPORT
(26) AKRON CANTON FOOD BANK 350 OPPORTUNITY PKWY AKRON,OH44307	34-1369388	501(C)(3)	9,673	SUPPORT
(27) CENTER FOR MARKETING & OPINION RESEARCH LLC 470 PORTAGE LAKES DR STE 102 AKRON,OH44319	20-4955751		8,600	SUPPORT
(28) SKYLAND PINES 3550 COLUMBUS RD NE CANTON,OH44705	34-1616309		5,000	SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1) AULTMAN HEALTH FOUNDATION SCHOLARSHIP	3	16,106
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

AULTMAN HOSPITAL RECEIVES MYRAID REQUESTS FOR SUPPORT FROM COMMUNITY ORGANIZATIONS EACH YEAR. A MULTIDISCIPLINARY COMMITTEE MEETS REGUARLY TO REVIEW SPONSORSHIP REQUESTS. THE AULTMAN FOUNDATION PARTNERS WITH LOCAL NONPROFIT ORGANIZATIONS TO SUPPORT PROJECTS THAT PROMOTE WELLNESS, HEALTH EDUCATION AND HUMAN SERVICES IN OUR COMMUNITY. SINCE 2007, MORE THAN 150 DIFFERENT AGENCIES HAVE RECEIVED GRANT FUNDING FROM THE AULTMAN FOUNDATION IN EXCESS OF $1.65 MILLION. AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES - ALL SCHOLARSHIPS ARE APPLIED DIRECTLY TO THE COLLEGE FOR TUITION OF THE ENROLLEE. THE AULTMAN FOUNDATION - AFTER A GRANTEE IS SELECTED, THEY COMPLETE AND SIGN A GRANT ACCEPTANCE AGREEMENT AND A W-9 FORM. GRANTEES ARE ISSUED THEIR FUNDING IN ONE LUMP SUM IN THE FORM OF A CHECK. THE AULTMAN FOUNDATION STAFF REQUEST A PROGRESS REPORT AT 6 MONTHS FROM THE DATE OF FUNDING AND A YEAR END REPORT AT THE END OF THE FUNDING YEAR. DETAILS REQUESTED FROM THE YEAR END REPORT INCLUDE: A COMPLETE FINANCIAL REPORT; OBJECTIVES; BENEFITS; COMMUNITY VALUE; FUTURE FUNDING; AND ORGANIZATIONAL GROWTH EVALUATION. IF A PROJECT IS NOT COMPLETE AT THE TIME OF THE YEAR END REPORT, THE AGENCY SUBMITS A REQUEST FOR AN EXTENSION. THE AGREEMENT STATES THAT THE GRANTEE SHALL RETURN TO THE AULTMAN FOUNDATION ANY UNEXPENDED FUNDS IF THE GRANTEE HAS NOT PEFORMED IN ACCORDANCE WITH THE AGREEMENT AND APPROVED BUDGET OR IF THE GRANTEE LOSES ITS 501(C) (3) EXEMPTION. THE AULTMAN FOUNDATION STAFF PERFORMS ONSITE VISITS POST FUNDING WHERE POSSIBLE AND FEASIBLE.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1EDWARD J ROTH IIIPRESIDENT / CEO - AHF	(i) (ii)	0 ------------- 588,234	0 ------------- 2,100	0 ------------- 25,677	0 ------------- 7,950	0 ------------- 15,486	0 ------------- 639,447	0 ------------- 0
2CHRISTOPHER E REMARKCEO - AH; DIRECTOR - AH,ACON & ANCMG	(i) (ii)	383,604 ------------- 0	2,100 ------------- 0	19,190 ------------- 0	7,950 ------------- 0	16,151 ------------- 0	428,995 ------------- 0	0 ------------- 0
3ANNE GUNTHERCNO - AH; DIRECTOR - AH & ACON	(i) (ii)	221,359 ------------- 0	2,100 ------------- 0	19,025 ------------- 0	6,769 ------------- 0	8,501 ------------- 0	257,754 ------------- 0	0 ------------- 0
4MILAN R DOPIRAK MDDIRECTOR - AH	(i) (ii)	0 ------------- 311,038	0 ------------- 88,958	0 ------------- 26,830	0 ------------- 7,950	0 ------------- 9,175	0 ------------- 443,951	0 ------------- 0
5RICK L HAINESDIRECTOR - AH; CEO - AULTCARE	(i) (ii)	0 ------------- 408,144	0 ------------- 100	0 ------------- 22,643	0 ------------- 7,950	0 ------------- 9,565	0 ------------- 448,402	0 ------------- 0
6REBECCA J CROWLPRESIDENT - ACON	(i) (ii)	0 ------------- 186,539	0 ------------- 1,100	0 ------------- 20,156	0 ------------- 5,826	0 ------------- 15,486	0 ------------- 229,107	0 ------------- 0
7ADAM LUNTZTREASURER - ACON; CFO - AH	(i) (ii)	0 ------------- 156,775	0 ------------- 2,100	0 ------------- 18,568	0 ------------- 4,884	0 ------------- 14,956	0 ------------- 197,283	0 ------------- 0
8EILEEN F GOODDIRECTOR - ACON / SENIOR VP-CLINICAL	(i) (ii)	0 ------------- 188,460	0 ------------- 1,100	0 ------------- 25,496	0 ------------- 5,697	0 ------------- 429	0 ------------- 221,182	0 ------------- 0
9VICTORIA L HAINESDIRECTOR - TAF / VP-FOUNDATION SERVI	(i) (ii)	0 ------------- 163,868	0 ------------- 1,100	0 ------------- 19,790	0 ------------- 5,025	0 ------------- 9,803	0 ------------- 199,586	0 ------------- 0
10TERESA L WURST MDDIRECTOR - TAF	(i) (ii)	177,334 ------------- 0	6,110 ------------- 0	646 ------------- 0	5,633 ------------- 0	14,067 ------------- 0	203,790 ------------- 0	0 ------------- 0
11ANDREW NAUMOFF MDVICE CHAIR - AOH	(i) (ii)	0 ------------- 190,085	0 ------------- 105,004	0 ------------- 2,183	0 ------------- 7,950	0 ------------- 10,232	0 ------------- 315,454	0 ------------- 0
12MARCHELLE L SUPPAN DPMDIRECTOR/CEO - AOH	(i) (ii)	182,635 ------------- 0	2,100 ------------- 0	18,250 ------------- 0	5,678 ------------- 0	4,803 ------------- 0	213,466 ------------- 0	0 ------------- 0
13CLIFORD G JOHNSON MDMEDICAL DIRECTOR - ANCMG	(i) (ii)	250,877 ------------- 0	93,716 ------------- 0	74,148 ------------- 0	7,950 ------------- 0	15,486 ------------- 0	442,177 ------------- 0	0 ------------- 0
14JULIA FIORENTINO MDDIRECTOR - ANCMG	(i) (ii)	181,159 ------------- 0	80,923 ------------- 0	10,379 ------------- 0	7,899 ------------- 0	7,640 ------------- 0	288,000 ------------- 0	0 ------------- 0
15MATTHEW HIESTAND MDDIRECTOR - ANCMG	(i) (ii)	240,102 ------------- 0	85,574 ------------- 0	8,006 ------------- 0	7,950 ------------- 0	15,486 ------------- 0	357,118 ------------- 0	0 ------------- 0
16MARIA YOUNG MDDIRECTOR - ANCMG	(i) (ii)	186,852 ------------- 0	83,687 ------------- 0	9,710 ------------- 0	7,950 ------------- 0	16,151 ------------- 0	304,350 ------------- 0	0 ------------- 0
17SHRUTI TREHAN MDDIRECTOR - ANCMG	(i) (ii)	1,353,718 ------------- 0	364,497 ------------- 0	21,406 ------------- 0	7,950 ------------- 0	15,486 ------------- 0	1,763,057 ------------- 0	0 ------------- 0
18ROBERT C MOLNARVP-PHYSICIAN SERVICES;DIRECTOR-ANCMG	(i) (ii)	0 ------------- 184,412	0 ------------- 2,100	0 ------------- 18,395	0 ------------- 5,706	0 ------------- 15,145	0 ------------- 225,758	0 ------------- 0
19MARK D WRIGHTCFO - AHF	(i) (ii)	0 ------------- 337,840	0 ------------- 2,100	0 ------------- 18,812	0 ------------- 7,950	0 ------------- 15,725	0 ------------- 382,427	0 ------------- 0
20JEANNINE SHAMBAUGHVP-CHIEF INTERNAL AFFAIRS - ACON	(i) (ii)	0 ------------- 117,428	0 ------------- 1,100	0 ------------- 18,613	0 ------------- 3,646	0 ------------- 15,486	0 ------------- 156,273	0 ------------- 0
21JEAN PADDOCKCHIEF ACADEMIC OFFICER - ACON	(i) (ii)	0 ------------- 120,599	0 ------------- 1,100	0 ------------- 18,250	0 ------------- 3,708	0 ------------- 10,232	0 ------------- 153,889	0 ------------- 0
22VIVIAN LEGGETTCHIEF EXTERNAL AFFAIRS OFFICER-ACON	(i) (ii)	0 ------------- 138,504	0 ------------- 1,100	0 ------------- 19,101	0 ------------- 4,319	0 ------------- 10,232	0 ------------- 173,256	0 ------------- 0
23AMY BUDDVICE PRESIDENT - ANCMG	(i) (ii)	129,116 ------------- 0	2,100 ------------- 0	18,546 ------------- 0	4,036 ------------- 0	9,481 ------------- 0	163,279 ------------- 0	0 ------------- 0
24ALLISON M OPRANDI MDPHYSICIAN	(i) (ii)	334,324 ------------- 0	2,730 ------------- 0	20,616 ------------- 0	7,950 ------------- 0	15,360 ------------- 0	380,980 ------------- 0	0 ------------- 0
25SUSAN E MERCER MDVP-MEDICAL EDUCATION - AH	(i) (ii)	284,959 ------------- 0	2,100 ------------- 0	23,724 ------------- 0	7,950 ------------- 0	6,134 ------------- 0	324,867 ------------- 0	0 ------------- 0
26LORI L MERTES MDPHYSICIAN/CHIEF QUALITY OFFICER - AH	(i) (ii)	284,801 ------------- 0	2,100 ------------- 0	18,920 ------------- 0	7,950 ------------- 0	0 ------------- 0	313,771 ------------- 0	0 ------------- 0
27WILLIAM FAYEN MDDIRECTOR - ANCMG	(i) (ii)	166,044 ------------- 0	68,317 ------------- 0	11,411 ------------- 0	7,096 ------------- 0	8,501 ------------- 0	261,369 ------------- 0	0 ------------- 0
28RAZA A KHAN MDDIRECTOR - ANCMG	(i) (ii)	822,658 ------------- 0	119,810 ------------- 0	20,884 ------------- 0	7,950 ------------- 0	16,027 ------------- 0	987,329 ------------- 0	0 ------------- 0
29PRABHCHARAN GILL MDPHYSICIAN - AH	(i) (ii)	574,639 ------------- 0	57,284 ------------- 0	6,167 ------------- 0	7,950 ------------- 0	12,465 ------------- 0	658,505 ------------- 0	0 ------------- 0
30MICHAEL A KREW MDPHYSICIAN - AH	(i) (ii)	573,689 ------------- 0	56,984 ------------- 0	4,483 ------------- 0	7,950 ------------- 0	16,151 ------------- 0	659,257 ------------- 0	0 ------------- 0
31STEVEN M WEAVER MDPHYSICIAN - ANCMG	(i) (ii)	418,911 ------------- 0	149,499 ------------- 0	8,528 ------------- 0	7,950 ------------- 0	16,151 ------------- 0	601,039 ------------- 0	0 ------------- 0
32TIMOTHY E MCDANIEL MDPHYSICIAN - AH	(i) (ii)	490,716 ------------- 0	50,400 ------------- 0	16,818 ------------- 0	7,950 ------------- 0	13,673 ------------- 0	579,557 ------------- 0	0 ------------- 0
33OSAMA MITRI MDPHYSICIAN - AH	(i) (ii)	363,034 ------------- 0	94,364 ------------- 0	19,046 ------------- 0	8,666 ------------- 0	16,151 ------------- 0	501,261 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 1A	ALL EMPLOYEES ARE ELIGIBLE TO RECEIVE REIMBURSEMENT FOR HEALTH CLUB COSTS UP TO $120 ANNUALLY AS PART OF THE ORGANIZATION'S EFFORT TO PROMOTE HEALTHY LIFESTYLES. THIS AMOUNT WAS INCLUDED AS TAXABLE COMPENSATION FOR ALL EMPLOYEES THAT RECEIVED THE BENEFIT.
PART I, LINE 3	SEE SCHEDULE O FOR THE NARRATIVE RELATED TO FORM 990, PART VI, LINE 15 FOR AN EXPLANATION OF EXECUTIVE COMPENSATION REVIEW.
PART I, LINE 4B	EDWARD J. ROTH III, CHRISTOPHER E. REMARK, RICK L. HAINES, VICTORIA L. HAINES, EILEEN F. GOOD, MARK D. WRIGHT, ADAM LUNTZ, REBECCA J. CROWL, ANNE M. GUNTHER, JEANNINE SHAMBUAGH, JEAN PADDOCK, VIVIAN LEGGETT AND MARCHELLE L. SUPPAN ARE PARTICIPANTS IN THE ORGANIZATION'S 457(B) PLAN. THERE WERE NO PAYOUTS IN 2015. AHF CONTRIBUTED $18,000 FOR EACH PERSON.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) ELIZABETH GOOD	FAMILY MEMBER TO EILEEN GOOD	102,395	WAGES		No
(2) TIFFANY GOOD-WITMER	FAMILY MEMBER TO EILEEN GOOD	225,984	WAGES		No
(3) TIMOTHY O'TOOLE	BOARD MEMBER AND OFFICER/OWNER CANTON AULTMAN EMERGENCY PHYSICIANS	5,602,798	TIMOTHY O'TOOLE IS A BOARD MEMBER AND ONE OF THE OFFICERS AND OWNERS OF CANTON AULTMAN EMERGENCY PHYSICIANS, WHICH PROVIDES SERVICES TO AULTMAN HEALTH FOUNDATION'S SUBORDINATE ORGANIZATIONS.		No
(4) JEFFREY MILLER MD	BOARD MEMBER AND OFFICER/OWNER PULMONARY PHYSICIANS INC	1,587,352	JEFFREY MILLER, MD IS A BOARD MEMBER AND ONE OF THE OFFICERS AND OWNERS OF PULMONARY PHYSICIANS INC, WHICH PROVIDES SERVICES TO AULTMAN HEALTH FOUNDATION'S SUBORDINATE ORGANIZATIONS.		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....	X	23	13,569	DONORS' VALUE
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		250	DONORS' VALUE
5 Clothing and household goods .......	X		137,748	DONORS' VALUE
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....	X	8	2,874	DONORS' VALUE
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( TRAVEL AND ENTERTAINMENT )	X	132	76,503	DONORS' VALUE
26 Other ( OTHER )	X	261	46,960	DONORS' VALUE
27 Other ( JEWELRY )	X	218	20,636	DONORS' VALUE
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that

it must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2015)

Page 2

Part II

Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	EDWARD J. ROTH III AND HARRY C.C. MACNEALY HAVE A BUSINESS RELATIONSHIP. RICK L. HAINES AND VICTORIA HAINES HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	AULTMAN HOSPITAL (AH), THE AULTMAN FOUNDATION (TAF), AULTMAN ORRVILLE HOSPITAL (AOH) AND AULTMAN NORTH CANTON MEDICAL GROUP (ANCMG) HAVE A SINGLE MEMBER, AULTMAN HEALTH FOUNDATION (AHF). AHF HAS A RIGHT TO PARTICIPATE IN EACH ORGANIZATIONS' GOVERANCE AND APPROVE SIGNIFICANT DECISIONS OF EACH ORGANIZATIONS' BOARD OF DIRECTORS. AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES (ACON) HAS A SINGLE MEMBER, AULTMAN HOSPITAL (AH). AH HAS THE RIGHT TO PARTICIPATE IN ACON'S GOVERNANCE AND APPROVE SIGNIFICANT DECISIONS OF THE ACON'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A	AH'S SOLE MEMBER, AHF, HAS THE RIGHT TO ELECT THE CEO OF AH, WHO SHALL BE THE PRESIDENT OF AH AND AN EX-OFFICIO VOTING MEMBER OF THE BOARD OF DIRECTORS OF AH. AHF ALSO ELECTS ITS OWN MEMBERS, FROM WHICH IT NOMINATES MEMBERS FOR THE AH BOARD OF DIRECTORS. AH DIRECTORS SHALL BE MEMBERS OF THE AHF BOARD OF DIRECTORS. AHF ALSO HAS THE POWER TO RATIFY AH'S BOARD OF DIRECTORS SELECTION OR REMOVAL OF OFFICERS. ACON'S SOLE MEMBER, AH, HAS THE RIGHT TO ELECT, EVALUATE, REAPPOINT, AND REMOVE ALL DIRECTORS OF THE ACON BOARD INCLUDING THE FILLING OF ANY VACANCIES. TAF'S SOLE MEMBER, AHF, HAS THE RIGHT TO APPOINT ALL THE DIRECTORS OF THE TAF'S BOARD. AOH'S SOLE MEMBER, AHF, HAS THE RIGHT TO APPOINT OR REPLACE THE DIRECTORS OF AOH'S BOARD FROM A SLATE OF CANDIDATES PRESENTED BY AOH'S BOARD. THE SOLE MEMBER OF ANCMG IS AHF. AHF, AS SOLE MEMBER, HAS THE RESERVED POWER TO ELECT OR APPOINT BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	AH'S SOLE MEMBER, AHF, HAS THE FOLLOWING APPROVAL RIGHTS, WHETHER RESERVED TO IT OR SUBJECT TO APPROVAL BY IT: APPROVAL OF THE ANNUAL BUDGET, BYLAWS, ARTICLES OF INCORPORATION, BORROWING, LENDING, ALL MERGERS AND ACQUISITIONS, AND EXECUTIVE COMPENSATION; ELECTION OF A CEO, WHO SERVES AS THE PRESIDENT OF AH AND AN EX-OFFICIO VOTING MEMBER OF THE BOARD OF DIRECTORS OF AH; RATIFICATION OF THE ELECTION AND REMOVAL OF OFFICERS, EXCEPT FOR VICE PRESIDENTS; AND THE ELECTION OF THE AHF DIRECTORS, FROM WHICH IT NOMINATES DIRECTORS FOR AH'S BOARD. ACON'S SOLE MEMBER, AH, HAS THE FOLLOWING APPROVAL RIGHTS: THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF ACON, MERGERS OR AFFILIATIONS; THE FORMATION OF SUBSIDIARIES AND THE DISSOLUTION OR DIVESTITURE OF THE SAME; ANY ACTION OR FAILURE TO ACT THAT COULD ADVERSELY IMPACT THE TAX-EXEMPT STATUS OF ACON, THE DISSOLUTION OR DIVESTITURE OF THE SAME; ANY ACTION OR FAILURE TO ACT THAT COULD ADVERSELY IMPACT THE TAX-EXEMPT STATUS OF ACON, COMPLIANCE WITH FEDERAL OR STATE LAW, OR THE ABILITY OF THE MEMBER TO OBTAIN PAYMENT OF CERTAIN COSTS UNDER APPLICABLE MEDICARE REIMBURSEMENT REGULATIONS; THE BORROWING OF MONEY FOR CAPITAL PURPOSES OR FOR ANY PURPOSE NOT INVOLVING DAY-TO-DAY OPERATIONS OF ACON; THE PURCHASE, SALE, LEASE (AS LESSEE OR LESSOR) OR DISPOSITION OF REAL PROPERTY OF ACON; THE APPOINTMENT OF FISCAL AUDITORS; THE ADOPTION, ALTERING, AMENDING, OR REPEALING OF THE ARTICLES OF INCORPORATION AND CODE OF REGULATIONS; THE LIQUIDATION, DISSOLUTION, WINDING UP OR ABANDONMENT OF ACON; THE APPROVAL OF THE ACON'S STRATEGIC PLAN, UPON THE RECOMMENDATION OF THE ACON BOARD; THE REVIEW AND APPROVAL OF ALL YEARLY CAPITAL AND OPERATIONAL BUDGETS OF ACON, UPON THE RECOMMENDATION OF THE ACON BOARD; AND ANY OTHER MATTERS RESERVED FOR THE MEMBER UNDER OHIO LAW. TAF'S SOLE MEMBER, AHF, MUST APPROVE BY RESOLUTION OF THE AHF BOARD OR EXECUTIVE COMMITTEE OF THE BOARD, THE FOLLOWING ACTIONS OF TAF'S BOARD: ADOPTION OF THE STRATEGIC PLAN; APPROVAL OF THE ANNUAL BUDGET; AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION; INCURRENCE OF DEBT OUTSIDE OF THE FINANCIAL THRESHOLDS ESTABLISHED BY THE SOLE MEMBER; AND INDEMNIFICATION OF AN OFFICER OR DIRECTOR OF TAF. AOH'S SOLE MEMBER, AHF, HAS THE RIGHT TO APPROVE THE FOLLOWING ACTION OF AOH'S BOARD: AMENDING OR RESTATING THE ARTICLES OF INCORPORATION OR THE CODE OF REGULATIONS; EFFECTING A MERGER, CONSOLIDATION, AFFILIATION OR CHANGE IN CONTROL WITH AN ENTITY NOT AFFILIATED WITH THE MEMBER; EXECUTING THE SALE, TRANSFER, EXCHANGE OR OTHER DISPOSITION OF GREATER THAN 5% OF AOH'S ASSETS; EFFECTING PARTIAL OR TOTAL DISSOLUTION; AND INCURRING ANY DEBT OR INDEBTNESS ON BEHALF OF THE HOSPITAL. ONLY THE SOLE MEMBER HAS THE AUTHORITY TO TAKE THE FOLLOWING ACTIONS: APPROVING APPOINTMENT OR TERMINATION OF THE PRESIDENT AND CEO OF AOH AND GIVING THE FINAL APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGET OF AOH. AHF, AS SOLE MEMBER OF ANCMG, HAS THE RESERVED POWER TO APPROVE ANY CHANGE IN THE ORGANIZATION'S MISSION OR PURPOSE, APPROVE ANY AMENDMENT TO THE ORGANIZATION'S ARTICLES OF INCORPORATION OR APPROVE ANY AMENDMENT TO THE CODE OF REGULATIONS.
FORM 990, PART VI, SECTION B, LINE 11	A DETAIL REVIEW OF THE FORM 990 IS PERFORMED BY AN INDEPENDENT CPA FIRM. AHF'S FINANCE DEPARTMENT CAREFULLY REVIEWS AND ANALYZES THE TAX RETURN. THE DEPARTMENT RECONCILES THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARES THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. IN ADDITION, THE FINANCE DEPARTMENT DOES A COMPARATIVE ANALYSIS TO THE PRIOR YEAR RETURN. THE ANALYSIS AND RECONCILIATION SCHEDULES ALONG WITH A COMPLETE COPY OF THE 990 ARE PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. A COMPLETE COPY OF THE 990 IS THEN MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH A SECURED INTERNET PORTAL PRIOR TO THE FILING DATE.
FORM 990, PART VI, SECTION B, LINE 12C	THE BOARD OF DIRECTORS HAVE A CONFLICT OF INTEREST POLICY. AS A RESULT OF THIS POLICY, EACH YEAR BOARD MEMBERS, OFFICERS, AND SENIOR STAFF COMPLETE A FORM DISCLOSING ANY CONFLICTS OF INTEREST THEY MAY HAVE. THE COMPLIANCE OFFICE REVIEWS THESE DISCLOSURE FORMS AND INFORMS THE BOARD CHAIRMAN, AND OTHER APPROPRIATE OFFICERS, OF NOTABLE CONFLICTS, IF ANY. THOSE WITH CONFLICTS ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS RELATING TO THE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	THE AULTMAN HEALTH FOUNDATION AND ITS AFFILIATED ENTITIES USES THE FOLLOWING REFERENCE MATERIALS FOR THE DEVELOPMENT OF EXECUTIVE COMPENSATION: OHIO HOSPITAL ASSOCIATION (OHA), MERCER INTEGRATED HEALTH NETWORK, INCLUDING SURVEY DATA FOR BOTH HOSPITALS AND HEALTH PLANS, AND SULLIVAN CODER AND ASSOCIATES (SCA) AND THE CHRONICLES OF HIGHER EDUCATION AND COLLEGE AND UNIVERSITY PROFESSIONAL ASSOCIATION FOR HUMAN RESOURCES (CUPA). 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 CODER & 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 CODER 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 19	AULTMAN HEALTH FOUNDATION AND SUBORDINATE ORGANIZATIONS MAKE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:	INTEREST RATE SWAP SETTLEMENT -34,941. INTERFUND TRANSFERS -20,252,801.
GROUP RETURN	THIS GROUP RETURN CONTAINS THE ACTIVITY OF ALL THE SUBORDINATE ORGANIZATIONS INCLUDED UNDER GROUP EXEMPTION NUMBER 6141 OF THE AULTMAN HEALTH FOUNDATION. THIS RETURN IS MARKED INITIAL AS THIS IS THE FIRST YEAR A GROUP RETURN HAS BEEN FILED FOR THESE SUBORDINATES AS THESE ORGANIZATIONS HAVE FILED SEPARATE RETURNS IN PRIOR YEARS. THESE SUBORDINATES ARE: AULTMAN HOSPITAL (34-0714538) AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES (20-1359433) THE AULTMAN FOUNDATION (20-8090459) ORRVILLE HOSPITAL FOUNDATION DBA AULTMAN ORRVILLE HOSPITAL (34-0733138) AULTMAN NORTH CANTON MEDICAL GROUP (34-1088530)
FEDERAL ELECTIONS	AULTMAN HEALTH FOUNDATION GROUP RETURN EMPLOYER IDENTIFICATION NUMBER: 32-0483994 FOR THE YEAR ENDING DECEMBER 31, 2015 AULTMAN HEALTH FOUNDATION GROUP RETURN IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER REG. SEC. 1.263(A)-1(F).

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION GROUP RETURN

Employer identification number

32-0483994

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)AULTMAN HEALTH FOUNDATION 2600 SIXTH ST SW CANTON,OH44710 34-1445390	SUPPORT ORGANIZATION	OH	501(C)(3)	LINE 11B, II	N/A		No
(2)TUSCARAWAS VALLEY REGIONAL CANCER CENTER 300 MEDICAL PARK DRIVE DOVER,OH44622 31-1689698	MEDICAL SERVICE	OH	501(C)(3)	LINE 3	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) WEST TUSCARAWAS PROPERTY MANAGEMENT LLC 2600 SIXTH ST SW CANTON,OH44710 20-0090246	PROPERTY MGMT	OH	N/A
(2) AULTMAN ONCOLOGY CENTER OF EXCELLENCE LLC 2600 SIXTH ST SW CANTON,OH44710 45-4215510	HEALTCARE	OH	AULTMAN HOSPITAL	RELATED	93,952	46,084		No		Yes		72.900 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) MCKINLEY ASSURANCE SPC PO BOX 1051 GEORGE TOWN,GRAND CAYMANS CJ 98-0468384	PORTFOLIO	CJ	N/A	C				No
(2) AULTCARE CORPORATION 2600 SIXTH ST SW CANTON,OH44710 34-1488123	PREF. PROVIDER ORG.	OH	N/A	C				No
(3) AULTCARE HOLDING COMPANY 2600 SIXTH ST SW CANTON,OH44710 47-1165287	HOLDING COMPANY	OH	N/A	C				No
(4) NORTH CENTRAL MEDICAL RESOURCES INC 2600 SIXTH ST SW CANTON,OH44710 34-1610344	MEDICAL EQUIPMENT RENTAL	OH	N/A	C				No
(5) OHIO SPECIALTY PHYSICIANS CORPORATION 2600 SIXTH ST SW CANTON,OH44710 34-1853300	HEALTH SERVICES	OH	N/A	C				No
(6) OHIO HOSPITAL BASED PHYSICIANS CORP 2600 SIXTH ST SW CANTON,OH44710 34-1871647	HEALTH SERVICES	OH	N/A	C				No
(7) OHIO PHYSICIANS PROFESSIONAL CORP 2600 SIXTH ST SW CANTON,OH44710 31-1509897	HEALTH SERVICES	OH	N/A	C				No
(8) AULTMAN MSO 2600 SIXTH ST SW CANTON,OH44710 31-1509904	ADMIN SERVICES	OH	N/A	C				No
(9) AULTCARE HEALTH INSURING CORPORATION 2600 SIXTH ST SW CANTON,OH44710 46-3305099	INSURANCE	OH	N/A	C				No
(10) AULTCARE INSURANCE COMPANY 2600 SIXTH ST SW CANTON,OH44710 34-1624818	INSURANCE	OH	N/A	C				No
(11) AULTRA ADMINISTRATIVE GROUP 2600 SIXTH ST SW CANTON,OH44710 20-4951704	ADMIN SERVICE	OH	N/A	C				No
(12) AULTCOMP MCO INC 2600 SIXTH ST SW CANTON,OH44710 27-4379962	HEALTH SERVICES	OH	N/A	C				No
(13) WAYNE HEALTH SERVICES & SUPPLIES 2600 SIXTH ST SW CANTON,OH44710 34-1501390	MEDICAL SUPPLIES	OH	N/A	C				No
(14) AULTMAN MEDICAL GROUP 2600 SIXTH ST SW CANTON,OH44710 45-3166014	HEALTH SERVICES	OH	N/A	C				No
(15) MAINSIGHT ASO LLC 2600 SIXTH ST SW CANTON,OH44710 47-3587655	HEALTH SERVICES	OH	N/A	C				No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF THE AULTMAN HEALTH SYSTEM IS TO "LEAD OUR COMMUNITY TO IMPROVED HEALTH."
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	58
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	36
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	5,232
6	Total number of volunteers (estimate if necessary) .............	6	762
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,036,736
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,196,581	1,686,641
9	Program service revenue (Part VIII, line 2g) .........	506,444,541	517,661,811
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	105,577	182,953
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	11,621,255	13,287,587
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	522,367,954	532,818,992
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	622,587	604,432
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	266,241,926	261,665,042
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	338	7,370
b	Total fundraising expenses (Part IX, column (D), line 25) 7,370
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	243,906,262	272,926,714
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	510,771,113	535,203,558
19	Revenue less expenses. Subtract line 18 from line 12.......	11,596,841	-2,384,566
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	340,282,313	322,143,298
21	Total liabilities (Part X, line 26).............	72,398,478	77,176,541
22	Net assets or fund balances. Subtract line 21 from line 20.....	267,883,835	244,966,757

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 383,992,639 including grants of $ 461,800 ) (Revenue $ 463,154,072 )
	AULTMAN HOSPITAL (AH) IS A NOT-FOR-PROFIT TEACHING HOSPITAL SERVING STARK AND SURROUNDING COUNTIES IN NORTHEAST OHIO. THE HOSPITAL'S MAJOR PROGRAMS INCLUDE WOMEN AND CHILDREN'S SERVICES, EMERGENCY AND TRAUMA SERVICES, HEART SERVICES, CANCER CARE; NEUROSURGERY, ORTHOPEDICS AND CRITICAL-CARE MEDICINE. EACH YEAR, AULTMAN HOSPITAL PROVIDES A SIGNIFICANT AMOUNT OF THE AREA'S TOTAL CARE FOR PATIENTS HAVING NO GOVERNMENT OR PRIVATE HEALTH CARE INSURANCE. IN 2015, AULTMAN PROVIDED MORE THAN $570,000 IN NET CHARITY CARE FOR UNINSURED AND UNDERINSURED PATIENTS. AULTMAN ALSO SERVES THOUSANDS OF PATIENTS COVERED BY PROGRAMS SUCH AS MEDICAID AND HAD A MEDICAID SHORTFALL OF APPROX. $31 MILLION.SUBACUTE SERVICES: AULTMAN PROVIDES POST-ACUTE SERVICES AT ITS AULTMAN WOODLAWN FACILITY. AULTMAN WOODLAWN INCLUDES A 60-BED UNIT FOR PATIENTS REQUIRING SKILLED NURSING CARE AND A 30-BED UNIT FOR PATIENTS NEEDING REHABILITATION. AULTMAN WOODLAWN FEATURES INDOOR THERAPY ENVIRONMENTS SUCH AS A MOCK KITCHEN, BEDROOM, STORE AND GAS STATION - ALONG WITH AN OUTDOOR COURTYARD FEATURING A HYDROPONIC GARDEN - TO HELP PATIENTS IMPROVE THEIR MOBILITY AND PREPARE FOR DISCHARGE. AULTMAN WOODLAWN ALSO HOUSES AULTMAN'S HOSPICE, PALLIATIVE CARE, GRIEF SERVICES AND HOME HEALTH CARE PROGRAMS. AULTMAN HOME MEDICAL SUPPLY IS ALSO PART OF THE POST-ACUTE CARE SERVICES AULTMAN PROVIDES.AULTMAN PROVIDES AN ARRAY OF MEDICAL SERVICES AT COMMUNITY CENTERS LOCATED THROUGHOUT STARK AND CARROLL COUNTIES. IMMEDIATE CARE SERVICES ARE AVAILABLE FOR MINOR INJURIES AND ILLNESSES - SEVEN DAYS A WEEK, EVERY DAY OF THE YEAR. SERVICES SUCH AS PHYSICAL AND OCCUPATIONAL THERAPY, CARDIAC REHABILITATION, OUTPATIENT LABORATORY SERVICES, SPORTS MEDICINE PROGRAMS AND DIAGNOSTIC TESTING ARE ALSO AVAILABLE AT THE AULTMAN SATELLITE FACILITIES.AULTMAN HOSPITAL'S MISSION IS TO LEAD OUR COMMUNITY TO IMPROVED HEALTH. AULTMAN HOSPITAL HAS BEEN MEETING THE HEALTH CARE NEEDS OF STARK AND SURROUNDING COUNTIES FOR MORE THAN 120 YEARS. AULTMAN CARES FOR ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. AULTMAN CONTINUOUSLY INVESTS IN FACILITIES AND TECHNOLOGY TO IMPROVE PATIENT CARE. AULTMAN PROVIDES EDUCATIONAL OPPORTUNITIES FOR STUDENTS IN HIGH SCHOOL, COLLEGE, MEDICAL SCHOOL AND RESIDENCY PROGRAMS. THROUGH OUTREACH EFFORTS INCLUDING THE WORKING ON WELLNESS (WOW) MOBILE HEALTH-FAIR UNIT, AULTMAN OFFERS HEALTH AND WELLNESS EDUCATION FOR OUR COMMUNITY. AULTMAN IS ONE OF THE LOWEST-COST HEALTH CARE PROVIDERS IN NORTHEASTERN OHIO, HELPING LOCAL BUSINESSES STAY FINANCIALLY HEALTHY AND MAINTAIN GOOD JOBS IN OUR COMMUNITY. IN RECOGNITION OF THE HOSPITAL'S LOW-COST AND HIGH-QUALITY PHILOSOPHY, AULTMAN HAS EARNED ACCOLADES INCLUDING BEING RANKED AS ONE OF THE BEST HOSPITALS FOR 2014-15 IN OHIO BY U.S. NEWS AND WORLD REPORT, BEING NAMED STARK COUNTY'S "MOST PREFERRED HOSPITAL" BY NATIONAL RESEARCH CORPORATION AND EARNING THE "MAGNET" DESIGNATION FOR NURSING EXCELLENCE.

4b	(Code: ) (Expenses $ 31,498,689 including grants of $ 0 ) (Revenue $ 30,047,726 )
	AULTMAN NORTH CANTON MEDICAL GROUP (ANCMG) PROVIDES MEDICAL SERVICES TO CITIZENS OF THE COMMUNITY IN AN OUTPATIENT SETTING WITH DIAGNOSTIC CAPABILITIES ENABLING PATIENTS TO BE DIAGNOSED AND TREATED EFFECTIVELY, REDUCING THE NEED TO HOSPITALIZE THE PATIENT FOR CARE. THIS RESULTS IN HEALTH CARE COST REDUCTIONS. IN ADDITION, CHARITABLE SERVICES WERE PROVIDED TO PATIENTS WHO WERE INDIGENT, AND FEE REDUCTION CONSIDERATIONS WERE GIVEN TO OTHERS WHO WERE NOT CONSIDERED INDIGENT BUT WERE EXPERIENCING FINANCIAL HARDSHIPS. HEALTH EDUCATION PROGRAMS OPEN TO THE COMMUNITY AT LARGE WERE CONDUCTED TO PROMOTE HEALTH CONSCIOUSNESS WITH THE OBJECTIVE BEING TO IMPROVE THE OVERALL HEALTH STATUS OF THE PUBLIC.ANCMG HEALTH EDUCATION LIBRARY PROVIDES CURRENT HEALTH CARE INFORMATION ON AN ARRAY OF TOPICS, UTILIZING CONTINUOUSLY UPDATED MATERIALS SUCH AS BOOKS, NEWSLETTERS, PAMPHELTS, VIDEOS AND COMPUTER RESOURCES.

4c	(Code: ) (Expenses $ 20,041,259 including grants of $ 0 ) (Revenue $ 25,841,697 )
	ORRVILLE HOSPITAL FOUNDATION DBA AULTMAN ORRVILLE HOSPITAL (AOH) IS A NOT-FOR-PROFIT, TWENTY-FIVE BED CRITICAL ACCESS HOSPITAL THAT HAS SERVED ORRVILLE AND THE EASTERN WAYNE COUNTY COMMUNITY FOR MORE THAN SIXTY YEARS. AOH IS AN ACUTE-CARE, FULL-SERVICE HOSPITAL ACCREDITED BY THE JOINT COMMISSION.AS A NOT-FOR-PROFIT HOSPITAL, AOH PROVIDES HIGH-QUALITY HEALTH CARE PROGRAMS AND SERVICES THAT ARE ACCESSIBLE TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. AOH FUNDS ARE GENERALLY REINVESTED IN FACILITY AND EQUIPMENT IMPROVEMENTS, ENHANCEMENTS IN PATIENT CARE, MEDICAL TRAINING, EDUCATION, PHYSICIAN RECRUITMENT AND COMMUNITY OUTREACH. EACH YEAR, AOH PROVIDES A SIGNIFICANT AMOUNT OF CARE FOR PATIENTS HAVING NO GOVERNMENT OR PRIVATE HEALTH CARE INSURANCE AND NO SIGNIFICANT LEVEL OF INCOME. AOH ALSO SERVES PATIENTS COVERED BY PUBLIC PROGRAMS SUCH AS MEDICAID, AND PAYMENTS FROM THESE FEDERALLY FUNDED PROGRAMS DO NOT ALWAYS COVER THE TOTAL COST OF SERVICE. SINCE BECOMING A SUBSIDIARY OF AULTMAN HEALTH FOUNDATION, AOH HAS MADE IMPROVEMENTS IN ITS DELIVERY OF CARE, AND THE COMMUNITY HAS GREATER ACCESS TO ADVANCED HEALTH CARE SERVICES. AOH COMBINES CLOSE TO HOME CONVENIENCE WITH CUTTING EDGE TECHNOLOGY TO OFFER AN ARRAY OF INPATIENT AND OUTPATIENT SERVICES. AOH PROVIDES CARE RANGING FROM THE FAMILY BIRTH CENTER TO SKILLED NURSING CARE ON THE INPATIENT TRANSITIONAL CARE UNIT. ADDITIONAL SERVICES INCLUDE DIAGNOSTIC IMAGING SERVICES, LABORATORY AND OUTPATIENT TESTING, REHABILITATION SERVICES, SURGICAL AND ENDOSCOPIC PROCEDURES, MEDICAL AND SURGICAL CARE, AND A HIGHLY EFFECTIVE AND EFFICIENT EMERGENCY DEPARTMENT.

	(Code: ) (Expenses $ 4,814,712 including grants of $ 16,106 ) (Revenue $ 4,600,011 )
	AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES (ACON) IS A HEALTH-SYSTEM AFFILIATED INSTITUTION OF HIGHER LEARNING COMMITTED TO MEETING THE NEEDS OF NURSING AND ALLIED HEALTH STUDENTS BY PROVIDING A COHERENT, GENERAL AND PROFESSIONAL EDUCATIONAL EXPERIENCE TO PREPARE INDIVIDUALS FOR SERVICE AND LEADERSHIP ROLES. WITH MORE THAN 100 YEARS OF NURSING EDUCATION EXPERIENCE, AULTMAN COLLEGE OFFERS AN ACCREDITED ASSOCIATE OF SCIENCE IN NURSING AND RADIOGRAPHY DEGREE PROGRAMS, AS WELL AS AN RN-BSN COMPLETION PROGRAM. ENROLLMENT AT ACON REMAINED STEADY WITH APPROXIMATELY 350 STUDENTS ENROLLED IN 2015. AULTMAN COLLEGE GRADUATED 101 STUDENTS IN 2015. FACULTY, STAFF AND STUDENTS DONATED MORE THAN 3,379 HOURS OF COMMUNITY SERVICE IN 2015 THROUGH THE COLLEGE'S SERVICE LEARNING PROGRAM.

	(Code: ) (Expenses $ 522,584 including grants of $ 126,526 ) (Revenue $ 1,412 )
	THE AULTMAN FOUNDATION (TAF) RAISES AND ADMINISTERS FUNDS IN ORDER TO SUPPORT AND PROMOTE EDUCATION AND WELLNESS OUTREACH PROGRAMMING THAT WILL IMPROVE THE HEALTH OF THE COMMUNITY. THE FOUNDATION PROVIDES GRANT FUNDING TO AREA NONPROFIT ORGANIZATIONS THAT PROVIDE SERVICES FOCUSING ON WELLNESS, HEALTH EDUCATION AND HUMAN SERVICES - WITH SPECIAL CONSIDERATION FOR THE UNDERSERVED MEMBERS OF THE POPULATION SUCH AS THE POOR, ELDERLY, AND CHILDREN.ONCE A YEAR THE AULTMAN FOUNDATION ACCEPTS GRANT REQUESTS FROM 501 C (3) NONPROFIT ORGANIZATIONS. ENDEAVORS THAT RECEIVED THE AULTMAN FOUNDATION'S FINANCIAL SUPPORT INCLUDED SUBSTANCE ABUSE TREATMENT, WELLNESS PROGRAMS, SENIOR CARE PROGRAMS AND MORE.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 5,337,296 including grants of $ 142,632 ) (Revenue $ 4,601,423 )
4e	Total program service expenses440,869,883

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	9,349,529	3,859,050	656,057

1a	Federated campaigns..		1a
b	Membership dues..		1b	22,685
c	Fundraising events..		1c	817,520
d	Related organizations		1d	125,000
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	721,436

g	Noncash contributions included in lines 1a-1f:$ 298,540
h Total.Add lines 1a-1f.......		1,686,641

			Business Code
2a	NET PATIENT SERVICE REVENUE	621110	402,926,096	402,926,096
b	PREMIUM REVENUE	621110	104,148,320	104,148,320
c	PHARMACY REVENUE	446110	5,987,384	5,987,384
d	TUITION REVENUE	611710	4,600,011	4,600,011
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			517,661,811

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			186,289			186,289
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,430,998
b	Less: rental expenses		181,703
c	Rental income or (loss)		2,249,295
d	Net rental income or (loss)......			2,249,295			2,249,295
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		239,506
b	Less: cost or other basis and sales expenses		242,842
c	Gain or (loss)		-3,336
d	Net gain or (loss).....			-3,336			-3,336
8a	Gross income from fundraising events (not including $ 817,520of contributions reported on line 1c). See Part IV, line 18 ....
	a		239,316
b	Less: direct expenses ...b		151,971
c	Net income or (loss) from fundraising events..			87,345			87,345
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	MISCELLANEOUS REVENUE		900099	6,024,857	5,983,107		41,750
b	FOOD SERVICE		722210	3,029,286			3,029,286
c	LAB AND LAUNDREY INCOME		621500	1,036,736		1,036,736
d	All other revenue ....			860,068			860,068
e	Total. Add lines 11a–11d ......			10,950,947
12	Total revenue. See Instructions......			532,818,992	523,644,918	1,036,736	6,450,697

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	588,326	588,326
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	16,106	16,106
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	6,742,901	5,801,044	941,857
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	200,708,625	164,979,398	35,729,227
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	7,603,085	6,247,721	1,355,364
9	Other employee benefits .......	31,982,345	26,281,322	5,701,023
10	Payroll taxes ...........	14,628,086	12,027,266	2,600,820
11	Fees for services (non-employees):
a	Management ......	223,452	180,996	42,456
b	Legal .........	2,371,882	1,945,363	426,519
c	Accounting ...........	117,760	95,863	21,897
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17	7,370			7,370
f	Investment management fees ......	7,230	5,929	1,301
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	44,326,676	36,392,225	7,934,451
12	Advertising and promotion ....	2,125,346	1,742,707	382,639
13	Office expenses .......	12,483,047	10,250,746	2,232,301
14	Information technology ......	1,755,609	1,449,011	306,598
15	Royalties ..
16	Occupancy ...........	13,904,033	11,468,710	2,435,323
17	Travel ............	1,467,846	1,207,095	260,751
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	305,256	252,753	52,503
20	Interest ...........	382,718	321,213	61,505
21	Payments to affiliates .......	27,325,448	22,406,867	4,918,581
22	Depreciation, depletion, and amortization ..	22,834,481	18,751,045	4,083,436
23	Insurance ...	3,761,340	3,095,992	665,348
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	93,215,421	76,469,366	16,746,055
b	BAD DEBT EXPENSE	19,511,923	15,978,140	3,533,783
c	ONCOLOGY	13,430,782	11,819,088	1,611,694
d	HOSPITAL FRANCHISE FEE	7,474,329	6,124,413	1,349,916
e	All other expenses	5,902,135	4,971,178	930,957
25	Total functional expenses. Add lines 1 through 24e	535,203,558	440,869,883	94,326,305	7,370
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,510,268	1	1,043,867
2	Savings and temporary cash investments .........			7,491,612	2	3,327,275
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			55,359,310	4	54,547,689
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....			994,499	7	941,461
8	Inventories for sale or use ........			3,377,425	8	3,364,903
9	Prepaid expenses and deferred charges ......			3,862,661	9	4,060,739
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	563,362,626
b	Less: accumulated depreciation	10b	322,202,863	252,819,946	10c	241,159,763
11	Investments—publicly traded securities .			4,663,486	11	7,768,386
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			1,752,781	13	1,991,525
14	Intangible assets ...............			256,967	14	231,270
15	Other assets. See Part IV, line 11 ...........			8,193,358	15	3,706,420
16	Total assets. Add lines 1 through 15 (must equal line 34)...			340,282,313	16	322,143,298

17	Accounts payable and accrued expenses .....	48,736,203	17	39,882,057
18	Grants payable ...		18
19	Deferred revenue .........	2,939,553	19	2,741,754
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	16,740,000	23	25,935,000
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	3,982,722	25	8,617,730
26	Total liabilities. Add lines 17 through 25..	72,398,478	26	77,176,541

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	262,715,309	27	239,227,706
28	Temporarily restricted net assets ...........	4,663,526	28	5,234,051
29	Permanently restricted net assets	505,000	29	505,000
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	267,883,835	33	244,966,757
34	Total liabilities and net assets/fund balances ........	340,282,313	34	322,143,298