TY 2020 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	47.00 ................. 8.00	X	X	776,388	15,474
(2) MARK D WRIGHT...................................................................... TREASURER/CFO/ DIRECTOR - AHF	48.00 ................. 7.00	X	X	468,572	3,630
(3) DARRYL J DILLENBACK...................................................................... CHAIR - AHF	7.00 ................. 0.00	X	X	0	0
(4) EMIL ALECUSAN...................................................................... VICE CHAIR - AHF	8.00 ................. 0.00	X	X	0	0
(5) BRYAN RICE...................................................................... 2ND VICE CHAIR/SECRETARY	6.00 ................. 0.00	X	X	0	0
(6) BARBARA ABBOTT...................................................................... DIRECTOR - AHF	2.00 ................. 0.00	X		0	0
(7) BRIAN S BELDEN...................................................................... DIRECTOR - AHF	5.00 ................. 4.00	X		0	0
(8) ROGER BETTIS...................................................................... DIRECTOR - AHF	2.00 ................. 0.00	X		0	0
(9) PEGGY CLAYTOR...................................................................... DIRECTOR - AHF	3.00 ................. 0.00	X		0	0
(10) NATE J COOKS...................................................................... DIRECTOR - AHF	1.00 ................. 3.00	X		0	0
(11) STEPHEN G DEUBLE...................................................................... DIRECTOR - AHF	2.00 ................. 0.00	X		0	0
(12) MILAN R DOPIRAK MD...................................................................... DIRECTOR - AHF	1.00 ................. 1.00	X		0	0
(13) LEO DOYLE...................................................................... DIRECTOR - AHF	8.00 ................. 8.00	X		0	0
(14) DAVID M FINDLEY...................................................................... DIRECTOR - AHF	2.00 ................. 0.00	X		0	0
(15) RYAN FULMER...................................................................... DIRECTOR - AHF	2.00 ................. 0.00	X		0	0
(16) T STEPHEN GREGORY...................................................................... DIRECTOR - AHF	6.00 ................. 4.00	X		0	0
(17) PATRICIA A GRISCHOW...................................................................... DIRECTOR - AHF	2.00 ................. 3.00	X		0	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) RICK L HAINES........................................................................ DIRECTOR - AHF; CEO - AULTCARE	4.00 .......................51.00	X				0	579,171	12,027
(19) JOSEPH R HALTER JR........................................................................ DIRECTOR - AHF	1.00 .......................2.00	X				0	0	0
(20) MICHAEL E HANKE........................................................................ DIRECTOR - AHF	3.00 .......................2.00	X				0	0	0
(21) JOHN B HUMPHREY JR MD........................................................................ DIRECTOR - AHF	6.00 .......................2.00	X				0	0	0
(22) GEOFF KARCHER........................................................................ DIRECTOR - AHF	4.00 .......................0.00	X				0	0	0
(23) JOANNE KRIVETZKY MD........................................................................ DIRECTOR - AHF; MED STAFF PRES-ELECT	2.00 .......................4.00	X				30,000	0	0
(24) BRIAN LAYMAN........................................................................ DIRECTOR - AHF	3.00 .......................1.00	X				0	0	0
(25) MICHAEL LYNCH MD........................................................................ DIRECTOR - AHF	7.00 .......................48.00	X				7,254	419,157	27,246
(26) RON LYONS........................................................................ DIRECTOR - AHF	1.00 .......................1.00	X				0	0	0
(27) LORI MARTINO........................................................................ DIRECTOR - AHF	1.00 .......................1.00	X				0	0	0
(28) JUDY MINTON........................................................................ DIRECTOR - AHF; AH WOMEN'S BOARD PRESIDENT	1.00 .......................3.00	X				0	0	0
(29) LORI L MERTES MD........................................................................ PRESIDENT - INNOVATIONS BOARD	1.00 .......................54.00	X				0	419,849	3,989
(30) JEFFREY MILLER MD........................................................................ DIRECTOR - AHF	2.00 .......................7.00	X				0	0	0
(31) PRABHCHARAN GILL MD........................................................................ DIRECTOR - AHF	2.00 .......................53.00	X				16,350	664,164	30,101
(32) MICHAEL RICH MD........................................................................ DIRECTOR - AHF	51.00 .......................4.00	X				447,367	0	26,879
(33) JESSE ROPER........................................................................ DIRECTOR - AHF	2.00 .......................0.00	X				0	0	0
(34) TIM SEIFERT........................................................................ DIRECTOR - AHF	1.00 .......................1.00	X				0	0	0
(35) LOUIS G SHAHEEN MD........................................................................ DIRECTOR - AHF	1.00 .......................3.00	X				6,250	0	0
(36) DOUGLAS J SIBILA........................................................................ DIRECTOR - AHF	2.00 .......................2.00	X				0	0	0
(37) JOHN A SIRPILLA........................................................................ DIRECTOR - AHF	4.00 .......................1.00	X				0	0	0
(38) TODD M SOMMER........................................................................ DIRECTOR - AHF	1.00 .......................2.00	X				0	0	0
(39) RYAN STENGER........................................................................ DIRECTOR - AHF	2.00 .......................0.00	X				0	0	0
(40) R CLINT ZOLLINGER ESQ........................................................................ DIRECTOR - AHF	6.00 .......................0.00	X				0	0	0
(41) SHRUTI TREHAN MD........................................................................ DIRECTOR - AHF	2.00 .......................53.00	X				0	1,447,468	21,983
(42) WILLIAM WALLACE MD........................................................................ DIRECTOR - AHF	4.00 .......................6.00	X				0	0	0
(43) MARK AUBLE........................................................................ DIRECTOR - AHF	1.00 .......................1.00	X				0	0	0
(44) AKBAR SHAH MD........................................................................ CHAIR - ASH; PHYSICIAN	5.00 .......................50.00	X	X			0	903,981	26,536
(45) DANIEL RODRIGUEZ MD........................................................................ VICE CHAIR - ASH	5.00 .......................50.00	X	X			0	212,548	17,120
(46) DIANA BOYD........................................................................ SECRETARY & TREASURER - ASH	5.00 .......................0.00	X	X			0	0	0
(47) KRISTEN DEDENT........................................................................ CEO - ASH	52.00 .......................3.00	X	X			112,664	0	125
(48) JACQUELINE DEGARMO........................................................................ DIRECTOR - ASH	5.00 .......................1.00	X				0	0	0
(49) DEANNA HATFIELD........................................................................ DIRECTOR - ASH	1.00 .......................0.00	X				0	0	0
(50) DENISE HILL........................................................................ DIRECTOR - ASH	1.00 .......................1.00	X				0	0	0
(51) ERIC JOHNSON........................................................................ DIRECTOR - ASH	1.00 .......................0.00	X				0	0	0
(52) GEORGE KEFALAS MD........................................................................ DIRECTOR - ASH	1.00 .......................2.00	X				0	0	0
(53) ELLEN LINZ........................................................................ DIRECTOR - ASH	1.00 .......................0.00	X				0	0	0
(54) DAVID MOTTS........................................................................ DIRECTOR - ASH	1.00 .......................0.00	X				0	0	0
(55) CHADI BOU SERHAL MD........................................................................ DIRECTOR - ASH	1.00 .......................1.00	X				0	0	0
(56) MELANIE MIRANDE MD........................................................................ CHAIR - IHC	1.00 .......................0.00	X	X			0	0	0
(57) BRIAN MCCLAIN MD........................................................................ VICE CHAIR - IHC	1.00 .......................2.00	X	X			0	0	0
(58) STEVE NAM MD........................................................................ TREASURER - IHC	1.00 .......................4.00	X	X			12,369	0	0
(59) DOUGLAS BLOCKER MD........................................................................ DIRECTOR - IHC	1.00 .......................0.00	X				5,854	0	0
(60) ANTHONY DEGENHARD DO........................................................................ DIRECTOR - IHC	2.00 .......................5.00	X				18,625	0	0
(61) ANDY R HART MD........................................................................ DIRECTOR - IHC	1.00 .......................0.00	X				0	0	0
(62) LEWIS HUMBLE MD........................................................................ DIRECTOR - IHC	1.00 .......................0.00	X				1,625	0	0
(63) JAMES JOHNS MD........................................................................ DIRECTOR - IHC	1.00 .......................0.00	X				38,931	0	0
(64) STEVEN KELLY MD........................................................................ DIRECTOR - IHC	4.00 .......................51.00	X				0	1,014,785	23,796
(65) ROGER MUSA MD........................................................................ DIRECTOR - IHC	5.00 .......................50.00	X				8,624	259,882	314
(66) TIMOTHY O'TOOLE MD........................................................................ DIRECTOR - IHC	1.00 .......................2.00	X				1,625	0	0
(67) JOHN PRODAFIKAS........................................................................ DIRECTOR - IHC	3.00 .......................52.00	X				0	757,643	23,996
(68) CHRISTOPHER E REMARK........................................................................ DIRECTOR - IHC	7.00 .......................48.00	X				0	519,756	4,303
(69) ROBERT SABOTA MD........................................................................ DIRECTOR - IHC	1.00 .......................1.00	X				0	0	0
(70) JOHN WESTERBECK MD........................................................................ DIRECTOR - IHC	1.00 .......................3.00	X				2,438	0	0
(71) JAMES WILSON MD........................................................................ DIRECTOR - IHC	1.00 .......................0.00	X				3,688	0	0
(72) ANDREW ZURICK MD........................................................................ MEDICARE BENEFICIARY - IHC	1.00 .......................0.00	X				2,250	0	0
(73) DAVID MALLAMACI MD........................................................................ DIRECTOR - IHC	1.00 .......................0.00	X				15,563	0	0
(74) HOWARD METZGER MD........................................................................ DIRECTOR - IHC	55.00 .......................0.00	X				263,752	0	13,561
(75) CHARLES ZOLLINGER........................................................................ DIRECTOR - IHC	1.00 .......................0.00	X				3,938	0	0
(76) ALLISON M OPRANDI MD........................................................................ CEO - IHC	53.00 .......................2.00			X		440,799	0	6,369
(77) MATTHEW RITZERT........................................................................ VP - IHC	55.00 .......................0.00			X		160,829	0	2,840
(78) ELIZABETH A GETZ........................................................................ CIO	50.00 .......................5.00			X		321,481	0	3,683
(79) ROBERT C MOLNAR........................................................................ SVP, REGIONAL DEVELOPMENT	51.00 .......................4.00			X		273,357	0	2,982
(80) MARK N ROSE........................................................................ SVP - LEGAL SERVICES	50.00 .......................5.00			X		375,216	0	6,583
(81) JASON JUSTUS........................................................................ CEO - POMERENE	55.00 .......................0.00			X		239,348	0	835
(82) SUSAN E OLIVERA........................................................................ VP - HUMAN RESOURCES	53.00 .......................2.00			X		295,523	0	3,580
(83) ADAM LUNTZ........................................................................ CFO - AH; TREASURER - ACON	50.00 .......................5.00				X	304,199	0	3,095
(84) RONALD RUSNAK MD........................................................................ DIRECTOR OF CLINICAL INFORMATICS	55.00 .......................0.00				X	362,196	0	2,336
(85) KEVIN D PETE........................................................................ SVP	50.00 .......................5.00				X	316,289	0	5,357
(86) TIMOTHY TEYNOR........................................................................ VP - PUBLIC POLICY	50.00 .......................5.00				X	223,308	0	11,612
(87) RAFAEL GONZALEZ........................................................................ VP - CHIEF TECHNOLOGY OFFICER	55.00 .......................0.00				X	217,504	0	715

(A) Name and business address	(B) Description of services	(C) Compensation
CERNER CORP 2800 ROCKCREEK PWKY KANSAS CITY,MO64117	SOFTWARE SUPPORT	6,721,456
DELL FINANCIAL SERVICES ONE DELL WAY ROUND ROCK,TX78682	SOFTWARE SUPPORT	1,471,732
PNC BANK PO BOX 931034 CLEVELAND,OH44193	FINANCIAL SERVICES	1,376,695
ALLSCRIPTS HEALTHCARE 305 CHURCH AT NORTH HILLS RALEIGH,NC27609	SOFTWARE SUPPORT	993,906
CISCO SYSTEMS INC 170 W TASMAN DRIVE SAN JOSE,CA95134	SOFTWARE SUPPORT	683,371
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 43

- 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.
right arrow

Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION

Employer identification number

34-1445390

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 12, 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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

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 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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 ...............................1

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

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 above (see instructions))	(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)
(A) AULTMAN HOSPITAL	340714538	3	Yes		15,524,407	0

Total 1					15,524,407	0

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2020

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. 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—2019. 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—2020. 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—2019. 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) 2020

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. 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—2019. 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) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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.

Yes

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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

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 lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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).

Yes

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 line 2 above, 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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2020

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 (explain in Part VI). 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 0.015 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 0.035	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) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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

Schedule A (Form 990 or 990-EZ) 2020

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

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

Employer identification number

34-1445390

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 (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

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) 2020

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) 2017	(b) 2018	(c) 2019	(d) 2020	(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) 2020

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|No

(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? .......................

Yes

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

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

Yes

271,675

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

271,675

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:	THIS REPRESENTS PAYMENTS TO VARIOUS PROFESSIONAL ORGANIZATIONS FOR CONDUCTING FEDERAL AND STATE ADVOCACY, GOVERNMENT RELATIONS REPRESENTATION, AND GENERAL LEGISLATIVE COUNSELING AND BUSINESS REGULATIONS ON BEHALF OF THE ORGANIZATION.

Schedule C (Form 990 or 990EZ) 2020

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION

Employer identification number

34-1445390

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 7/25/06, 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 FASB 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 FASB 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 FASB 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) 2020

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 ....	776,367	733,598	734,605	727,562	718,271
b	Contributions ...					25,000
c	Net investment earnings, gains, and losses	44,156	46,769	4,643	13,033	15,263
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	4,000	4,000	5,650	5,990	30,972
g	End of year balance ......	816,523	776,367	733,598	734,605	727,562

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 %

Term 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)

Yes

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

Yes

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 .....	1,877,417		1,877,417
b	Buildings ....	3,260,935	2,284,474	976,461
c	Leasehold improvements
d	Equipment ....	3,230,881	2,335,481	895,400
e	Other .....	111,570	108,512	3,058
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				3,752,336

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program 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)INVESTMENT IN AFFILIATES	381,760,881	C
(2)ASSETS LIMITED AS TO USE	23,646,256	C
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	405,407,137

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	1,504,094
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) 2020

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 CHAPLANCY 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 ACCOUNTING STANDARDS CODIFICATION, THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS RECORDED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION.

Schedule D (Form 990) 2020

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

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION

Employer identification number

34-1445390

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: . . . . . . . .

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

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) . . .
b	Medicaid (from Worksheet 3, column a) . . . . .	2,109,853	985,038	1,124,815	1.940 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	2,109,853	985,038	1,124,815	1.940 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .
k	Total. Add lines 7d and 7j .	2,109,853	985,038	1,124,815	1.940 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

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.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

77,062

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. ......

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).....

1,622,892

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

1,389,763

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

233,129

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2020

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?1Name, 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)
1	AULTMAN SPECIALTY HOSPITAL 2600 SIXTH ST SW CANTON,OH44710 HTTP://WWW.AULTMAN.ORG 1454 AULTMAN SPECIALTY HOSPITAL 134246188	X	LONG-TERM ACUTE CARE

Schedule H (Form 990) 2020

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 SPECIALTY 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?........................

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

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): SEE PART V, SECTION B, LINE 7D

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 19

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

Yes

If "Yes" (list url): SEE PART V, SECTION B, LINE 7D

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) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	AULTMAN SPECIALTY 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 %

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)

Was widely publicized 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):

SEE PART V, PAGE 8

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

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

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

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

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

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

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2020

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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 SPECIALTY HOSPITAL	PART V, SECTION B, LINE 5: SINCE 2010, THE STARK COUNTY HEALTH DEPARTMENT HAS FACILITATED A COLLABORATIVE CHA PROCESS TO MEET AFFORDABLE CARE ACT REQUIREMENTS FOR NONPROFIT HOSPITALS AND PUBLIC HEALTH ACCREDITATION BOARD STANDARDS FOR HEALTH DEPARTMENTS. LOCAL PUBLIC HEALTH DEPARTMENTS, HEALTH CARE SYSTEMS, MENTAL HEALTH, SOCIAL SERVICE AGENCIES AND NON-PROFIT ORGANIZATIONS SUPPORT AND GUIDE THIS PROCESS. THE ASSESSMENT PROCESS IS AN ONGOING CYCLE THAT INCLUDES BUILDING PARTNERSHIPS; COORDINATING A CONSORTIUM; ASSESSING DATA, COMMUNITY NEEDS AND CAPACITY; AND PLANNING, PRIORITIZATION, ACTION DEVELOPMENT, IMPLEMENTATION AND EVALUATION. THE ADVISORY COMMITTEE SELECTED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) MODEL, FOR THE 2020-2022 CYCLE. THE MAPP MODEL IS AN EVIDENCE-BASED, COMMUNITY-WIDE STRATEGIC PLANNING PROCESS THAT ASSISTS COMMUNITIES WITH PRIORITIZING PUBLIC HEALTH ISSUES, IDENTIFYING RESOURCES FOR ADDRESSING THOSE ISSUES AND DEVELOPING A SHARED, LONG-TERM COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE APPROACH IMPROVES PUBLIC HEALTH PRACTICE THROUGH SIX PHASES AND FOUR ASSESSMENTS. THREE SIGNIFICANT COMPONENTS SERVE AS THE FOUNDATION OF THE MAPP PROCESS: 1) STRATEGIC PLANNING, 2) COLLABORATION AND 3) QUALITY IMPROVEMENT. THE ADVISORY COMMITTEE SELECTED CENTER FOR MARKETING AND OPINION RESEARCH (CMOR) TO CONDUCT THE 2019 CHA AS THEY DID FOR PREVIOUS CHA CYCLES. AULTMAN HEALTH FOUNDATION LEADERS SERVE AS MEMBERS OF THE ADVISORY COMMITTEE. THE 2019 CHA SERVES AS A FOUNDATION OF THE JOINT 2019 AULTMAN HOSPITAL, AULTMAN ALLIANCE COMMUNITY HOSPITAL, & AULTMAN SPECIALTY HOSPITAL CHNA. THE 2019 CHA IS AVAILABLE AT HTTPS://WWW.STARKCOUNTYOHIO.GOV/PUBLIC-HEALTH/COMMUNITY-HEALTH-ASSESSMENT. ADDITIONALLY, AULTMAN HEALTH FOUNDATION USES THE COMMUNITY HEALTH ASSESSMENT TOOLKIT AS A FRAMEWORK (ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT, 2017).CMOR GATHERED PRIMARY AND SECONDARY DATA COLLECTION THROUGH FOUR PHASES: 1) COMMUNITY SURVEY, 2) COMMUNITY HEALTH LEADER SURVEY, 3) SECONDARY DATA AND 4) COMMUNITY FOCUS GROUP. THE CHA INCLUDED A COMBINATION OF QUANTITATIVE DEMOGRAPHIC AND HEALTH DATA, AS WELL AS QUALITATIVE DATA THAT REFLECTS THE EXPERIENCES AND OPINIONS OF COMMUNITY RESIDENTS AND HEALTH LEADERS. AFTER GATHERING THE DATA, CMOR COMPILED THE INFORMATION BY SOURCE AND PREPARED A REPORT WITH NARRATIVE AND VISUAL DISPLAYS OF DATA. WHEN AVAILABLE, DATA WAS COMPARED TO PREVIOUS DATA, AS WELL AS OTHER STATE AND NATIONAL DATA. ANALYSIS INCLUDED SURVEY DATA IN CONJUNCTION WITH HEALTH AND DEMOGRAPHIC DATA. USING ALL DATA AVAILABLE, CMOR IDENTIFIED COMMUNITY HEALTH NEEDS FOR STARK COUNTY.COMMUNITY SURVEY. THE FIRST PHASE CONSISTED OF A RANDOM SAMPLE TELEPHONE SURVEY OF STARK COUNTY HOUSEHOLDS. TELEPHONE INTERVIEWS ENSURED ADEQUATE SAMPLE SIZE AND REPRESENTATIVENESS OF THE POPULATION. THE FINAL SAMPLE SIZE OF 800 RESULTED IN AN OVERALL SAMPLING ERROR OF +/- 3.5% WITHIN A 95% CONFIDENCE LEVEL. AN OVERSAMPLE OF APPROXIMATELY 160 AFRICAN-AMERICAN RESIDENTS AND 105 CANTON RESIDENTS WAS CONDUCTED IN ADDITION TO THE 800 INTERVIEWS IN ORDER TO ATTAIN ENOUGH CASES OF THIS POPULATION TO BE ABLE TO DRAW STATISTICALLY VALID CONCLUSIONS. DATA COLLECTION BEGAN ON JULY 5, 2018 AND ENDED ON AUGUST 7, 2018. MOST CALLING TOOK PLACE BETWEEN THE EVENING HOURS OF 5:15 P.M. AND 9:15 P.M. SOME INTERVIEWS WERE CONDUCTED DURING THE DAY AND ON SOME WEEKENDS TO ACCOMMODATE RESPONDENT SCHEDULES. THE INTERVIEWS TOOK AN AVERAGE OF 14.4 MINUTES.SECONDARY DATA. THE SECOND PHASE CONSISTED OF REVIEWING AND ANALYZING SECONDARY DATA SOURCES TO IDENTIFY PRIORITY AREAS OF CONCERN WHEN ANALYZED ALONGSIDE SURVEY DATA. CMOR GATHERED AND COMPILED HEALTH AND DEMOGRAPHIC DATA FROM VARIOUS SOURCES. COMMUNITY LEADER SURVEY. THE THIRD PHASE CONSISTED OF A WEB SURVEY OF COMMUNITY LEADERS WHO WERE KNOWLEDGEABLE ABOUT PUBLIC HEALTH. A TOTAL OF 101 COMMUNITY LEADERS COMPLETED THE WEB SURVEY BETWEEN OCTOBER 25 AND NOVEMBER 12, 2018. SEE APPENDIX 2 ORGANIZATIONS RESPONDING TO THE INVITATION TO PARTICIPATE IN THE COMMUNITY LEADER SURVEY.COMMUNITY FOCUS GROUP. THE FOURTH PHASE CONSISTED OF A MODERATED DISCUSSION WITH A DIVERSE DEMOGRAPHIC MIX OF ADULT STARK COUNTY RESIDENTS. THE COMMUNITY FOCUS GROUP WAS HELD ON FEBRUARY 20, 2019, AT THE STARK COUNTY HEALTH DEPARTMENT. CMOR MODERATED THE DISCUSSION. PARTICIPANTS IN THE COMMUNITY FOCUS GROUP COMPRISED A DIVERSE GROUP OF INDIVIDUAL CITIZENS.
AULTMAN SPECIALTY HOSPITAL	PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING HOSPITAL FACILITIES: AULTMAN HOSPITAL, AULTMAN ALLIANCE COMMUNITY HOSPITAL, AND MERCY MEDICAL CENTER.
AULTMAN SPECIALTY HOSPITAL	PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING NON-HOSPITAL FACILITIES: ACCESS HEALTH STARK COUNTY; ALLIANCE CITY HEALTH DEPARTMENT; ALLIANCE FAMILY HEALTH CENTER; BEACON CHARITABLE PHARMACY; CANTON CITY PUBLIC HEALTH; COMMQUEST; MASSILLON CITY HEALTH DEPARTMENT; MY COMMUNITY HEALTH CENTER; OHIO STATE UNIVERSITY EXTENSION; PARAMOUNT ADVANTAGE; PEGASUS FARM; SISTERS OF CHARITY FOUNDATION OF CANTON; STARKFRESH; STARK COUNTY HEALTH DEPARTMENT; STARK COUNTY COMMUNITY ACTION AGENCY; STARK COUNTY FAMILY COUNCIL; STARK COUNTY JOBS AND FAMILY SERVICES; STARK COUNTY DISTRICT LIBRARY; STARK MENTAL HEALTH & ADDICTION RECOVERY; STARK PARKS; STARK COUNTY TASC; UNITED WAY OF GREATER STARK COUNTY; YMCA OF CENTRAL STARK COUNTY.IN ADDITION, THE COLLABORATION CONTRACTED WITH CENTER FOR MARKETING & OPINION RESEARCH TO CONDUCT THE 2018 STARK COUNTY HEALTH NEEDS ASSESSMENT AS THEY DID FOR PREVIOUS CYCLES. CMOR PROVIDES PUBLIC OPINION RESEARCH SERVICES TO COLLEGES AND UNIVERSITIES, HOSPITALS AND HEALTH CARE ORGANIZATIONS, BUSINESSES AND COMMUNITY-BASED ORGANIZATIONS AND GOVERNMENT AGENCIES. THEY HAVE EXPERTISE IN ASKING THE RIGHT QUESTIONS TO THE RIGHT PEOPLE THE RIGHT WAY USING TELEPHONE, WEB AND MAIL SURVEYS, FIELD, INTERCEPT AND KEY INFORMANT INTERVIEWS AND FOCUS GROUP ADMINISTRATION, AS WELL AS A WIDE RANGE OF CONSULTING SERVICES.
AULTMAN SPECIALTY HOSPITAL	PART V, SECTION B, LINE 7D: THE CHNA AND CHNA IMPLEMENTATION PLAN CAN BE FOUND AT THE FOLLOWING URL:AULTMAN.ORG/HOME/ABOUT/AULTMAN-HOSPITAL/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
AULTMAN SPECIALTY HOSPITAL	PART V, SECTION B, LINE 11: AULTMAN SPECIALTY HOSPITAL DEVELOPED A STRATEGY FOR THE SELECTED PRIORITY HEALTH NEEDS AND/OR SOCIAL DETERMINANTS OF HEALTH. THE HOSPITAL THEN SELECTED STRATEGIES THAT IMPACT THE CLINICAL NEEDS OF OUR PATIENT POPULATION AND SOCIAL DETERMINANTS OF THE PRIORITY NEED.NEED 1: OBESITY & HEALTHY LIFESTYLE1. BEE HEALTHY EMPLOYEE WELLNESS PROGRAM DECREASE ADULT OBESITY BY 5%, DECREASE PERCENT OF ADULTS REPORTING A BMI OF 30 OR MORE TO < 31%, INCREASE PERCENT OF ADULTS REPORTING EXERCISE IN PAST MONTH TO >78.8%, INCREASE THE PERCENT OF ADULTS THAT REPORT THE FREQUENCY OF EXERCISE 3-7 TIMES PER WEEK TO >44%, DECREASE THE PERCENT OF ADULTS THAT SELF-DESCRIBE WEIGHT AS OVERWEIGHT TO <53.4%ACTIONS:A. BEE HEALTHY RUNB. CAF NUTRITION OFFERINGSC. ONLINE WELLNESS PORTAL (CHALLENGES, PROGRAMS, TRACKING FOOD/FITNESS/WATER)D. AULTMAN EMPLOYEE GYME. TELEPHONE COACHINGF. 100 DAYS OF SUMMER WALKING CHALLENGEG. BEE HEALTHY PROGRAM CASH INCENTIVE AND REDUCED HEALTH PLAN PREMIUMS FOR COMPLETION OF REQUIREMENTS:- ONE AGE- OR GENDER-APPROPRIATE PREVENTIVE SCREENING.- A DENTAL AND/OR VISION VISIT.- COMPLETE THE ONLINE HEALTH RISK ASSESSMENT VIA THE BEE HEALTHY WELLNESS PORTAL.ANTICIPATED IMPACT: BEE HEALTHY PARTICIPATION RATE = NUMBER OF EMPLOYEES ENROLLED/NUMBER OF EMPLOYEESNEED 2: MENTAL HEALTH1. HEROIN/OPIATE USE DECREASE "UNINTENTIONAL OVERDOSE DEATH RATE, STARK COUNTY" TO <75 PER YEAR, INCREASE THE PERCENTAGE OF COMMUNITY HEALTH LEADERS THAT FEEL THAT THERE ARE ADEQUATE SERVICES AND PROGRAMS ALREADY IN PLACE IN THE COMMUNITY TO ADDRESS THE HEROIN AND OPIATE CRISIS >49.5%, DECREASE THE PERCENTAGE OF COMMUNITY HEALTH LEADERS THAT REPORT TREATMENT SERVICES AS "WHAT IS MISSING:HEROIN/OPIOID USE" TO <37.2%ACTIONS:A. AULTMAN OPIOID COMMITTEE- AULTMAN HOSPITAL'S MEDICAL EXECUTIVE COMMITTEE RECOMMENDATION TO ADD AN ADDICTION SPECIALIST- SUBCOMMITTEE IT: GOAL BETTER TRANSITIONS BETWEEN PRACTITIONERS. DESCRIPTION: PROMOTE SAFE, EFFECTIVE AND OPTIMAL UTILIZATION OF TECHNOLOGY WITHIN THE CLINICAL SETTING: CREATE DASHBOARD(S) FOR PROVIDER FEEDBACK (CHRONIC OPIOID MEASURES AND ACUTE OPIOID MEASURES) (I.E. BENZODIAZEPINE CO-PRESCRIBING), EVALUATE CERNER'S OPIOID TOOLKIT AND MAKE RECOMMENDATION, FACILITATE CHANGES TO EMR- SUBCOMMITTEE REGULATORY/COMPLIANCE: GOAL SAFE PRESCRIBING. DESCRIPTION: ASSURE THAT REGULATORY AND COMPLIANCE STANDARDS RELATING TO PAIN ASSESSMENT AND MANAGEMENT ARE BEING MET.- SUBCOMMITTEE ACUTE/CHRONIC PAIN: GOAL PROPER TREATMENT & PROPER EVALUATION. DESCRIPTION: EVALUATES STANDARDS OF CLINICAL PRACTICE AND PATIENT CARE FOR CONSISTENCY WITH EVIDENCE-BASED PRACTICE, QUALITY OUTCOMES, REGULATORY REQUIREMENTS.- SUBCOMMITTEE EDUCATION: GOAL EDUCATION TO PHYSICIANS, NURSES, CLINICIANS AND PATIENTS. DESCRIPTION: TO UTILIZE CONSISTENT EDUCATIONAL PROGRAMS TO ENHANCE STAFF KNOWLEDGE BASE ABOUT ALL ASPECTS OF THE OPIOID CRISIS. WORKS IN COLLABORATION WITH MEDICAL STAFF AND ADMINISTRATION TO SECURE TOPICS, SPEAKERS AND LOGISTICS FOR THE HEALTHCARE DELIVERY SYSTEM. FOCUS ON UNDERSTANDING OHIO LAW, MORPHINE EQUIVALENT DOSE AND INTERPRETATION OF A URINE DRUG SCREEN. PROVIDE PATIENT EDUCATION AND DRUG DISPOSAL KITS ON DISCHARGE.ANTICIPATED IMPACT:A. OPIOID PRESCRIPTION PILL QUANTITY/DAY SUPPLY <7 DAYS AT PATIENT DISCHARGEB. NUMBER OF OPIOID IV PUSH DOSES IN ACCEPTABLE RANGE ADMINISTERED IN INPATIENT SETTINGS (EXCLUSIONS: ED, OR, END OF LIFE CARE PATIENTS)C. NUMBER OF NALOXONE DOSES ADMINISTERED IN INPATIENT SETTINGS (UNITS EXCLUDED: ED, OR)D. NUMBER OF DISCHARGE SCRIPTS WRITTEN FOR OPIOIDS INCLUDING QUANTITY DISPENSED, DAY SUPPLY AND ICD-10 INDICATION.E. PERCENT COMPLIANCE WITH REGULATORY AND COMPLIANCE STANDARDS FOR PAIN ASSESSMENT AND MANAGEMENT.F. PERCENT OF CREDENTIALED AND EMPLOYED PROVIDERS COMPLETING SMARTRX EDUCATION.
AULTMAN SPECIALTY HOSPITAL	PART V, SECTION B, LINE 13H: AULTMAN HEALTH FOUNDATION IS THE PARENT COMPANY OF AULTMAN SPECIALTY HOSPITAL (ASH). ASH HAS A FINANCIAL ASSISTANCE POLICY (FAP) WHICH HAS THE SAME PROVISIONS AS THE POLICY FOR AULTMAN HOSPITAL AND OTHER FACILITIES WITHIN AULTMAN HEALTH FOUNDATION. ACCORDING TO THE POLICY ALL MEDICALLY NECESSARY SELF-PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE FEDERAL POVERTY GUIDELINES (FPG) AND ARE UPDATED ANNUALLY BASED ON THE UPDATES PUBLISHED BY THE UNITED STATES HEALTH AND HUMAN SERVICES DEPARTMENT. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% - 100% OF FPG RECEIVES A 100% DISCOUNT, 101% - 150% OF FPG RECEIVES A 90% DISCOUNT, 151% - 200% OF FPG RECEIVES A 80% DISCOUNT, 201% - 300% OF FPG RECEIVES A 65% DISCOUNT, 301% AND ABOVE IS DISCOUNTED AT 58%.
AULTMAN SPECIALTY HOSPITAL	PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE INFORMATION CAN BE FOUND AT THE FOLLOWING URL:AULTMAN.ORG/HOME/PATIENTS-AND-VISITORS/INSURANCE-AND-BILLING/ FINANCIAL-ASSISTANCE/
PART V, SECTION B, LINE 13A:	ALL MEDICALLY NECESSARY SELF-PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE UPDATES PUBLISHED BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% - 100% OF FPG RECEIVES A 100% DISCOUNT, 101% - 150% OF FPG RECEIVES A 90% DISCOUNT, 151% - 200% OF FPG RECEIVES A 80% DISCOUNT, 201% - 300% OF FPG RECEIVES A 65% DISCOUNT, 301% AND ABOVE IS DISCOUNTED AT 58%.

Schedule H (Form 990) 2020

Page 9

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2020

Page 10

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:	AULTMAN HEALTH FOUNDATION IS THE PARENT COMPANY OF AULTMAN SPECIALTY HOSPITAL (ASH). ASH HAS A FINANCIAL ASSISTANCE POLICY (FAP) WHICH HAS THE SAME PROVISIONS AS THE POLICY FOR AULTMAN HOSPITAL AND OTHER FACILITIES WITHIN AULTMAN HEALTH FOUNDATION. ACCORDING TO THE POLICY ALL MEDICALLY NECESSARY SELF-PAY PATIENTS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. ELIGIBILITY CRITERIA IS BASED ON THE FEDERAL POVERTY GUIDELINES (FPG) AND ARE UPDATED ANNUALLY BASED ON THE UPDATES PUBLISHED BY THE UNITED STATES HEALTH AND HUMAN SERVICES DEPARTMENT. THE PERCENT OF ASSISTANCE PROVIDED IS DETERMINED ON A SLIDING SCALE AS FOLLOWS: 0% - 100% OF FPG RECEIVES A 100% DISCOUNT, 101% - 150% OF FPG RECEIVES A 90% DISCOUNT, 151% - 200% OF FPG RECEIVES A 80% DISCOUNT, 201% - 300% OF FPG RECEIVES A 65% DISCOUNT, 301% AND ABOVE IS DISCOUNTED AT 58%.
PART I, LINE 7:	THE ORGANIZATION USED THE COST TO CHARGE RATIO CALCULATED IN WORKSHEET 2 OF SCHEDULE H.
PART I, LINE 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. THE MOST RECENT REPORT IS AVAILABLE ON AULTMAN'S WEBSITE (SEE AULTMAN.ORG/HOME/ABOUT/AULTMAN-HOSPITAL/ANNUAL-REPORT/).
PART III, LINE 2:	BAD DEBT EXPENSE CONSISTS OF AMOUNTS DEEMED UNCOLLECTIBLE AND REFERRED TO COLLECTION AGENCY, PER THE ORGANIZATION'S WRITTEN DEBT COLLECTION POLICY.
PART III, LINE 3:	METHODOLOGY FOR BAD DEBT RELATED TO CHARITY CARE:PATIENTS REFERRED TO THE ASH ARE REFERRED HERE BECAUSE THEIR ILLNESSES ARE COMPLEX AND WILL REQUIRE LONG-TERM ACUTE CARE SERVICES. MOST OF THE PATIENTS WITH SUCH MEDICALLY COMPLEX ILLNESSES ARE ELDERLY AND HAVE CHRONIC AS WELL AS ACUTE ILLNESS AND ARE ABLE TO QUALIFY FOR MEDICARE OR MEDICAID. IF THE PATIENT MEETS THE HEALTH CRITERIA FOR ADMISSIONS INTO A LONG TERM ACUTE CARE FACILITY, ASH ACCEPTS THE PATIENT REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS ARE OFTEN CONSIDERED SELF-PAY PATIENTS AT THE TIME OF ADMISSION AND THEN THROUGH OUR OUTREACH PROGRAM THESE PATIENTS ARE USUALLY ABLE TO QUALIFY FOR MEDICAID OR SOME OTHER FORM OF ASSISTANCE. BECAUSE OF THIS, ASH HAD NO BAD DEBT EXPENSE ATTRIBUTABLE TO CHARITY CARE IN 2020. THE ORGANIZATION DOES HAVE A FINANCIAL ASSISTANCE POLICY WHICH HAS THE SAME PROVISIONS AS THE POLICY FOR ANY OTHER FACILITY WITHIN THE AULTMAN HEALTH FOUNDATION.
PART III, LINE 4:	SEE THE "PATIENT SERVICE REVENUE AND PATIENT RECEIVABLES" PARAGRAPHS IN NOTE 3 ON PAGES 20-21 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:	ASH HAS A SURPLUS OF $233,129 WITH ITS MEDICARE PATIENTS. 100% OF THIS SURPLUS SHOULD BE TREATED AS COMMUNITY BENEFIT, SINCE ASH IS PROVIDING SERVICES TO ELDERLY INDIVIDUALS WHO MAY OTHERWISE STRUGGLE TO RECEIVE CARE. THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED IN LINE 6 IS THE MEDICARE COST REPORT.
PART III, LINE 9B:	ASH FOLLOWS THE SAME COLLECTION PROCEDURES OUTLINED IN THE PARENT COMPANY'S COLLECTION POLICY. FOR THOSE PATIENTS KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE, THE ORGANIZATION REPEATEDLY OFFERS PATIENTS ACCESS TO FINANCIAL HELP DURING THEIR HOSPITAL STAY AND AFTER AS WELL AS WITH EACH BILLING NOTICE. BILLS ARE SENT TO A COLLECTION AGENCY AS A LAST RESORT AND ONLY: WHEN PATIENTS HAVE THE ABILITY TO PAY SOME PORTION OF THEIR HEALTHCARE EXPENSES BUT DECLINE TO DO SO; WHEN PATIENTS DECLINE TO WORK WITH THE ORGANIZATION TO DETERMINE IF THEY QUALIFY FOR FREE OR DISCOUNTED CARE VIA FEDERAL, STATE, LOCAL OR HOSPITAL ASSISTANCE PROGRAMS; OR WHEN THE ORGANIZATION IS UNABLE TO LOCATE THE PATIENT OR PERSON RESPONSIBLE FOR THE BILL.
PART VI, LINE 2:	NEEDS ASSESSMENT:AULTMAN SPECIALTY HOSPITAL (ASH) ASSESSES THE COMMUNITY'S HEALTH CARE NEEDS IN A VARIETY OF WAYS. IT STUDIES PROTOCOL VOLUME AND PATIENT SATISFACTION SURVEYS. IT DOCUMENTS MEDICAL CONDITIONS THAT THOUSANDS OF COMMUNITY MEMBERS AND MEDICAL STAFF MEMBERS CAN INQUIRE ABOUT IN THE SHARON LANE HEALTH CENTER HEALTH LIBRARY. IT TRACKS ATTENDANCE AT THE MORE THAN 100 "HEALTH TALK" PRESENTATIONS HELD EACH YEAR TO DETERMINE WHAT TOPICS ARE OF MOST INTEREST TO THE COMMUNITY. IN 2019, ASH COLLABORATED WITH AREA HOSPITALS AND HEALTH CARE FACILITIES TO CONDUCT A COMMUNITY HEALTH SURVEY. THE GOAL WAS TO GAUGE THE HEALTH STATUS AND HEALTH HABITS OF STARK COUNTY RESIDENTS - AND IDENTIFY AREAS WHERE AULTMAN CAN IMPROVE THE HEALTH OF OUR COMMUNITY. FIFTEEN QUESTIONS WERE INCLUDED ON THE POLL OF 1,276 STARK COUNTY HOUSEHOLDS. THE SURVEY SHOWED ACCESS TO HEALTH INSURANCE COVERAGE AND HEALTH CARE AS THE TOP PRIORITY; ALONG WITH OBESITY AND LACK OF HEALTHY LIFESTYLE CHOICE; OTHER AREAS OF CONCERN WERE PRESCRIPTION DRUG MISUSE, LARGER NEED FOR MENTAL HEALTH SERVICES, AND GREATER ACCESS TO DENTAL CARE. THE HOSPITAL IS CURRENTLY IN THE PROCESS OF DEVELOPING ITS IMPLEMENTATION PLAN.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:IF ABLE, AT THE TIME OF REGISTRATION PATIENTS ARE ASKED TO FILL OUT THE HOSPITAL CARE ASSURANCE PROGRAM APPLICATION WHICH INCLUDES CONTACT INFORMATION FOR QUESTIONS AND ASSISTANCE IN COMPLETING THE FORMS. SIGNS AND APPLICATIONS ARE POSTED AT ALL POINTS OF ADMISSIONS INFORMING PATIENTS OF THE FREE CARE PROGRAMS WHICH ARE AVAILABLE. IN 2010, THE APPLICATION WAS ADDED TO THE INTERNET FOR EASY PATIENT ACCESS. ASH STAFF ASSISTS SELF-PAY INPATIENTS WITH THE MEDICAID PROCESS AND OTHER PROGRAMS UNDER WHICH THEY ARE ELIGIBLE FOR ASSISTANCE. PATIENTS WHO ARE UNABLE TO BE SCREENED DURING THEIR STAY RECEIVE FOLLOW UP ASSISTANCE WITH QUALIFYING FOR THE ASSISTANCE PROGRAM THAT MOST APPROPRIATELY FITS THEIR FINANCIAL NEEDS. THE APPLICATION AND CONTACT INFORMATION FOR THE OUTREACH DEPARTMENT IS PRINTED ON THE BACK OF EVERY STATEMENT.
PART VI, LINE 4:	COMMUNITY INFORMATION:ASH ENCOURAGES ITS EMPLOYEES AND BOARD MEMBERS TO BE ACTIVELY INVOLVED IN THE COMMUNITY.THE ORGANIZATION HAS ELEVEN BOARD MEMBERS WHO ARE ACTIVELY INVOLVED IN THE COMMUNITY TO BE REPRESENTATIVES OF THE COMMUNITY'S INTERESTS IN HEALTH CARE SERVICES.THE MEDICAL STAFF IS COMPRISED OF 202 PHYSICIANS. ANY PHYSICIAN IN GOOD STANDING WITHIN AULTMAN HOSPITAL'S MEDICAL STAFF AND WITH AN APPROPRIATE SPECIALTY TO CARE FOR MEDICALLY COMPLEX PATIENTS MAY APPLY FOR PRIVILEGES AT ASH.ASH'S SERVICE AREA INCLUDES STARK, WAYNE, HOLMES, CARROLL AND TUSCARAWAS COUNTIES. THE CORE MARKET FOR THE HOSPITAL IS STARK COUNTY. THE UNITED STATES CENSUS BUREAU ESTIMATED THE 2017 POPULATION OF OUR FIVE COUNTY AREAS TO BE OVER 650,690. THE ORGANIZATION IS ONE OF ONLY 2 FACILITIES WITHIN THE 5 COUNTY AREAS WHO ARE CONSIDERED LONG-TERM ACUTE CARE FACILITIES AND WHO PROVIDE THE SPECIALIZATION NEEDED TO CARE FOR PATIENTS WITH SUCH COMPLEX MEDICAL CONDITIONS.
PART VI, LINE 5:	AULTMAN SPECIALTY HOSPITAL (ASH) IS A WHOLLY OWNED SUBSIDIARY OF AULTMAN HEALTH FOUNDATION. AULTMAN HEALTH FOUNDATION SUPPORTS AND PROMOTES THE HEALTH OF ITS COMMUNITY MEMBERS IN A VARIETY OF WAYS. FROM EDUCATIONAL PROGRAMS TO HEALTH SCREENINGS, AULTMAN ACTIVELY PROMOTES HEALTH AND WELLNESS IN THE COMMUNITY. EDUCATIONAL PROGRAMS INCLUDE MORE THAN 100 FREE HEALTH TALK PRESENTATIONS EACH YEAR, FEATURING LOCAL PHYSICIANS AND HEALTH CARE PROFESSIONALS. THE AULTMAN WEBSITE HAS ADDITIONAL HEALTH CARE RESOURCES, INCLUDING A HEALTH LIBRARY, SYMPTOM CHECKER, VIDEOS AND RISK ASSESSMENTS.AULTMAN'S WORKING ON WELLNESS (WOW) MOBILE HEALTH-FAIR UNIT DEBUTED IN FEBRUARY 2009. STAFFED BY MEDICAL PROFESSIONALS, THE WOW VAN VISITS SCHOOLS, COMMUNITY CENTERS, CHURCHES, SENIOR CENTERS AND BLOCK PARTIES TO PROVIDE FREE SCREENINGS AND HEALTH EDUCATION. SCREENINGS SUCH AS BLOOD PRESSURE CHECKS, HEIGHT, WEIGHT AND BODY MASS INDEX/PERCENTAGE OF BODY FAT ARE PROVIDED. IN 2020, THE WOW STAFF REACHED MORE THAN 3,700 PEOPLE.ADDITIONAL OUTREACH EFFORTS INCLUDED AULTMAN REPRESENTATIVES ATTENDING HEALTH FAIRS THROUGHOUT THE YEAR. THESE EVENTS INCLUDE SENIOR DAY AT THE PRO FOOTBALL HALL OF FAME, THE CANTON FARMERS' MARKET AND HEALTH FAIRS AT LOCAL SCHOOLS.2020 MARKED THE THIRTEENTH YEAR AULTMAN HOSTED THE CAREERS IN HEALTH CARE SUMMER PROGRAM FOR HIGH SCHOOL SENIORS AND COLLEGE STUDENTS INTERESTED IN HEALTH CARE CAREERS. SYMPOSIUM PRESENTERS INCLUDED AULTMAN DOCTORS, NURSES, STAFF AND ADMINISTRATORS WHO SHARED INSIGHT ON THE CHALLENGES AND OPPORTUNITIES OF WORKING IN HEALTH CARE. THE EVENT ALSO INCLUDED A HEALTH CARE CAREER FAIR WITH MORE THAN A DOZEN DEPARTMENTS AND SERVICES REPRESENTED. JOB SHADOWING EXPERIENCES WITH DOCTORS, NURSES AND OTHER HEALTH CARE PROFESSIONALS WERE AVAILABLE.CRITICALLY INJURED PATIENTS WHO NEED SPECIALIZED CARE ARE BROUGHT TO AULTMAN'S LEVEL II TRAUMA CENTER. AULTMAN HOSPITAL HAS THE ONLY LEVEL II TRAUMA CENTER FOR ADULT AND PEDIATRIC PATIENTS IN ITS FIVE-COUNTY SERVICE AREA. THE LEVEL II DESIGNATION FROM THE AMERICAN COLLEGE OF SURGEONS CERTIFIES AULTMAN HAS THE FACILITIES, TECHNOLOGY AND SPECIALLY TRAINED CLINICAL STAFF TO TREAT TRAUMA PATIENTS. IN 2020, AULTMAN HEALTH FOUNDATION CONTRIBUTED TO THE BETTERMENT OF THE STARK COUNTY COMMUNITY WITH THE FOLLOWING ACTIVITIES.THROUGH THE SAFETY FIRST PROGRAM, AULTMAN STRIVES TO KEEP OUR COMMUNITY'S KIDS SAFE BY PREVENTING HEAD TRAUMA AND OTHER BIKE-RELATED INJURIES. IN 2020, HUNDREDS OF AULTMAN EMPLOYEES VOLUNTEERED TO TEACH NEARLY 4,300 LOCAL FIRST-GRADE STUDENTS ABOUT BIKE SAFETY. TOPICS INCLUDED THE IMPORTANCE OF WEARING A BIKE HELMET AND OTHER SAFETY GEAR; OBEYING TRAFFIC SIGNS AND SIGNALS; AND USING HAND SIGNALS. IN ADDITION TO THE IN-CLASS EDUCATION, EACH STUDENT RECEIVED A FREE BICYCLE SAFETY BOOKLET AND BIKE HELMET. SINCE THE PROGRAM'S INCEPTION IN 2005, SAFETY FIRST HAS REACHED ABOUT 35,000 STUDENTS WITH THE IMPORTANT MESSAGE OF BICYCLE SAFETY. THE AULTMAN WORKING ON WELLNESS (WOW) TEAM PROVIDES HEALTH SCREENINGS AND EDUCATION AT NO COST TO LEAD OUR COMMUNITY TO IMPROVED HEALTH. THE WOW TEAM VISITED 100 SITES IN 2020 RANGING FROM SCHOOLS, COMMUNITY/OUTREACH CENTERS, CHURCHES, HEALTH FAIRS AND MORE. THE WOW TEAM IS STAFFED BY REGISTERED NURSES WHO PROVIDE HEALTH EDUCATION, RESOURCES AND REFERRALS, AS NEEDED. HEALTH INFORMATION IS AVAILABLE ON A VARIETY OF MEDICAL TOPICS AND CAN BE CUSTOMIZED TO FIT AN INDIVIDUAL'S NEEDS. THE WOW TEAM PROVIDED HEALTH EDUCATION TO MORE THAN 3,700 COMMUNITY MEMBERS IN 2020.AULTMAN CANCER CENTER BELIEVES THAT EVERY CANCER PATIENT SHOULD BE ABLE TO RECEIVE UP-TO-DATE QUALITY CARE IN THEIR OWN COMMUNITY. THIS DRIVES THE COMMITMENT FOR EXCELLENCE, QUALITY, VALUE AND SERVICE. AULTMAN HOSPITAL REGISTERED NURSE NAVIGATORS, A FINANCIAL RESOURCE ADVOCATE AND A SURVIVORSHIP COORDINATOR RAISE AWARENESS OF HEALTHY LIFESTYLE CHOICES AND CANCER PREVENTION STRATEGIES THROUGH COMMUNITY CANCER SCREENING EVENTS, EDUCATION AND FOLLOW-UP ACTIVITIES. THESE ANNUAL CANCER PREVENTION OUTREACH EVENTS DEMONSTRATE HOW AULTMAN EMPLOYEES AND LOCAL PHYSICIANS WHO VOLUNTEER THEIR TIME FOR THIS ENDEAVOR PROVIDED ACCESS TO SCREENING SERVICES FOR OVER 500 RESIDENTS WITH OVER 1000 SCREENINGS IN STARK AND SURROUNDING COUNTIES. THEY PARTICIPATE IN COMMUNITY OUTREACH EVENTS, A SCHOOL-BASED INITIATIVE WITH SIXTH-GRADE STUDENTS, A HOMELESS SHELTER AND PARTNER WITH THE MINORITY COMMUNITY TO RAISE AWARENESS ABOUT HEALTH DISPARITIES ASSOCIATED WITH LIFESTYLE CHOICES. THE AULTMAN CANCER CENTER CONDUCTS FREE CANCER SCREENING DAYS FOR BREAST, CERVICAL, COLON, LUNG, PROSTATE AND SKIN CANCER FOLLOWING NATIONALLY RECOMMENDED SCREENING GUIDELINES. THE AULTMAN CANCER CENTER ENCOURAGES PEOPLE WITH A FAMILY HISTORY OF CANCER OR THOSE WHO HAVE NEVER BEEN SCREENED TO TAKE ADVANTAGE OF THE FREE CANCER SCREENINGS. CANCER SCREENING DAYS ALSO OFFER EDUCATIONAL MATERIALS THAT TEACH THE SIGNS AND SYMPTOMS OF CANCER, AS WELL AS IMPORTANT SCREENING GUIDELINES FOR MEN AND WOMEN AS THEY AGE. THE EVENTS EMPHASIZE THAT BEST CANCER PREVENTION IS TO LIVE A HEALTHY LIFESTYLE BY NOT USING TOBACCO PRODUCTS, LIMITING TIME IN THE SUN AND ALWAYS USING SUNSCREEN WITH SPF 15 OR HIGHER, LEADING A PHYSICALLY ACTIVE LIFE AND MAINTAINING A HEALTHY WEIGHT.FOOD INSECURITY IS A CRITICAL ISSUE IN NORTHEASTERN OHIO, AND AULTMAN TEAM MEMBERS GIVE GENEROUSLY TO THE ANNUAL HARVEST FOR HUNGER CAMPAIGN. IN 2020, AULTMAN EMPLOYEES DONATED $31,282 IN MONETARY GIFTS THAT HELPED THOUSANDS OF FAMILIES AND INDIVIDUALS IN NEED.AULTMAN MEDICAL EDUCATION HOSTED THE TWELFTH ANNUAL CAREERS IN HEALTH CARE PROGRAM, DESIGNED FOR STUDENTS 18 AND OLDER WITH INTERESTS IN HEALTH CARE CAREERS. THE PROGRAM INCLUDED PRESENTATIONS FROM DOCTORS, NURSES AND HOSPITAL ADMINISTRATORS, PROVIDING A GLIMPSE AT HOW A HOSPITAL RUNS. THE SYMPOSIUM ALSO FEATURED A CAREER FAIR THAT ENABLE THE STUDENTS TO TALK WITH EMPLOYEES FROM MORE THAN A DOZEN AULTMAN DEPARTMENTS. SUMMER JOB SHADOWING EXPERIENCES WERE ALSO AVAILABLE FOR SYMPOSIUM PARTICIPANTS. FOR WOMEN WHO CANNOT AFFORD BASIC CLOTHING ITEMS SUCH AS BRAS, EACH DAY PRESENTS EMOTIONAL AND UNCOMFORTABLE SITUATIONS. WHILE AULTMAN EMPLOYEES CONTINUE TO DONATE TOWARDS THIS BASIC NEED, AND DONATIONS HAVE BEEN DISTRIBUTED TO LOCAL BATTERED WOMEN AND HOMELESS SHELTERS AS WELL AS THE STARK COUNTY YWCA.AULTMAN HEALTH FOUNDATION TEAM MEMBERS AND THEIR LOVED ONES SUPPORT ANNUAL FUNDRAISING WALKS FOR ORGANIZATIONS INCLUDING THE MARCH OF DIMES AND JUVENILE DIABETES RESEARCH FOUNDATION. AULTMAN NOT ONLY PARTICIPATES IN THE AMERICAN CANCER SOCIETY'S RELAY FOR LIFE AND MAKING STRIDES AGAINST BREAST CANCER WALK - ALONG WITH THE AMERICAN HEART ASSOCIATION'S HEART WALK - BUT CLINICIANS ARE ON HAND TO PROVIDE EDUCATIONAL INFORMATION ABOUT REDUCING RISKS OF CANCER AND HEART DISEASE.EVERY YEAR, AULTMAN ORGANIZES A FUNDRAISING CAMPAIGN TO BENEFIT UNITED WAY. IN 2020, AULTMAN EMPLOYEES AND PHYSICIANS GENEROUSLY DONATED $457,659 TO FUND PROGRAMS TO BENEFIT COMMUNITY MEMBERS OF ALL AGES AND FROM ALL WALKS OF LIFE.AS PART OF AULTMAN HEALTH FOUNDATION'S MISSION TO LEAD OUR COMMUNITY TO IMPROVED HEALTH, THE AULTMAN AMBASSADOR PROGRAM (AAP) PROVIDES AN OPPORTUNITY TO EMPOWER HIGH SCHOOL STUDENTS TO BE "AULTMAN AMBASSADORS" TO ENGAGE THEIR PEERS, FAMILIES AND COMMUNITIES IN PROMOTING HEALTHY LIFESTYLE CHANGES. AAP IS PARTNERED WITH THE ALLIANCE FOR A HEALTHIER GENERATION HEALTHY SCHOOLS PROGRAM TO PROVIDE EVIDENCE-BASED RESOURCES ON THE CORE PRINCIPLES OF THE AAP: NUTRITION, HYDRATION, PHYSICAL ACTIVITY, SLEEP AND STRESS. THE AAP IS CURRENTLY PARTNERED WITH SIXTEEN HIGH SCHOOLS AND FIVE COLLEGE/UNIVERSITIES IN THREE COUNTIES; STARK, MAHONING, AND WAYNE. FOR THE 2019/2020 SCHOOL YEAR THE PROGRAM INVOLVED 201 TOTAL STUDENT AMBASSADORS WITH 51 SENIORS. AULTMAN CONTINUES TO EXPAND THE AMBASSADOR PROGRAM IN THE GREATER STARK COUNTY AREAS. IN ADDITION TO PROVIDING CARE FOR PATIENTS WITH NO INSURANCE, AULTMAN ALSO SERVES THOUSANDS OF PATIENTS COVERED BY PROGRAMS SUCH AS MEDICAID. PAYMENTS FROM THESE FEDERALLY FUNDED PROGRAMS DO NOT ALWAYS COVER THE TOTAL COST OF SERVICE.
PART VI, LINE 6:	AULTMAN'S BOARD OF DIRECTORS HAS 50 NON-EMPLOYED MEMBERS. A TOTAL OF 69 OF THE 75 VOTING BOARD MEMBERS RESIDE IN THE CORE MARKET AREA. 4 RESIDE IN THE TERTIARY MARKET AND 2 LIVE OUT OF STATE.COMMUNITY PHYSICIANS REQUESTING AND ULTIMATELY QUALIFYING FOR MEDICAL STAFF PRIVILEGES WOULD BE GRANTED PRIVILEGES IN THEIR RESPECTIVE MEDICAL DEPARTMENTS.
PART VI, LINE 7, REPORTS FILED WITH STATES	OH

Schedule H (Form 990) 2020

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
AULTMAN HEALTH FOUNDATION

Employer identification number
34-1445390

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	(h) Purpose of grant or assistance
(1) HOF VILLAGE 2626 FULTON DR NW CANTON,OH44718			443,554	2019-2020 SPONSORSHIP BILLING - 5 PAYMENTS OVER THE LAST 5 MONTHS OF 2020
(2) COMMUNITY BUILDING PARTNERSHIP 400 MARKET AVENUE N STE 100 CANTON,OH44702	45-1560552	501(C)(3)	66,000	FUNDING PARTNERSHIP FOR ANOTHER 3 - YEAR PERIOD (2020, 2021, 2022) FOR $66,000 PER YEAR
(3) CANTON REGIONAL CHAMBER 222 MARKET AVENUE N CANTON,OH44702	34-0129930	501(C)(6)	65,930	ECONOMIC DEVELOPMENT, CHAMBER WEBSITE, 2020 LIGHT UP DOWNTOWN, 2020 BLUES FEST, AND OTHER EVENTS
(4) YMCA OF CENTRAL STARK 4700 DRESSLER ROAD NW CANTON,OH44718	34-0714392	501(C)(3)	53,000	CAMPAIGN PLEDGE FOR THE YMCA CAPITAL PROJECT
(5) ARTS IN STARK 900 CLEVELAND AVENUE NW CANTON,OH44702	34-6609771	501(C)(3)	52,000	2020 ANNUAL ARTS CAMPAIGN
(6) CITY OF MASSILLON 151 LINCOLN WAY EAST MASSILLON,OH44646		CITY OF MASSILLON	50,000	SUPPORT THE COMPLETION OF THE DUNCAN PLAZA PROJECT
(7) HOF MARATHON LLC 132 5TH ST NW CANTON,OH44702			40,000	TITLE SPONSORSHIP FOR THE HOF MARATHON
(8) ACCESS HEALTH STARK COUNTY 408 9TH ST SW CANTON,OH44707	46-2949527	501(C)(3)	40,000	SUPPORT OF ACCESS HEALTH STARK COUNTY
(9) UNITED WAY GREATER STARK 401 MARKET AVENUE N CANTON,OH44702	13-4254191	501(C)(3)	37,566	SUPPORT FOR PROSPERITY @ WORK
(10) THE NORTH CANTON MEDICAL FOUNDATION 6046 WHIPPLE AVENUE NW NORTH CANTON,OH44720	46-3060489	501(C)(3)	30,000	GENERAL SUPPORT
(11) MASSILLON MUSEUM 121 LINCOLN WAY EAST MASSILLON,OH44646	34-6001833	501(C)(3)	20,000	CAPITAL CAMPAIGN PLEDGE - MASSILLON MUSEUM - 2ND INSTALLMENT
(12) AKRON CANTON FOOD BANK 350 OPPORTUNITY PARKWAY AKRON,OH44307	34-1369388	501(C)(3)	20,000	GROWING FOR GOOD CAPITAL CAMPAIGN FOR ALRON-CANTON REGIONAL FOODBANK
(13) ALLIANCE AREA DEVELOP 2500 W STATE ST SUITE E11 ALLIANCE,OH44601	31-1652174	501(C)(3)	20,000	2020 AAD CHARITABLE CONTRIBUTION - ALLIANCE AREA DEVELOPMENT
(14) UNIVERSITY OF MOUNT UNION 1972 CLARK AVENUE ALLIANCE,OH44601	34-0714687	501(C)(3)	20,000	UNIVERSITY OF MOUNT UNION HEALTH AND MEDICAL SUPPORT
(15) QUALITY HEATING & COOLING 1930 LINCOLN WAY EAST MASSILLON,OH44646			17,843	INSTALLATION OF DUCTLESS SYSTEM FOR MALONE ATHLETICS
(16) JR COLEMAN FAMILY SERVICES 1731 GRACE AVENUE NE CANTON,OH44705	34-1321317	501(C)(3)	15,000	CAPITAL CAMPAIGN PLEDGE - NAMING RIGHTS TO ADULT DAY MEMORY ROOM
(17) AMERICAN HEART ASSOCIATION 4916 HILLS DALES RD NW CANTON,OH44708	13-5613797	501(C)(3)	14,000	SPONSOR GALA S20 CANTON OH
(18) ELITE CONSTRUCTION 817 SOUTH UNION AVENUE ALLIANCE,OH44601			13,382	MALONE ATHLETIC TRAINING ROOM, OSBOURNE HALL
(19) GREATER STARK COUNTY URBAN LEAGUE 1400 SHERRICK ROAD SW CANTON,OH44707	20-3863189	501(C)(3)	10,600	HOLIDAY FOOD GIVEAWAY, BRONZE SPONSORSHIP BLACK AND WHITE BALL
(20) OHIO FOUNDATION OF INDEPENDENT COLLEGES 250 E BROAD ST SUITE 1700 COLUMBUS,OH43215	31-4441082	501(C)(3)	10,000	SCHOLARSHIP FUNDS FOR THE OFIC 2019-20 CAMPAIGN
(21) TEAM NEO FOUNDATION 1111 SUPERIOR AVENUE - SUITE 1600 CLEVELAND,OH44114	34-1885407	501(C)(3)	10,000	TEAM NEO 2020 INVESTMENT PARTNER COMMITMENT
(22) AMERICAN CANCER SOCIETY 10501 EUCLID AVENUE CLEVELAND,OH44106	24-0726080	501(C)(3)	9,000	CORPORATE SPONSORSHIP - RELAY FOR LIFE & MAKING STRIDES AGAINST BREAST CANCER
(23) INNIS MAGGIORE GROUP 4715 WHIPPLE AVENUE NW CANTON,OH44718			8,500	WALSH STADIUM SPONSORSHIP
(24) COPLEY OHIO NEWSPAPER PO BOX 5214 CAROL STREAM,IL60197			7,000	VAPING MAGAZINES
(25) WHISLER PLUMBING 2521 LINCOLN WAY EAST MASSILLON,OH44646			6,348	PLUMBING RENOVATIONS AT MALONE OSBOURNE HALL
(26) EVENT DAY MARKETING PO BOX 2203 NORTH CANTON,OH44720			6,000	NAME ON PRESS RELEASES, ADVERTISING, AND WEB PROMOTION & LOGO RECOGNITION AND LINKS TO AULTMAN
(27) CENTRAL CATHOLIC HIGH SCHOOL 4824 TUSCARAWAS ST W CANTON,OH44708	34-0714566	501(C)(3)	5,500	SCOREBOARD SPONSORSHIP
(28) JUNIOR ACHIEVEMENT OF NORTH CENTRAL OHIO INC 4353 EXECUTIVE CIRCLE NW CANTON,OH44718	34-0940986	501(C)(3)	5,300	2020 JUNIOR ACHIEVEMENT BOWL-A-THON & INSPIRE

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) 2020

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(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 HEALTH FOUNDATION'S (AHF) COMMUNITY SUPPORT POLICY/PROCEDURE PROVIDES GUIDANCE IN RESPONSE TO COMMUNITY ORGANIZATION REQUESTS FOR SUPPORT. AHF DEEMS IT BENEFICIAL AND NECESSARY TO BE A GOOD CORPORATE CITIZEN AND WILL CONSIDER SUPPORT OF COMMUNITY ENDEAVORS AND PROJECTS THAT WILL IMPROVE THE LIVES AND LIVELIHOOD OF THE COMMUNITY IT SERVES. A SPONSORSHIP COMMITTEE MEETS REGULARLY TO REVIEW REQUESTS FOR SUPPORT FROM VARIOUS COMMUNITY ORGANIZATIONS.

Schedule I (Form 990) 2020

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow

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

Attach to Form 990.
Graphic Arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION

Employer identification number

34-1445390

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 on 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 on 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 nonfixed
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) 2020

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)
1SHRUTI TREHAN MD DIRECTOR - AHF	(i) (ii)	0 ------------- 656,561	0 ------------- 790,907	0 ------------- 0	0 ------------- 19,500	0 ------------- 2,483	0 ------------- 1,469,451	0 ------------- 0
2STEVEN KELLY MD DIRECTOR - IHC	(i) (ii)	0 ------------- 841,776	0 ------------- 173,009	0 ------------- 0	0 ------------- 21,450	0 ------------- 2,346	0 ------------- 1,038,581	0 ------------- 0
3AKBAR SHAH MD CHAIR - ASH; PHYSICIAN	(i) (ii)	0 ------------- 756,369	0 ------------- 147,612	0 ------------- 0	0 ------------- 21,450	0 ------------- 5,086	0 ------------- 930,517	0 ------------- 0
4EDWARD J ROTH III PRESIDENT/CEO	(i) (ii)	625,029 ------------- 0	151,359 ------------- 0	0 ------------- 0	2,659 ------------- 0	12,815 ------------- 0	791,862 ------------- 0	0 ------------- 0
5JOHN PRODAFIKAS DIRECTOR - IHC	(i) (ii)	0 ------------- 641,815	0 ------------- 115,828	0 ------------- 0	0 ------------- 21,453	0 ------------- 2,543	0 ------------- 781,639	0 ------------- 0
6PRABHCHARAN GILL MD DIRECTOR - AHF	(i) (ii)	0 ------------- 638,864	0 ------------- 25,300	16,350 ------------- 0	0 ------------- 23,250	0 ------------- 6,851	16,350 ------------- 694,265	0 ------------- 0
7RICK L HAINES DIRECTOR - AHF; CEO - AULTCARE	(i) (ii)	0 ------------- 437,621	0 ------------- 141,550	0 ------------- 0	0 ------------- 2,659	0 ------------- 9,368	0 ------------- 591,198	0 ------------- 0
8CHRISTOPHER E REMARK DIRECTOR - IHC	(i) (ii)	0 ------------- 422,456	0 ------------- 97,300	0 ------------- 0	0 ------------- 2,659	0 ------------- 1,644	0 ------------- 524,059	0 ------------- 0
9MICHAEL RICH MD DIRECTOR - AHF	(i) (ii)	322,536 ------------- 0	124,831 ------------- 0	0 ------------- 0	25,357 ------------- 0	1,522 ------------- 0	474,246 ------------- 0	0 ------------- 0
10MARK D WRIGHT TREASURER/CFO/ DIRECTOR - AHF	(i) (ii)	385,272 ------------- 0	83,300 ------------- 0	0 ------------- 0	2,659 ------------- 0	971 ------------- 0	472,202 ------------- 0	0 ------------- 0
11MICHAEL LYNCH MD DIRECTOR - AHF	(i) (ii)	0 ------------- 415,357	0 ------------- 3,800	7,254 ------------- 0	0 ------------- 25,637	0 ------------- 1,609	7,254 ------------- 446,403	0 ------------- 0
12ALLISON M OPRANDI MD CEO - IHC	(i) (ii)	346,908 ------------- 0	83,083 ------------- 0	10,808 ------------- 0	2,659 ------------- 0	3,710 ------------- 0	447,168 ------------- 0	0 ------------- 0
13LORI L MERTES MD PRESIDENT - INNOVATIONS BOARD	(i) (ii)	0 ------------- 355,356	0 ------------- 64,493	0 ------------- 0	0 ------------- 2,659	0 ------------- 1,330	0 ------------- 423,838	0 ------------- 0
14MARK N ROSE SVP - LEGAL SERVICES	(i) (ii)	301,316 ------------- 0	73,900 ------------- 0	0 ------------- 0	2,659 ------------- 0	3,924 ------------- 0	381,799 ------------- 0	0 ------------- 0
15RONALD RUSNAK MD DIRECTOR OF CLINICAL INFORMATICS	(i) (ii)	325,402 ------------- 0	36,794 ------------- 0	0 ------------- 0	0 ------------- 0	2,336 ------------- 0	364,532 ------------- 0	0 ------------- 0
16ELIZABETH A GETZ CIO	(i) (ii)	271,436 ------------- 0	50,045 ------------- 0	0 ------------- 0	2,659 ------------- 0	1,024 ------------- 0	325,164 ------------- 0	0 ------------- 0
17KEVIN D PETE SVP	(i) (ii)	261,044 ------------- 0	55,245 ------------- 0	0 ------------- 0	3,545 ------------- 0	1,812 ------------- 0	321,646 ------------- 0	0 ------------- 0
18ADAM LUNTZ CFO - AH; TREASURER - ACON	(i) (ii)	271,499 ------------- 0	32,700 ------------- 0	0 ------------- 0	2,659 ------------- 0	436 ------------- 0	307,294 ------------- 0	0 ------------- 0
19SUSAN E OLIVERA VP - HUMAN RESOURCES	(i) (ii)	247,298 ------------- 0	48,225 ------------- 0	0 ------------- 0	2,659 ------------- 0	921 ------------- 0	299,103 ------------- 0	0 ------------- 0
20HOWARD METZGER MD DIRECTOR - IHC	(i) (ii)	219,235 ------------- 0	44,517 ------------- 0	0 ------------- 0	11,284 ------------- 0	2,277 ------------- 0	277,313 ------------- 0	0 ------------- 0
21ROBERT C MOLNAR SVP, REGIONAL DEVELOPMENT	(i) (ii)	204,811 ------------- 0	68,546 ------------- 0	0 ------------- 0	2,659 ------------- 0	323 ------------- 0	276,339 ------------- 0	0 ------------- 0
22ROGER MUSA MD DIRECTOR - IHC	(i) (ii)	0 ------------- 239,694	0 ------------- 20,188	8,624 ------------- 0	0 ------------- 0	0 ------------- 314	8,624 ------------- 260,196	0 ------------- 0
23JASON JUSTUS CEO - POMERENE	(i) (ii)	239,048 ------------- 0	300 ------------- 0	0 ------------- 0	0 ------------- 0	835 ------------- 0	240,183 ------------- 0	0 ------------- 0
24TIMOTHY TEYNOR VP - PUBLIC POLICY	(i) (ii)	223,008 ------------- 0	300 ------------- 0	0 ------------- 0	2,659 ------------- 0	8,953 ------------- 0	234,920 ------------- 0	0 ------------- 0
25DANIEL RODRIGUEZ MD VICE CHAIR - ASH	(i) (ii)	0 ------------- 180,365	0 ------------- 32,183	0 ------------- 0	0 ------------- 15,960	0 ------------- 1,160	0 ------------- 229,668	0 ------------- 0
26RAFAEL GONZALEZ VP - CHIEF TECHNOLOGY OFFICER	(i) (ii)	200,591 ------------- 0	16,913 ------------- 0	0 ------------- 0	0 ------------- 0	715 ------------- 0	218,219 ------------- 0	0 ------------- 0
27MATTHEW RITZERT VP - IHC	(i) (ii)	134,354 ------------- 0	26,475 ------------- 0	0 ------------- 0	2,659 ------------- 0	181 ------------- 0	163,669 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

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	MARK ROSE, TIM TEYNOR, ED ROTH, & MARK WRIGHT ARE PARTICIPANTS IN THE ORGANIZATION'S 457 (F) PLAN. THERE WERE NO CONTRIBUTIONS IN 2020.

Schedule J (Form 990) 2020

Additional Data

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
AULTMAN HEALTH FOUNDATION

Employer identification number
34-1445390

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	OHIO HIGHER EDUCATIONAL FACILITY COMMISSION	34-6849674	67756CDM7	11-02-2018	135,145,347	TO REFUND SERIES 2017 BONDS, REFINANCE PRIOR DEBTS AND NEW MONEY		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	135,145,347
4 Gross proceeds in reserve funds .............	8,972,310
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	111,466,281
12 Other unspent proceeds .............	14,706,756
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........	X
16 Has the final allocation of proceeds been made? ..........		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	2.290 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0.190 %
6 Total of lines 4 and 5 .............	2.480 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2020

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION

Employer identification number

34-1445390

Return Reference	Explanation
FORM 990, PART III, LINE 1 (CONTINUED);	THE MISSION OF AULTMAN HEALTH FOUNDATION IS TO "LEAD OUR COMMUNITY TO IMPROVED HEALTH." THE VERTICALLY INTEGRATED HEALTH SYSTEM OF AULTMAN HOSPITAL AND AULTCARE HEALTH PLANS ENABLE AULTMAN TO BE ONE OF THE LOWEST-COST HEALTH CARE PROVIDERS IN NORTHEASTERN OHIO. LOWER COSTS HELP LOCAL BUSINESSES STAY FINANCIALLY HEALTHY AND MAINTAIN GOOD JOBS IN OUR COMMUNITY. IN ADDITION TO PROVIDING HIGH-QUALITY, LOW-COST HEALTH CARE, AULTMAN HEALTH FOUNDATION PROVIDES HEALTH EDUCATION FOR THE COMMUNITY. FOR EXAMPLE, THE AULTMAN WORKING ON WELLNESS (WOW) TEAM PROVIDES HEALTH SCREENINGS AND EDUCATION AT NO COST TO LEAD OUR COMMUNITY TO IMPROVED HEALTH. THE WOW TEAM VISITED 100 SITES IN 2020 RANGING FROM SCHOOLS, COMMUNITY/OUTREACH CENTERS, CHURCHES, HEALTH FAIRS AND MORE. THE WOW TEAM IS STAFFED BY REGISTERED NURSES WHO PROVIDE HEALTH EDUCATION, RESOURCES AND REFERRALS, AS NEEDED. HEALTH INFORMATION IS AVAILABLE ON A VARIETY OF MEDICAL TOPICS AND CAN BE CUSTOMIZED TO FIT AN INDIVIDUAL'S NEEDS. THE WOW TEAM PROVIDED HEALTH EDUCATION TO MORE THAN 3,700 COMMUNITY MEMBERS IN 2020.
PART V, LINE 2	AULTMAN HEALTH FOUNDATION'S EMPLOYEES ARE PAID BY A COMMON PAYMASTER. AULTMAN HEALTH FOUNDATION IS A PARENT COMPANY WITH THE FOLLOWING SUBSIDIARIES: - AULTMAN SPECIALTY HOSPITAL LLC - AULTMAN NORTH CANTON MEDICAL GROUP - MICKINLEY ASSURANCE SEGREGATED PORTFOLIO CO. - AULTMAN HOSPITAL AND SUBSIDIARIES - THE AULTMAN FOUNDATION - THE ORRVILLE HOSPITAL FOUNDATION DBA AULTMAN ORRVILLE HOSPITAL - AULTCARE CORPORATION - INTEGRATED HEALTH COLLABORATIVE LLC - AULTMAN INNOVATIONS LLC - ALLIANCE COMMUNITY HOSPITAL AND SUBSIDIARIES - CARING HANDS, INC. - AULTCARE HOLDING COMPANY AND SUBSIDIARIES
FORM 990, PART VI, SECTION A, LINE 1	THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE THAT CONSISTS OF THE CHAIR, VICE CHAIR, PRESIDENT/CEO, SECRETARY, TREASURER, PRESIDENT OF THE MEDICAL STAFF AT AULTMAN HOSPITAL, AND THE PAST CHAIR. THE EXECUTIVE COMMITTEE MEETS ONLY AS NECESSARY BETWEEN MEETINGS OF THE BOARD OF DIRECTORS AND HAS AND EXERCISES THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF THE ORGANIZATION, EXCEPT IN MATTERS IN WHICH THE BOARD IS REQUIRED TO ACT BY LAW, BY THE ARTICLES OF INCORPORATION, OR BY THE CODE OF REGULATIONS.
FORM 990, PART VI, SECTION A, LINE 2	GEOFF KARCHER AND BRYAN RICE ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. JOSEPH HALTER AND GEOFF KARCHER ARE BOARD MEMBERS OF THE AULTMAN HEALTH FOUNDATION AND AULTMAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 7A	ONE AHF BOARD MEMBER IS APPOINTED BY ALLIANCE COMMUNITY HOSPITAL, ONE BOARD MEMBER IS APPOINTED BY AULTMAN ORRVILLE HOSPITAL. IN ADDITION, THE AULTMAN HOSPITAL MEDICAL STAFF PRESIDENT, THE AULTMAN HOSPITAL MEDICAL STAFF PRESIDENT-ELECT, AND THE PHYSICIAN CHAIRMAN OF THE BOARD OF AULTCARE CORPORATION ARE EX -OFFICIO VOTING MEMBERS OF THE AHF BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY AULTMAN HEALTH FOUNDATION'S FINANCE DEPARTMENT. AHF'S FINANCE DEPARTMENT CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN. THE DEPARTMENT RECONCILED THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARED THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. IN ADDITION, THE FINANCE DEPARTMENT DID A COMPARATIVE ANALYSIS TO THE PRIOR YEAR RETURN. THE ANALYSIS AND RECONCILIATION SCHEDULES, ALONG WITH A COMPLETE COPY OF THE 990, WERE PROVIDED TO THE CHIEF FINANCIAL OFFICER FOR REVIEW AND APPROVAL. A COMPLETE COPY OF THE 990 WAS THEN MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH A SECURED INTERNET PORTAL PRIOR TO THE FILING DATE.
FORM 990, PART VI, SECTION B, LINE 12C	THE AULTMAN HEALTH FOUNDATION'S BOARD OF DIRECTORS HAS A CONFLICT OF INTEREST POLICY. AS A RESULT OF THIS POLICY, EACH YEAR BOARD MEMEBERS, OFFICERS, AND SENIOR STAFF COMPLETE A FORM DISCLOSING ANY CONFLICTS OF INTEREST THEY MAY HAVE. THE COMPLIANCE OFFICE REVIEWS THESE DISCLOSURE FORMS AND INFORMS THE BOARD CHAIRMAN, AND OTHER APPROPRIATE OFFICERS, OF NOTABLE CONFLICTS, IF ANY. THOSE WITH CONFLICTS ARE ASKED TO RECUSE THEMSELVES FROM DISCUSSIONS RELATING TO THE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15	THE AULTMAN HEALTH FOUNDATION AND ITS AFFILIATED ENTITIES USE THE FOLLOWING REFERENCE MATERIALS FOR THE DEVELOPMENT OF EXECUTIVE COMPENSATION: OHIO HOSPITAL ASSOCIATION (OHA), MERCER INTEGRATED HEALTH NETWORK, INCLUDING SURVEY DATA FOR BOTH HOSPITALS AND HEALTH PLANS, AND SULLIVAN COTTER AND ASSOCIATES (SCA). ADDITIONAL SOURCES OF SALARY SURVEY DATA ARE AVAILABLE FOR USE WHERE APPROPRIATE INCLUDING COMPDATASURVEYS.COM, SALARY.COM, AND CHAMPS. IN THESE CASES, THE SURVEY IS REFERENCED WHERE APPLICABLE. EXECUTIVE PERFORMANCE, WAGE RECOMMENDATIONS AND BONUS PAYMENTS ARE REVIEWED BY THE CEO PRIOR TO REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE AULTMAN HEALTH FOUNDATION BOARD OF DIRECTORS. THE CEO'S COMPENSATION IS ALSO REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE OF THE AULTMAN HEALTH FOUNDATION BOARD OF DIRECTORS HAS ENGAGED SULLIVAN COTTER & ASSOCIATES, INC., AN INDEPENDENT COMPENSATION CONSULTING FIRM FOR REVIEW OF EXECUTIVE COMPENSATION PRACTICES. THE AULTMAN HEALTH FOUNDATION AND ITS AFFILIATED ENTITIES USE THE FOLLOWING REFERENCE MATERIALS FOR THE DEVELOPMENT OF PHYSICIAN COMPENSATION: MEDICAL GROUP MANAGEMENT ASSOCIATES (MGMA), AMERICAN MEDICAL GROUP ASSOCIATION (AMGA), HOSPITAL AND HEALTHCARE COMPENSATION SERVICE (HHCS) AND SULLIVAN COTTER AND ASSOCIATES (SCA). IN ADDITION TO SALARY SURVEYS, AULTMAN HOSPITAL ALSO RETAINS AN INDEPENDENT CONSULTING FIRM FOR PHYSICIANS COMPENSATION SERVICES. ALL PHYSICIAN COMPENSATION RECOMMENDATIONS ARE SENT TO THE CEO, VP OF PHYSICIAN SERVICES, COO, AND CNO FOR FINAL APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19	AULTMAN HEALTH FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
PART VI, SECTION A, LINE 2	EDWARD ROTH III IS A PAID EMPLOYEE OF THE ORGANIZATION. CHRISTOPHER REMARK, RICK HAINES, MILAN DOPIRAK MD, MICHAEL LYNCH MD, AND MICHAEL RICH MD ARE PAID EMPLOYEES OF A RELATED ORGANIZATION.
FORM 990, PART IX, LINE 11G	CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,247,183. MANAGEMENT AND GENERAL EXPENSES 292,549. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,539,732. PURCHASED MAINTENANCE: PROGRAM SERVICE EXPENSES 1,590,403. MANAGEMENT AND GENERAL EXPENSES 373,057. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,963,460. ASH PATIENT SERVICES: PROGRAM SERVICE EXPENSES 667,029. MANAGEMENT AND GENERAL EXPENSES 156,464. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 823,493. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,765,303. MANAGEMENT AND GENERAL EXPENSES 648,651. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,413,954. PROFESSIONAL FEES - PHYSICIAN: PROGRAM SERVICE EXPENSES 160,834. MANAGEMENT AND GENERAL EXPENSES 37,726. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 198,560. PROFESSIONAL FEES - NONPHYSICIAN: PROGRAM SERVICE EXPENSES 1,941. MANAGEMENT AND GENERAL EXPENSES 455. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,396. HOSPITAL FRANCHISE FEE: PROGRAM SERVICE EXPENSES 94,553. MANAGEMENT AND GENERAL EXPENSES 22,177. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 116,730.
FORM 990, PART XI, LINE 9:	INTERFUND TRANSFERS 104,422,295.
FEDERAL ELECTIONS	SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION AULTMAN HEALTH FOUNDATION 2600 SIXTH STREET SW CANTON, OH 44710 EMPLOYER IDENTIFICATION NUMBER: 34-1445390 FOR THE YEAR ENDING DECEMBER 31, 2019 AULTMAN HEALTH FOUNDATION 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) 2020

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

AULTMAN HEALTH FOUNDATION

Employer identification number

34-1445390

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
(1) AULTMAN SPECIALTY HOSPITAL 2600 SIXTH ST SW CANTON,OH44710 13-4246188	LONG-TERM ACUTE CARE	OH	6,219,433	5,578,767	AULTMAN HEALTH FOUNDATION
(2) INTEGRATED HEALTH COLLABORATIVE LLC 2600 SIXTH ST SW CANTON,OH44710 45-4325320	HEALTH COLLABORATIVE	OH	2,900,266	193,098	AULTMAN HEALTH FOUNDATION
(3) AULTMAN INNOVATIONS LLC 2600 SIXTH ST SW CANTON,OH44710 81-0847842	IP HOLDING AND MARKETING	OH	1,005	2,691	AULTMAN HEALTH FOUNDATION

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 HOSPITAL 2600 SIXTH ST SW CANTON,OH44710 34-0714538	HOSPITAL	OH	501(C)(3)	LINE 3	AULTMAN HEALTH FOUNDATION	Yes
(2)THE AULTMAN FOUNDATION 2600 SIXTH ST SW CANTON,OH44710 20-8090459	FUNDRAISING	OH	501(C)(3)	LINE 7	AULTMAN HEALTH FOUNDATION	Yes
(3)ORRVILLE HOSPITAL FOUNDATION (DBA AULTMAN ORRVILLE HOSPITAL) 832 S MAIN ST ORRVILLE,OH44667 34-0733138	HOSPITAL	OH	501(C)(3)	LINE 3	AULTMAN HEALTH FOUNDATION	Yes
(4)AULTMAN COLLEGE OF NURSING AND HEALTH 2600 SIXTH ST SW CANTON,OH44710 20-1359433	COLLEGE	OH	501(C)(3)	LINE 2	AULTMAN HOSPITAL		No
(5)AULTMAN NORTH CANTON MEDICAL GROUP 2600 SIXTH ST SW CANTON,OH44710 34-1088530	HEALTHCARE	OH	501(C)(3)	LINE 10	AULTMAN HEALTH FOUNDATION	Yes
(6)TUSCARAWAS VALLEY REGIONAL CANCER CENTER 300 MEDICAL PARK DRIVE DOVER,OH44622 31-1689698	MEDICAL SERVICE	OH	501(C)(3)	LINE 3	N/A		No
(7)DARTMOUTH CHILD CARE CENTER CONTRACTING SERVICES INC 125 DARTMOUTH AVE SW CANTON,OH44710 34-1652364	SUPPORT ORGANIZATION	OH	501(C)(3)	LINE 12C, III-FI	AULTMAN HOSPITAL	Yes
(8)ALLIANCE COMMUNITY HOSPITAL 200 E STATE STREET ALLIANCE,OH44601 34-0714581	HOSPITAL	OH	501(C)(3)	LINE 3	AULTMAN HEALTH FOUNDATION	Yes
(9)ALLIANCE COMMUNITY HOSPITAL AUXILIARY 200 E STATE STREET ALLIANCE,OH44601 34-0777659	SUPPORT ORGANIZATION	OH	501(C)(3)	LINE 12C, III-FI	ALLIANCE COMMUNITY HOSPITAL	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2020

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	(k) Percentage ownership
(1) WEST TUSCARAWAS PROPERTY MANAGEMENT LLC 2600 SIXTH ST SW CANTON,OH44710 20-0090246	PROPERTY MGMT	OH	AULTCARE INSURANCE COMPANY	EXCLUDED	894,903	22,382,806		No			No	100.000 %
(2) AULTMAN ONCOLOGY CENTER OF EXCELLENCE LLC 2600 SIXTH ST SW CANTON,OH44710 45-4215510	HEALTHCARE	OH	AULTMAN HOSPITAL	RELATED	116,290	3,489		No			No	83.740 %

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	(h) Percentage ownership	(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	(h) Percentage ownership	Yes	No
(1) MCKINLEY ASSURANCE SPC PO BOX 1051 GEORGE TOWN,GRAND CAYMANS CJ 98-0468384	PORTFOLIO	CJ	AULTMAN HEALTH FOUNDATION	C	10,381,435	24,473,258	100.000 %	Yes
(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	AULTMAN HEALTH FOUNDATION	C			100.000 %	Yes
(4) NORTH CENTRAL MEDICAL RESOURCES INC 2600 SIXTH ST SW CANTON,OH44710 34-1610344	MEDICAL EQUIPMENT RENTAL	OH	AULTCARE HOLDING COMPANY	C	5,175,325	259,243,639	100.000 %	Yes
(5) OHIO SPECIALTY PHYSICIANS CORPORATION 2600 SIXTH ST SW CANTON,OH44710 34-1853300	HEALTH SERVICES	OH	NORTH CENTRAL MEDICAL RESOURCES	C	2,172,456	168,253	100.000 %	Yes
(6) OHIO HOSPITAL BASED PHYSICIANS CORP 2600 SIXTH ST SW CANTON,OH44710 34-1871647	HEALTH SERVICES	OH	NORTH CENTRAL MEDICAL RESOURCES	C	14,402,723	976,418	100.000 %	Yes
(7) OHIO PHYSICIANS PROFESSIONAL CORP 2600 SIXTH ST SW CANTON,OH44710 31-1509897	HEALTH SERVICES	OH	NORTH CENTRAL MEDICAL RESOURCES	C	12,731,081	761,265	100.000 %	Yes
(8) AULTMAN MSO 2600 SIXTH ST SW CANTON,OH44710 31-1509904	ADMIN SERVICES	OH	NORTH CENTRAL MEDICAL RESOURCES	C	820,930	487,613	100.000 %	Yes
(9) AULTCARE HEALTH INSURING CORPORATION 2600 SIXTH ST SW CANTON,OH44710 46-3305099	INSURANCE	OH	AULTCARE HOLDING COMPANY	C	221,525,123	137,511,309	100.000 %	Yes
(10) AULTCARE INSURANCE COMPANY 2600 SIXTH ST SW CANTON,OH44710 34-1624818	INSURANCE	OH	AULTCARE HEALTH INSURING CORPORATION	C	267,936,109	100,635,940	100.000 %	Yes
(11) AULTRA ADMINISTRATIVE GROUP 2600 SIXTH ST SW CANTON,OH44710 20-4951704	ADMIN SERVICE	OH	AULTCARE HOLDING COMPANY	C	1,641,422	369,411	100.000 %	Yes
(12) AULTCOMP MCO INC 2600 SIXTH ST SW CANTON,OH44710 27-4379962	HEALTH SERVICES	OH	AULTRA ADMINISTRATIVE GROUP	C	2,523,539	42,876	100.000 %	Yes
(13) WAYNE HEALTH SERVICES & SUPPLIES 2600 SIXTH ST SW CANTON,OH44710 34-1501390	MEDICAL SUPPLIES	OH	NORTH CENTRAL MEDICAL RESOURCES	C	-522,307	-1	100.000 %	Yes
(14) AULTMAN MEDICAL GROUP 2600 SIXTH ST SW CANTON,OH44710 45-3166014	HEALTH SERVICES	OH	AULTCARE HOLDING COMPANY	C	17,143,210	5,007,262	100.000 %	Yes
(15) MAINSITE ASO LLC 2600 SIXTH ST SW CANTON,OH44710 47-3587655	HEALTH SERVICES	OH	AULTCARE HOLDING COMPANY	C		19,175	100.000 %	Yes
(16) HEALTH ALLIANCE INC 2600 SIXTH ST SW CANTON,OH44710 34-1531993	HEALTH SERVICES	OH	NORTH CENTRAL MEDICAL RESOURCES	C	485,933	37,899	100.000 %	Yes
(17) AULTMAN DEUBLE HEART & VASCULAR 2600 SIXTH ST SW CANTON,OH44710 84-2848226	HEALTH SERVICES	OH	AULTCARE HOLDING COMPANY	C	24,666,012	2,213,653	100.000 %	Yes
(18) AULTMAN NOW URGENT CARE LLC 2600 SIXTH ST SW CANTON,OH44710 84-4874605	HEALTH SERVICES	OH	AULTCARE HOLDING COMPANY	C	892,591	287,655	100.000 %	Yes
(19) AULTPLAN LLC 2600 SIXTH ST SW CANTON,OH44710 85-1242075	HEALTH SERVICES	OH	AULTCARE HOLDING COMPANY	C		-75,252	100.000 %	Yes

Schedule R (Form 990) 2020

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) ............................

Yes

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

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

Yes

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) ............................

Yes

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

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
(1) THE AULTMAN FOUNDATION	B	100,000	FMV
(2) AULTMAN HOSPITAL	K	409,250	FMV
(3) AULTMAN HOSPITAL	P	892,961	FMV
(4) AULTCARE INSURANCE COMPANY	Q	1,392,619	FMV
(5) AULTMAN HOSPITAL	Q	41,141,671	FMV
(6) ORRVILLE HOSPITAL FOUNDATION (DBA AULTMAN ORRVILLE HOSPITAL)	Q	223,452	FMV
(7) AULTMAN MEDICAL GROUP	Q	72,000

Schedule R (Form 990) 2020

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2020

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) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF AULTMAN HEALTH FOUNDATION 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	76
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	60
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	439
6	Total number of volunteers (estimate if necessary) .............	6	302
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	530	7,511
9	Program service revenue (Part VIII, line 2g) .........	51,060,546	53,053,869
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,057,898	3,643,396
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	215,004
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	55,118,974	56,919,780
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,102,393	1,636,198
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	29,026,556	28,994,288
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	25,700,699	27,244,924
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	55,829,648	57,875,410
19	Revenue less expenses. Subtract line 18 from line 12.......	-710,674	-955,630
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	485,704,990	589,960,745
21	Total liabilities (Part X, line 26).............	148,054,830	148,248,868
22	Net assets or fund balances. Subtract line 21 from line 20.....	337,650,160	441,711,877

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 22,282,535 including grants of $ 0 ) (Revenue $ 47,774 )
	WITH 120 EMPLOYEES, THE AULTMAN SYSTEMS AND TECHNOLOGY DEPARTMENT PROVIDES THE TECHNICAL INFRASTRUCTURE FOR BUSINESS AND CLINICAL SYSTEMS THROUGHOUT AHF, ITS SATELLITE FACILITIES AND SUBSIDIARIES. THE SYSTEMS AND TECHNOLOGY TEAM HANDLES EVERYTHING RELATED TO INFORMATION TECHNOLOGY AT AULTMAN HEALTH FOUNDATION - INCLUDING HARDWARE, SOFTWARE DATA SECURITY AND INTERNAL CUSTOMER SUPPORT.

4b	(Code: ) (Expenses $ 4,619,176 including grants of $ 0 ) (Revenue $ 6,004,417 )
	THE AULTMAN SPECIALTY HOSPITAL, LOCATED ON THE MAIN AULTMAN CAMPUS, PROVIDES LONG-TERM ACUTE CARE FOR PATIENTS WITH MEDICALLY COMPLEX CONDITIONS. PATIENTS' AVERAGE LENGTH OF STAY IS 25 DAYS, AND THEY ARE TYPICALLY TRANSFERRED FROM AULTMAN ICU OR STEP-DOWN UNITS OR OTHER LOCAL HOSPITALS. IN 2019, 201 PATIENTS WERE CARED FOR AT THE AULTMAN SPECIALTY HOSPITAL. THE FACILITY'S QUALITY PROGRAM HAS BEEN ENHANCED IN THE AREAS OF IMPROVED PREVENTION OF SKIN BREAKDOWN, VENTILATOR-ASSOCIATED PNEUMONIA, LINE SEPSIS, AND CLOSTRIDIUM DIFFICILE.

4c	(Code: ) (Expenses $ 4,956,483 including grants of $ 0 ) (Revenue $ 12,330 )
	THE 29-MEMBER AULTMAN HEALTH FOUNDATION HUMAN RESOURCES DEPARTMENT PROVIDES SUPPORT SERVICES RELATIVE TO EMPLOYEE BENEFITS, COMPENSATION, EDUCATION AND DEVELOPMENT, EMPLOYEE RECRUITING, NEW-HIRE ORIENTATION, DIVERSITY AND INCLUSION, AND EMPLOYEE EVENTS ACROSS AHF FACILITIES.

	(Code: ) (Expenses $ 15,524,410 including grants of $ 1,636,198 ) (Revenue $ 46,989,348 )
	AULTMAN HEALTH FOUNDATION (AHF) WAS FORMED AS A SUPPORT ENTITY AULTMAN HOSPITAL (AH) AND AHF'S SUBSIDIARIES. THIS STRUCTURE IS COMMON TO MANY HEALTH CARE SYSTEMS. AHF PERFORMS ACTIVITIES THAT DIRECTLY AND INDIRECTLY IMPACT AH. THERE IS A CLOSE WORKING RELATIONSHIP BETWEEN AHF AND AH AND SUBSTANTIAL RESOURCES OF AHF ARE COMMITTED TO FURTHERING THE AH MISSION.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 15,524,410 including grants of $ 1,636,198 ) (Revenue $ 46,989,348 )
4e	Total program service expenses47,382,604

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	5,774,176	7,198,404	301,067

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	7,511

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		7,511

		Business Code
2a	HEALTH SYSTEM ADMINISTRATION	561000	42,918,947	42,918,947
b	PATIENT SERVICE REVENUE	624100	6,004,417	6,004,417
c	OTHER INCOME	561000	3,206,360	3,206,360
d	PROPERTY MANAGEMENT REVENUE	561000	924,145	924,145
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		53,053,869

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,716,097			3,716,097
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses		72,701	7b
c	Gain or (loss)		-72,701	7c
d	Net gain or (loss).........			-72,701			-72,701
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OTHER MISC INCOME		900099	215,004			215,004
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			215,004
12	Total revenue. See instructions.....			56,919,780	53,053,869	0	3,858,400

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,634,698	1,634,698
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	1,500	1,500
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	4,581,810	3,711,266	870,544
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........	19,358,121	15,680,079	3,678,042
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	216,411	175,293	41,118
9	Other employee benefits .......	3,043,263	2,465,043	578,220
10	Payroll taxes ...........	1,794,683	1,453,694	340,989
11	Fees for services (non-employees):
a	Management ......	54,624	44,245	10,379
b	Legal .........	3,816	3,091	725
c	Accounting ...........	171,821	139,175	32,646
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	8,058,325	6,527,246	1,531,079
12	Advertising and promotion ....	76,925	62,309	14,616
13	Office expenses .......	686,555	556,110	130,445
14	Information technology ......	11,871,100	9,615,592	2,255,508
15	Royalties ..
16	Occupancy ...........	1,906,059	1,543,907	362,152
17	Travel ............	151,533	122,742	28,791
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	46,861	37,958	8,903
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	740,696	599,964	140,732
23	Insurance ...	95,905	77,683	18,222
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	598,203	598,203
b	MEDICATION	415,686	415,686
c	EDUCATION	398,914	323,120	75,794
d	RECRUITMENT	255,459	206,922	48,537
e	All other expenses	1,712,442	1,387,078	325,364
25	Total functional expenses. Add lines 1 through 24e	57,875,410	47,382,604	10,492,806	0
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
2	Savings and temporary cash investments .........			573,943	2	1,152,355
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			1,392,630	4	1,588,394
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			1,107,916	7	1,107,916
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			2,367,526	9	2,034,604
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	8,480,803
b	Less: accumulated depreciation	10b	4,728,467	3,403,228	10c	3,752,336
11	Investments—publicly traded securities .			75,268,014	11	163,422,329
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			395,342,700	13	405,407,137
14	Intangible assets ...............			1,716,667	14	1,304,667
15	Other assets. See Part IV, line 11 ...........			4,532,366	15	10,191,007
16	Total assets. Add lines 1 through 15 (must equal line 33)...			485,704,990	16	589,960,745

17	Accounts payable and accrued expenses .....	10,876,281	17	12,154,420
18	Grants payable ...		18
19	Deferred revenue .........	651,731	19	585,469
20	Tax-exempt bond liabilities .........	131,606,087	20	129,429,115
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	4,266,336	23	4,575,770
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	654,395	25	1,504,094
26	Total liabilities. Add lines 17 through 25..	148,054,830	26	148,248,868

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	337,650,160	27	441,711,877
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	337,650,160	32	441,711,877
33	Total liabilities and net assets/fund balances ........	485,704,990	33	589,960,745