Orrville Hospital Foundation

“The orrville hospital foundation, dba aultman orrville hospital (aoh) has a single member, aultman health foundation (ahf). Ahf has a right to participate in aoh's goverance and approve significant decisions of the aoh board of directors.”

“Aoh's sole member, ahf, has the right to appoint or replace the directors of aoh's board from a slate of candidates presented by aoh's board.”

“Aoh's sole member, ahf, has the right to approve the following action of aoh's board: amending or restating the articles of incorporation or the code of regulations; effecting a merger, consolidation, affiliation or change in control with an entity not affiliated with the member; executing the sale, transfer, exchange or other disposition of greater than 5% of aoh's assets; effecting partial or total dissolution; and incurring any debt or indebtness on behalf of the hospital. Only the sole member has the authority to take the following actions: approving appointment or termination of the president and ceo of aoh and giving the final approval of the annual operating and capital budget of aoh.”

“A detail review of the form 990 is performed by an independent cpa firm.aultman health foundation's finance department carefully reviews and analyzes the tax return. The department reconciles the general ledger amounts to the appropriate schedules on the form 990 and compares those amounts to the audited financial statements. In addition, the finance department does a comparative analysis to the prior year return. The analysis and reconciliation schedules along with a complete copy of the 990 are provided to the chief financial officer for review and approval. A complete copy of the 990 is then made available to the board of directors through a secured internet portal prior to the filing date.”

“The 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 aultman orrville hospital code of regulations, the governing document of the board of directors, includes a conflict of interest policy. Pursuant to the policy, board members, officers, and senior staff complete an annual form disclosing any conflicts of interest they may have. The compliance officer 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.”

“Aultman orrville hospital uses the following reference materials for the development of executive compensation: ohio hospital association , mercer integrated health network, including survey data for both hospitals and health plans, and sullivan cotter and associates . 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. Aultman orrville hospital uses the following reference materials for the development of physician compensation: medical group management associates , american medical group association , hospital and healthcare compensation service and sullivan cotter and associates . In addition to salary surveys, aultman orrville hospital also retains an independent consulting firm for physicians compensation services. All physician compensation recommendations are sent to the aultman orrville hospital ceo, aultman health foundation vp of physician services, aultman orrville hospital cfo, and aultman orrville cno for final approval.”

“Aultman orrville hospital makes its governing documents, conflict of interest policy and financial statements available to the public upon request.”

“Marcelle l suppan, dpm is a paid employee of the organization. Edward j. Roth iii, mark d. Wright and matthew a. Stewart are paid employees of a related organization.”

“Since 1999, aultman orrville hospital has been a member of the independent hospital network (ihn), which consists of five area hospitals, sharing a common mission of maintaining local, not-for-profit control. Building on a seventeen year relationship through the ihn, aultman orrville hospital entered into an affiliation agreement to become a subsidiary of the aultman health foundation. The affiliation allows aultman orrville hospital to remain a close-to-home, community hospital while improving access to advanced health care services.”

“Purchased services: program service expenses 984,500. Management and general expenses 230,932. Fundraising expenses 0. Total expenses 1,215,432. Professional fees - physician: program service expenses 1,462,929. Management and general expenses 343,156. Fundraising expenses 0. Total expenses 1,806,085. Professional fees - nonphysician: program service expenses 750,360. Management and general expenses 176,010. Fundraising expenses 0. Total expenses 926,370. Consulting fees: program service expenses 72,760. Management and general expenses 17,067. Fundraising expenses 0. Total expenses 89,827.”

“Interfund transfers -13,159.”

“Section 1.263(a)-1(f) de minimis safe harbor election orrville hospital foundation 832 s. Main street orrville, oh 44667-2208 employer identification number: 34-0733138 for the year ending december 31, 2014 orrville hospital foundation is making the de minimis safe harbor election under reg. Sec. 1.263(a)-1(f).”