2016-11-11T17:10:05-06:00 2015-12-31 ERNST & YOUNG LLP US 950 MAIN AVENUE SUITE 1800 CLEVELAND OH 44113 990 2015-01-01 340714357 Children's Hospital Medical Center of Akron % ALICIA LAMANCUSA VP FINANCE CHIL 3305438171 ONE PERKINS SQUARE AKRON OH 44308 MICHAEL P TRAINER Chief Finan Officer 3305431000 2016-11-11 true Terence M Kennedy P00089502 2168615000 2015 2017-02-10 21:41:12Z WILLIAM CONSIDINE ONE PERKINS SQUARE AKRON OH 44308 906379095 false X AKRONCHILDRENS.ORG X 1897 OH CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ("CHMCA") IS DEDICATED TO IMPROVING THE HEALTH OF CHILDREN THROUGH QUALITY PATIENT CARE, EDUCATION, ADVOCACY, COMMUNITY SERVICE. 32 24 5890 1483 883628 -206694 17901150 34249957 674092478 719630443 11051771 4391873 6708981 7053408 709754380 765325681 1879126 794047 0 0 397045824 440751068 0 0 0 219000234 252042443 617925184 693587558 91829196 71738123 1116607624 1153122950 529777980 500338803 586829644 652784147 X THE MISSION OF CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ("CHMCA") IS TO PROVIDE QUALITY MEDICAL AND SURGICAL CARE FOR INFANTS, CHILDREN, ADOLESCENTS, AND BURN VICTIMS OF ALL AGES, REGARDLESS OF ABILITY TO PAY. CHMCA IS AN INDISPENSABLE, INTEGRATED PEDIATRIC HEALTHCARE DELIVERY SYSTEM SERVING INFANTS, CHILDREN, ADOLESCENTS, AND ADULTS IN AKRON AND NORTHEAST OHIO. ESTABLISHED IN 1890 BY A GROUP OF WOMEN AFFILIATED WITH A LOCAL CHURCH, CHMCA HAS GROWN FROM A TWO-ROOM DAY NURSERY TO A MODERN 400-BED, FULL-SERVICE HOSPITAL. IN ITS 125 YEAR HISTORY, CHMCA HAS RECEIVED UNFAILING COMMUNITY SUPPORT AND OUTSTANDING LEADERSHIP WHICH HAS RESULTED IN CONTINUED IMPROVEMENT IN PATIENT CARE AND THE EXPANSION OF MEDICAL SERVICES. CHMCA IS A NOT-FOR-PROFIT FACILITY WHICH OPERATES TWENTY-FOUR(24) HOURS A DAY, SEVEN(7) DAYS A WEEK. CHMCA ACCEPTS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. DURING THE YEAR ENDED DECEMBER 31, 2015, TOTAL UNCOMPENSATED CARE (INCLUDING CHARITY CARE, ALLOWANCES AND CON false false 186975762 113272251 Program Achievement #1 - Subspecialty Physicians In keeping with Chmca's Mission to provide quality medical and surgical care for babies, children, adolescents, and burn victims of all ages, regardless of the ability to pay, CHMCA offers unique services in a broad range of pediatric subspecialties as described herein. Some of CHMCA's Subspecialty areas include: Ambulatory services, Heart Center, Neurosurgery, Sedation Service, Maternal Fetal Medicine, Care Center, Gastroenterology, Urology, Sports Medicine, Neurology, Nephrology, Endocrinology, Adolescent Medicine, Infectious Diseases, Hematology Services, Pulmonary Medicine, Palliative Care Program, locust Pediatrics, Rheumatology, Clinical Pharmacology and Toxicology, Psychiatric Services, Genetics, Orthopedics and Skeletal Dysplasis. The Showers Family Center for Childhood Cancer and Blood Disorders provides comprehensive care to children, teens and young adults with all types of childhood cancer, sickle cell disease, hemogloginopathies and bleeding/clotting disorders, as well as those who require stem cell/bone marrow transplants. The team includes board-certified pediatric hematologists-oncologists, advance practice nurses, physician assistants, certified pediatric oncology nurses, pharmacists, social workers, clinical research associates, child life specialists, counselors and educators. As a major teaching institution, CHMCA offers fellowship training in pediatric hematology-oncology and is a major pediatric teaching hospital affiliated with Northeast Ohio Medical University. The division of hematology-oncology also actively participates in national clinical trials for childhood cancer and blood disorders, and continues to explore the causes and treatments of these diseases through our basic science research program. As a member of the Children's Oncology Group (COG), we participate in the development of National Cancer Institute-approved treatment protocols and offer the most up-to-date cancer therapies. Our cancer program is one of only 12 Pediatric Cancer Programs in the country as verified by the American College of Surgeons Commission on Cancer. CHMCA's Center for Diabetes and Endocrinology consists of a team of board-certified pediatric endocrinologists, certified nurse practitioners and pediatric nurses who diagnose and treat infants, children and teens. Recognized by the American Diabetes Association for Quality Self-Management Education, our center is backed by a full-service lab, registered dietitians, social worker, child psychologist and others. The most common endocrine disorders we treat are diabetes, short stature, thyroid disease, metabolism disorders and pubertal disorders. In addition, we offer specialized care in bone health, endocrine disorders in cancer survivors and cystic fibrosis patients. CHMCA's NeuroDevelopmental Science Center (NDC) brings together 5 pediatric specialties - developmental-behavioral pediatrics, neurology, neurosurgery, physiatry, and behavioral neuropsychology, under one roof to deliver the best outcomes and quality of life for patients. CHMCA's NDC is dedicated to easing the circumstances each step of the way, from referral to diagnosis to treatment. Our goal is provide care that enriches the quality of life for children and families affected by neurological and developmental disorders. CHMCA's Division of Orthopedics specializes in the diagnosis and surgical and/or non-surgical treatment of all types of bone, joint, muscle and spine disorders and injuries in children, teens and young adults. Our experienced pediatric orthopedic surgeons offer complete care for conditions affecting the musculoskeletal system, with the support of pediatric nurse practitioners, nurses and orthopedic technicians. This includes: pediatric spine trauma and deformity, sports injury reconstruction, musculoskeletal neurology, congenital hand and musculoskeletal deformity, hip reconstruction, chest reconstruction, fragile bone evaluation and treatment, skeletal dysplasia, and brachial plexus treatment. CHMCA's Robert T. Stone Respiratory Center provides services for patients with all types of respiratory illnesses, including allergies, cystic fibrosis, bronchopulmonary dysplasia, and chronic respiratory failure. The Center has a team of doctors, nurse practitioners, nurse clinicians, pulmonary function technicians, dieticians, physical therapists and a social worker. We provide direct and consultative diagnosis and treatment, education, case management, and research. Our Center includes: cystic fibrosis center, which treats patients from birth through adulthood, asthma education program, pulmonary medicine, pulmonary function testing lab, sleep center, and cardiopulmonary exercise testing. CHMCA's Pediatric Urology department diagnoses and treats children and teens with problems related to the genito-urinary systems. Services include laser, laparoscopy, lithotripsy and other minimally invasive techniques to treat diseases. Our staff also uses urodynamic tests to show how well the bladder and sphincter muscles work and to help explain various urinary diseases. During 2015, CHMCA converted its emergency department in the Montrose area into its first pediatric urgent-care center to treat children for minor illnesses and injuries. Throughout the year, two other urgent care locations were opened in Mansfield and Warren. Total urgent care visits were 9,848 in 2015. 110813298 207662709 Program Achievement #2 - Inpatient Services Total Inpatient Days 73,548 (2015) 73,424 (2014) CHMCA's philosophy of care is centered around the families we serve. This means we respect each child and family's individual needs and strive to make the hospital experience as pleasant as possible. The routine care units, which consist of private rooms and accommodations for overnight stay by parents, are based upon the concept of family-centered care. The primary focus of the facility is to provide an environment conducive to pediatric patients, aiding their recovery in a modern hospital setting. Inpatient services include some of the following divisions: Neonatal Intensive Care Unit, Pediatric Intensive Care Unit, Psychiatric Care, Regional Burn Center, and Trauma Services. The 75 bed regional neonatal intensive care unit was built in the new Key Jewelers Pavilion and opened in 2015. Our neonatologists provide the highest level of intensive care for our youngest patients. Our neonatal expertise also expands beyond our NICU in the Kay Jewelers Pavilion on our hospital campus in Akron. We also operate NICU's at Akron General Medical Center, Summa Akron City Hospital and St. Elizabeth Boardman Hospital, as well as special care nurseries at our Beeghly campus hospital, St. Joseph Warren Hospital and Wooster Community Hospital. CHMCA's neonatology division is ranked among the best in the nation, according to the U.S. News and World Report. A transport team from the NICU is also available at all times for transfer of patients by ambulance or helicopter from any one of the thirty-five (35) network hospitals in the area. Total NICU patient days: 2015 2014 Neonatal at Akron 19,067 17,584 Neonatal at AGMC 3,919 4,205 Neonatal at St. E's 5,894 6,518 Neonatal at Summa 5,686 6,070 Neonatal at Beeghly 2,783 4,170 Neonatal at Wooster 446 0 Neonatal at St. Joseph 483 0 The Division of Pediatric Critical Care is responsible for overseeing and delivering care in the Pediatric Intensive Care Unit (PICU). Each year, the PICU cares for about 1,500 children and teens in Northeast Ohio with life-threatening medical and surgical problems. The 25,200 square foot pediatric intensive care unit includes 23 private rooms with pull-out sofas to encourage parents to stay overnight. Total patient days were 21,184 and 21,408 in 2015 and 2014, respectively. Since 1978, the Burn Institute has provided specialized care for burn victims of all ages throughout Northeastern Ohio. CHMCA is one of only two pediatric hospitals in the country that treat adult burn patients. The Burn Institute is verified by the American Burn Association and The Committee on Trauma of the American College of Surgeons, which recognizes individual and institutional commitment to total burn care and a formal system for quality burn care delivery. Each year, more than 250 burn victims are admitted to the Burn Center, which features 12 private patient rooms with bathrooms and accommodations for one parent or family member. The unit also has a treatment room, physical therapy room, operating room and tub room. The Burn Center comprehensively treats seriously burned victims by combining the skills of physicians, nurses, occupational therapists, physical therapists, dieticians, social workers, respiratory therapists, psychologists and psychiatrists. Besides providing expert treatment, the center's staff is actively involved in burn research and burn care training for professional and community groups. Total patient days for the burn center were 2,004 and 1,969 for 2015 and 2014, respectively. The Division of Emergency/Trauma Services supplies the emergency care needs of children from birth to twenty-one (21) years of age. As the sole pediatric institution in the area, the Division of Emergency/Trauma Services is the designated treatment center for all emergent pediatric problems. Children from Akron and the surrounding counties in Northeast Ohio accounted for the majority of the 99,031 visits during 2015. A full-time attending pediatric emergency medicine specialist is on duty twenty-four (24) hours a day involved in the direct care of patients and teaching fellows, residents, and medical students. The Division of Emergency/Trauma boasts one of the nation's first and most successful suture programs using specially trained technicians and nurses to do most of the suturing of lacerations in the emergency setting. They see between 400-750 patients per month who need stitches. Rounding out the specialized medical care in the Emergency Department are child life specialists who are accustomed to explaining procedures to children and comforting parents; social workers trained to identify needs of families and point them to helpful services; and chaplains and bereavement staff who are always on call. CHMCA is verified as a pediatric trauma center by the American College of Surgeons. The pediatric trauma verification is based on its ability to provide quality trauma care to trauma patients and their families from the time of injury, through the acute care phase, into the rehabilitation phase. 83370089 184632798 Program Achievement #4 - Ancillary Some of the key departments of Ancillary include: Centralized Core Lab, Microbiology/Virology labs, Cytogenetics, Radiology Diagnostic Imaging, Radiology MRI, Radiology CT, Radiology Ultrasound, Radiology Nuclear Medicine, Physical Therapy, Speech Pathology, Audiology, Occupational Therapy. The Centralized Core Lab (CCL) includes the Chemistry, Hematology, Coagulation, Urinalysis, Special Chemistry and Blood Bank laboratories. The chemistry analyzers tests for more than 60 different substances found in blood, urine and cerobrospinal fluid specimens. In addition to routine chemistries, testing is performed for therapeutic and immunosuppresive drug monitoring. Instruments are selected to use the smallest amounts of blood for testing in order to minimize blood loss for our pediatric patients. In addition to the CCL, laboratory services are provided by the Infectious Disease Laboratories (Microbiology, Virology, Immunology, and Molecular Diagnostics). The Radiology Division at CHMCA performs a full spectrum of diagnostic imaging procedures inclusive of Diagnostic/Fluoroscopic xrays, CT, Nuclear Medicine, Ultrasound, and MRI. The Radiology division is staffed with licensed Diagnostic Imaging Technologists and all our Pediatric imaging procedures are read by qualified Pediatric Radiologists with Board Certification and Certificae of Added Qualification (CAQ) credentials inclusive of expertise in specific radiology subspecialty areas of imaging. CHMCA's physical and occupational therapists are devoted to providing quality care in the hospital and to outpatients, schools and community programs. Our staff of pediatric therapists can provide specialized treatment from birth to age 21. We are affiliated with nine universities for teaching of students. Incorporating the support of families and skills of various medical professionals, the Occupational Therapy, Physical Therapy, Speech, Audiology, and Social Services staff strive to provide patients with the skills needed to overcome a variety of developmental, physical, and emotional disabilities. The Family Child Learning Center (FCLC), a cooperative effort of CHMCA and Kent State University, offers a host of therapy and educational services to handicapped infants, preschoolers and their families. Therapists and educators work together to significantly enhance the development of these children at an early age. FCLC provides an educational training ground for graduate students in education, speech pathology, motor learning and physical and occupational therapy. 180293143 214062685 Other Revenue 180293143 794047 214062685 561452292 true true false true false false false false false true true false false true true false false true false false true false false false true false true true true false true true false true false false false false false false true false false false false false false true true true false false true 300 0 true 5890 true true true true CJ false false false true true false false false false X 32 24 false false false false true true true true true false true true false true true true true false true true false OH X ALICIA LAMANCUSA VP FINANCE 3305438171 ONE PERKINS SQUARE AKRON OH 44308 X WILLIAM CONSIDINE PRESIDENT & CEO 40.0 10.0 X X 2096548 0 -46171 JOHN CROW MD CHAIRMAN,PEDIATRIC SURGERY 40.0 0.0 X 1136042 0 37184 NORMAN CHRISTOPHER MD CHAIRMAN, DEPT OF PEDS 40.0 0.0 X 491906 0 38117 ROBERT MCGREGOR MD CHIEF MEDICAL OFFICER 40.0 0.0 X X 538525 0 32676 MARY LINK GENERAL COUNSEL/ASST SECRETARY 40.0 2.0 X X 394030 0 28180 ROBERT STONE MD ASST CHAIR, COMM AFFAIRS 20.0 1.0 X 116113 0 5233 RICHARD GRIGG DIRECTOR 3.0 0.0 X 0 0 0 ROBERT TRABUCCO DIRECTOR/CHAIRMAN 21.0 1.0 X X 0 0 0 STEPHEN MYERS DIRECTOR/CHAIR OF FINANCE 8.0 0.0 X X 0 0 0 JOAN LAUCK DIRECTOR/SECRETARY 2.0 0.0 X X 0 0 0 ELINORE MARSH STORMER DIRECTOR 5.0 0.0 X 0 0 0 VIRGINIA ALBANESE DIRECTOR/VICE CHAIRMAN 6.0 0.0 X X 0 0 0 ROBERT BERK DIRECTOR 5.0 2.0 X 0 0 0 KRISTINA BUEHRLE DIRECTOR 13.0 0.0 X 0 0 0 JOHN P DELANEY DIRECTOR 3.0 0.0 X 0 0 0 PATRICIA GRANT DIRECTOR 15.0 1.0 X 0 0 0 WILLIAM HOPKINS DIRECTOR 7.0 0.0 X 0 0 0 WILLIAM KELLEHER DIRECTOR 3.0 0.0 X 0 0 0 DUANE ISHAM DIRECTOR 11.0 0.0 X 0 0 0 DALE KOBLENZER DIRECTOR 6.0 0.0 X 0 0 0 SCOTT LEVIN DIRECTOR 5.0 0.0 X 0 0 0 KATHLEEN LANE DIRECTOR 13.0 0.0 X 0 0 0 PHILIP MAYNARD DIRECTOR 8.0 12.0 X 0 0 0 GREGORY MCDERMOTT DIRECTOR 10.0 1.0 X 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SURGICAL SUBSPECIALTY 40.0 0.0 X 247806 0 26288 LINDA HETSON VP PROFESSIONAL SERVICES 40.0 0.0 X 228710 0 138305 TSULEE CHEN MD DIRECTOR, NEUROSURGERY 40.0 0.0 X 839174 0 21629 ANTON MILO MD DIRECTOR OF ENT 40.0 0.0 X 1398161 0 35944 MARK MCCOLLUM MD GENERAL PEDIATRIC SURGEON 40.0 0.0 X 1333002 0 37184 PHILIP SMITH MD DIRECTOR OF HEART CENTER 40.0 0.0 X 1122449 0 47260 ROBERT PARRY PEDIATRIC GENERAL SURGEON 40.0 0.0 X 965299 0 38168 15582870 0 1002891 659 false true false MARCUS THOMAS LLC 4781 RICHMOND ROAD CLEVELAND OH 44128 BROADCAST MEDIA 4987434 WELTYBOLDT LLC 3421 RIDGEWOOD ROAD FAIRLAWN OH 44333 CONSTR OF NEW TOWER 3993759 WELTY BUILDING COMPANY LTD 3421 RIDGEWOOD ROAD FAIRLAWN OH 44333 CONSTR OF NEW TOWER 3211988 WADSWORTH PEDIATRICS 1225 HIGH STREET WADSWORTH OH 44281 PHYSICIAN FEES 1549000 SHIFTWISE PO BOX 70870 ST PAUL MN 55170 WORKFORCE MGMT SERV 1387617 36 X 250190 29580083 3786058 633626 34249957 SUBSPECIALTY PHYSICIANS 900099 113272251 113272251 INPATIENT SERVICES 900099 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OF THAT AMOUNT, $449,089 PERTAINED TO DUES, $93,273 RELATED TO VARIOUS LOBBYING EXPENSES AND $132,150 WAS PAID FOR LOBBYING EFFORTS AND VARIOUS COMMUNICATIONS ON BEHALF OF CHMCA WITH GOVERNMENTAL AUTHORITIES. THOSE COMMUNICATIONS AND LOBBYING EFFORTS INVOLVE THE FOLLOWING: *PREPARED TESTIMONY FOR CHMCA TO TESTIFY BEFORE THE YOUTH SPORTS CONCUSSION AND HEAD INJURY RETURN TO PLAY GUIDELINES COMMITTEE *CONGRESSIONAL MEETINGS WITH FOLLOW UP FOR CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION PROGRAM SUPPORT IN THE FY15 OMNIBUS BILL *ATTENDED MEETINGS AND BRIEFINGS WITH THE HOUSE ENERGY & COMMERCE COMMITTEE ON KEY LEGISTLATION, INCLUDING THE COMPREHENSIVE HEALTH INNOVATION PROPOSAL *MET WITH APPROPRIATION COMMITTEE MEMBERS AND STAFF TO ADVOCATE FULL FUNDING OF THE CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION PROGRAM *MET WITH CONGRESSIONAL LEADERS AND THEIR STAFF TO ADVOCATE SPONSORSHIP OF ACE KIDS ACT *ATTENDED HEARINGS AND BRIEFINGS ON THE BUDGET NEGOTIATIONS THAT WOULD IMPACT FUNDING LEVELS FOR FY16 AND FY17. THE FOLLOWING ARE 2015 LOBBYING EXPENSES: ASSOCIATION OF AMERICAN MEDICAL COLLEGES $ 224 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS 34,153 AMERICAN HOSPITAL ASSOCIATION 9,683 OHIO CHILDREN'S HOSPITAL ASSOCIATION 42,047 OHIO HOSPITAL ASSOCIATION 4,666 CITIZENS FOR METRO PARKS 2,500 SUBTOTAL $93,273 LOBBYIST - CAPITAL CONSULTING GROUP 60,150 LOBBYIST - WALSH CAPITOL CONSULTING 72,000 TOTAL $225,423 ASSOCIATION OF AMERICAN MEDICAL COLLEGES, NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND AMERICAN HOSPITAL ASSOCIATION ARE NATIONAL ORGANIZATIONS THAT CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON HAS MEMBERSHIP. ALONG WITH OTHER HOSPITALS AS MEMBERS, THESE NATIONAL ORGANIZATIONS EXPRESS CONCERNS OF HEALTHCARE PROVIDERS IN ADVOCACY AND REPRESENTATION TO NATIONAL AND/OR STATE LEGISLATURES ON HEALTHCARE ISSUES THAT AFFECT US. AS AN EXAMPLE, THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES HAS BEEN SUCCESSFUL IN MINIMIZING GRADUATE MEDICAL EDUCATION SPENDING CUTS IN THE FEDERAL BUDGET LEGISLATION. THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND AMERICAN HOSPITAL ASSOCIATION HAVE BEEN A CONSTANT AND PERSUASIVE VOICE IN CHAMPIONING THE NEEDS OF CHILDREN AND THE HOSPITALS THAT CARE FOR THEM. OHIO CHILDREN'S HOSPITAL ASSOCIATION AND OHIO HOSPITAL ASSOCIATION ARE STATE OF OHIO ORGANIZATIONS THAT EXPRESS THE VIEWS OF OHIO CHILDREN'S HOSPITALS FOR MEDICAID AND CHILD HEALTHCARE ISSUES. LOCAL AGENCIES IN SUMMIT COUNTY, OHIO PROVIDE SERVICES TO RESIDENTS. AS A CORPORATE CITIZEN, THE EFFECT OF THE SUCCESS OR FAILURE OF THESE ISSUES HAS IMPLICATIONS ON OUR BUSINESS AND SERVICES WE PROVIDE. 84300290 8366805 -2702700 20432316 69532079 71912635 16013945 215179 3841469 84300290 55185519 12047723 8291351 3611958 71912635 48292758 7590996 3474164 4172399 55185519 42191502 11512095 -1529858 3880981 48292758 0.04980 0.20390 0.74630 false true true 12674684 12674684 506505361 232312269 274193092 13338268 4163947 9174321 309784409 213948822 95835587 14815328 2719075 12096253 403973937 BENEFICIAL INT IN FOUNDATION 109515113 UNAMORT PRACTICE RIGHTS SUMMA 3884483 DEFERRED FINANCING COSTS 2098558 OTHER ASSETS 1206409 116704563 0 DEFERRED BENEFIT PENSION LIABI 124689354 POST RETIREMENT PLANS 23495001 PROFESSIONAL LIABILITY RESERVE 2282000 OTHER LIABILITIES 30954180 181420535 Part V, Line 4 - Intended Use of Endowment Funds Temporarily restricted funds are subject to restrictions imposed by the donor. These funds are held until the specific purpose is met and they are released from restrictions. Permanently restricted funds are funds that are invested in perpetuity and are not available to fund any current operations. The earnings from the endowment funds can be used for the specific purpose imposed by the donor. The Board Designated funds include funds from unrestricted sources that have been internally designated to function as endowments. These funds are to be used for their sole purpose as they are designed for. CHMCA does have a policy in place to monitor all unrestricted, temporarily and permanently restricted funds. Part X, LINE 2 - FIN 48 CHMCA prepares consolidated financial statements including their affiliated subsidiaries. CHMCA adopted FIN 48 in 2007 and no disclosures were required under GAAP as CHMCA does not have any material tax contingencies that are required disclosures in the footnotes. 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X X X X true true X X true X Part V, Section C for full URL X X X X X true X false X X X X true X false false Facility Group B - Mahoning Valley 2 false false true X X X X X X X X X 13 true false true true X see Part V, Section C for Full URL X true 13 true see Part V, Section C for full URL false true X 200. 300. X X X X true true X X true X see Part V Section C for full URL X X X X X true X false X X X X true X false false Part V, Section B Group A Part V, Section B. Facility Policies and Practices, Community Health Needs Assessments (CHNA) CHMCA (#1); Children's Specialty Care Nursery AGMC (#5); Akron Children's Specialty Care Nursery @ Summa Akron City Hospital (#4); Children's Pediatric Unit Aultman (#6);Children's @ Wooster Community Hospital(#8) Line 5: Yes - Interviews were conducted with community leaders in a five-county area from March - April 2013 to gain insight on what they thought were significant health needs of children and adults in their communities, the factors that affect those health needs, other existing community health needs assessments, possible collaboration opportunities, and to get suggestions on what the hospitals can do to address the significant health needs identified in the CHNA. Focus Groups were conducted with 107 community residents in the same five-county area from April - May 2013. In addition, a questionnaire was distributed to the focus group participants to gather demographic information and basic perceptions of community health. Due to the observed information gap in the epidemiologic data on the health of children, adult and child substance abuse issues, and child mental health issues, several questions were asked to probe more deeply on these issues. The discussion guide, questionnaire, and protocol were reviewed and approved by the Kent State University Institutional Review Board. Leaders Interviewed: Executive Director, Mental Health and Recovery Services Board of Stark County School Nurse and Coordinator of Health Services, Canton City Schools Director, Summit County Job and Family Services Executive Director for Business Affairs, Akron Public Schools Administrator, Portage County Job and Family Services Nursing Director for the Medina County Educational Services Center, Medina City School District Medicaid Eligibility Services Administrator, Medina County Job and Family Services Executive Director, Portage County Mental Health and Recovery Board School Nurse, Canton City School Vice President for Business Development, Robinson Memorial Hospital Deputy Health Commissioner for Planning, Summit County Public Health Director of Business Services, Kent City School District Health Commissioner, Medina County Health Department Executive Director, County of Summit Alcohol, Drug Addiction & Mental Health Services Board Health Commissioner, Stark County Health Department Superintendent, Wooster City School District Director, Wayne County Family and Children First Council Community Resident Focus Groups: Community residents were recruited by posting and distributing flyers in the community. 35% of participants were from Summit County, 16% from Wayne County, 11% from Medina County, 28% from Stark County and 10% from Portage County. The average number of years the participants lived in their home county was 25 years. Line 6a: Yes Akron General Health System 400 Wabash Avenue Akron, Ohio 44307 Summa Health System 525 East Market Street Akron, Ohio 44304 Line 6b: Yes Kent State University of Public Health 800 East Summit Street Akron, Ohio 44240 Line 7(a)& Line 10 -Yes - Posted on our external website to https://www.akronchildrens.org/cms/community-needs-assessment/index.html Line 11 - Yes - The measured indicators in the 2013 CHNA have been addressed through CHMCA's clinical and programmatic efforts for many years. Our highly-qualified medical staff and professionals provide world-class patient centered care to address each of these indicators through our Center for Orthopedics and Sports Medicine, Center for Diabetes and Endocrinology, Robert T. Stone MD Respiratory Center, Heart Center, Division of Pediatric Psychiatry and Psychology, and the Showers Family Center for Childhood Cancer and Blood Disorders. Our 2013 CHNA identified and prioritized several community health needs. We drafted, and our Board of Directors approved implementation strategies that focused on addressing conditions related to diabetes, asthma, behavioral and mental health, and infant mortality. The remaining identified needs from the 2013 CHNA include conditions related to birth risk factors, child development, child lifestyle factors, substance abuse, abuse and neglect, access to health care, and environmental factors, were not formally addressed through implementation strategies. Although the reasons for this are varied to include a lack of funding and staff, and a lower priority for certain conditions because of our focus on pediatric conditions as a children's hospital, we will continue to look to CHNA data, as well as other data sources, on these conditions to guide our efforts and advance our mission of improving the health of the communities we serve. Specific Needs Not Addressed Although all of the community health needs identified by the CHNA and deliberated by our hospital teams are important, three emerged as high-priority areas based on the hospital's current activities, the potential for community impact, and available resources. Consequently, several areas will not be addressed in this Implementation Strategy. These include health areas that ranked lower during the prioritization process, health areas that were beyond the scope of the hospital, and health areas that require more resources than what are available: - Abuse & Neglect - Access to Health Care o Health Insurance Coverage o Access to Dental Care o Mental Health Insurance Coverage - Birth Risk Factors o Maternal Tobacco Smoking o First Trimester Prenatal Care - Child Development o Underweight - Child Lifestyle Factors o Overweight & Obesity o Exercise o Nutrition - Environmental Factors o Access to Healthy Foods - Substance Abuse o Alcohol Abuse & Excessive Drinking o Prescription Drug Abuse o Opioid Drug Abuse Additionally, CHMCA's clinicians do not provide care services for pregnant women, other than those whose babies have been diagnosed before birth or prenatally with a condition or disease that must be monitored by our Maternal Fetal Medicine (MFM) Center or Genetics Center. Therefore, we will not be able to impact the service area's rate of infants born at low birth weights or very low birth weights (other than caring for them after birth), the rate of preterm births (other than those mothers and babies being followed by our MFM Center), or the rate of pregnant women receiving prenatal care (other than those seen by MFM Center) or the rate of births to women who smoke. We do care for babies born at low and very low birth weights and preterm infants requiring hospitalization in the Neonatal Intensive Care Unit (NICU) on the Akron campus or NICUs that we operate at Akron General Health System, Summa Health System, St. Elizabeth Hospital in Youngstown, and the special care nursery at our Mahoning Valley Campus in Boardman. Data Limitations and Gaps Due to limited resources and time constraints, data was not available for every vulnerable population, such as the homeless or refugee populations. Where available, the most current data was used to determine the health needs of the community. Although the data available is rich with information, not surprisingly, data gaps and limitations existed that impacted the ability to conduct a more thorough and rigorous assessment. These include: 1. Pediatric data related to substance abuse (alcohol abuse and excessive drinking, prescription drug abuse and opioid drug abuse) are not readily available. Some data are available through the Ohio Department of Health Youth Risk Surveillance Survey. However, this data is limited and under sampled, not adequately representing the communities or specific populations. 2. County-wide data that characterize health risk and lifestyle behaviors like nutrition, exercise, and sedentary behaviors are not available for children. 3. Behavioral Health data was provided through the Ohio Hospital Association (OHA). The limitation of this data is that it is only data from reporting OHA hospitals. Therefore, one of the largest behavioral health agencies in the state, does not report data to the OHA. Therefore, the mental health data is skewed especially for Columbiana, Mahoning and Trumbull counties since a facility is located in Youngstown and many local children are referred there. 4. Due to time constraints and limited resources, we were unable to access pediatric Medicaid data that would have allowed us to more specifically target this vulnerable population. 5. County and State-wide chronic disease data are not available for children. 6. Injury data was fragmented and not readily available. Line 13 (h) - In circumstances where a family may not be eligible for charity care based solely on income or residence, but where the pursuit of payment would adversely affect the well being of the patient or his or her family, or cause undue hardship for the patient and or/family, Hospital management may approve charity care based on documented extenuating circumstances. Line 16b - Yes https://www.akronchildrens.org/cms/content/financia Part V. Section B Group B Part V, Section B. Facility Policies and Practices, Community Health needs Assessments Children's - Beeghly Campus (#2) & Children's at St. Elizabeth (#3); Children's at Mercy Health's St Joseph Hospital (#7) Line 5 - Yes - In addition to examining county-level epidemiologic data, interviews were conducted with community leaders in July - August 2013 to gain their insight on what they thought were the significant health needs of children and adults in their communities, the factors that affect those health needs, other existing community health needs assessments, possible collaboration opportunities, and to get suggestions on what the hospitals can do to address the significant health needs identified in the CHNA. These community leaders represent the broad interests of the communities served by the hospital facility including the medically underserved, low-income persons, minority groups, those with chronic disease needs, and leaders from local public health agencies and departments who have special knowledge and expertise in public health and children's health issues. Leaders Interviewed: Youngstown City Health District, Acting Health Commissioner Youngstown/Warren Regional Chamber, President & Chief Executive Officer Pediatric Associates of Youngstown, Physician Mahoning County Children's Services, Quality Improvement Supervisor Help Hotline Crisis Center, Chief Executive Officer Mahoning County District Board of Health, Health Commissioner Trumbull County Women, Infants, and Children (WIC) Program, Director Trumbull County Mental Health and Recovery Board, Director of Evaluation & Quality Improvement Trumbull County Children's Services, Executive Director St. Joseph Health Center, Chair of Pediatrics Columbiana County Mental Health and Recovery Services Board, Executive Director Portage/Columbiana Counties Women, Infants, and Children (WIC) Program, Director The Morning Journal, Editor Salem Community Hospital, Vice President for Medical Affairs Columbiana County Educational Service Center, Superintendent Columbiana County Department of Job and Family Services, Children's Services Administrator Coordinated Action for School Health (CASH) Coalition, Coordinator Columbiana County Health Department, Health Commissioner Community Resident Focus Groups In addition to the input from community leaders, focus groups were conducted with community residents in August - September 2013 to get their input on what they thought were the significant health needs of children and adults in their communities, the factors that affect those needs, the solutions they thought would solve those needs, and what the hospitals and other community groups could do to address those needs. Due to the observed information gap in the epidemiologic data on the health of children, adult and child substance abuse issues, and adult and child mental health issues, several questions were asked to probe more deeply on these issues. In addition, a questionnaire was distributed to focus group participants to gather demographic information and basic perceptions of community health. The discussion guide, questionnaire, and protocol were reviewed and approved by the Kent State University Institutional Review Board. A total of 82 people participated in the Community Resident Focus Groups. Fifty percent of participants were from Trumbull County, 31.7% from Mahoning County, and 18.3% were from Columbiana County. The average number of years that participants lived in their home county was 36.6 years. Six percent of the participants were African American, 90.2% were Caucasian, and 2.4% were Hispanic. Line 6(b) Kent State University of Public Health 800 East Summit Street Kent, Ohio 44240 Line 7(a)& Line 10 - Yes - https://www.akronchildrens.org/cms/community-needs-assessment/index.html Line 11: The measured indicators in the 2013 CHNA have been addressed through CHMCA's clinical and programmatic efforts for many years. Our highly-qualified medical staff and professionals provide world-class patient centered care to address each of these indicators through our Center for Orthopedics and Sports Medicine, Center for Diabetes and Endocrinology, Robert T. Stone, MD Respiratory Center, Heart Center, Division of Pediatric Psychiatry and Psychology, and the Showers Family Center for Childhood Cancer and Blood Disorders. Our 2013 CHNA identified and prioritized several community health needs. We drafted, and our Board of Trustees approved, implementation strategies that focused on addressing conditions related to diabetes, asthma, behavioral and mental health, and infant mortality. The remaining identified needs from the 2013 CHNA, include conditions related to child lifestyle factors, substance abuse, sexually transmitted diseases, access to health care, and environmental factors, were not formally addressed through implementation strategies. Although the reasons for this are varied to include a lack of funding and staff, and decisions based on conditions of priority, we will continue to look to CHNA data, as well as other data sources, on these indicators to guide our efforts and advance our mission of improving the health of the communities we serve. Specific Needs Not Addressed Although all of the community health needs identified by the CHNA and deliberated by our hospital teams are important, three emerged as high-priority areas based on the hospital's current activities, the potential for community impact, and available resources. Consequently, several areas will not be addressed in this Implementation Strategy. These include health areas that ranked lower during the prioritization process, health areas that were beyond the scope of the hospital, and health areas that require more resources than what are available: - Access to Health Care o Health Insurance Coverage o Access to Dental Care o Mental Health Insurance Coverage o Number of Pediatric Specialists - Child Lifestyle Factors o Overweight & Obesity o Exercise o Nutrition - Substance Abuse o Opioid Drug Abuse - Sexually Transmitted Diseases o Adolescent Gonorrhea - Environmental Factors o Access to Healthy Foods Additionally, CHMCA's clinicians do not provide care services for pregnant women, other than those whose babies have been diagnosed before birth or prenatally with a condition or disease that must be monitored by our Maternal Fetal Medicine (MFM) Center or Genetics Center. We do care for babies born at low and very low birth weights and preterm infants requiring hospitalization in the NICU on the Akron campus or NICUs that we operate at Akron General Health System, Summa Health System and St. Elizabeth Hospital in Youngstown, and the special care nursery at our Mahoning Valley Campus in Boardman. Data Limitations and Gaps Due to limited resources and time constraints, data was not available for every vulnerable population, such as the homeless or refugee populations. Where available, the most current data was used to determine the health needs of the community. Although the data available is rich with information, not surprisingly, data gaps and limitations existed that impacted the ability to conduct a more thorough and rigorous assessment. These include: 1. Pediatric data related to substance abuse (alcohol abuse and excessive drinking, prescription drug abuse and opioid drug abuse) are not readily available. Some data is available through the Ohio Department of Health Youth Risk Surveillance Survey. However, this data is limited and under sampled, not adequately representing the communities or specific populations. 2. County-wide data that characterize health risk and lifestyle behaviors like nutrition, exercise, and sedentary behaviors are not available for children. 3. Behavioral Health data was provided through the Ohio Hospital Association (OHA). The limitation of this data is that it is only data from reporting OHA hospitals. Therefore, one of the largest behavioral health agencies in the state, does not report data to the OHA. Therefore, the mental health data is skewed especially for Columbiana, Mahoning and Trumbull counties since a facility is located in Youngstown and many local children are referred there. 4. Due to time constraints and limited resources, we were unable to access pediatric Medicaid data that would have allowed us to more specifically target this vulnerable population. 5. County and State-wide chronic disease data are not available for children. 6. Injury data was fragmented and not readily available. Line 13 (h) - In circumstances where a family may not be eligible for charity care based solely on income or residence, but where the pursuit of payment would adversely affect the well being of the patient or his or her family, or cause undue hardship for the patient and or/family, hospital management may approve charity care based on documented extenuating circumstances. Line 16b - Yes - https://www.akronchildrens.org/cms/content/financial-services/index.html Line 16 (i) - Yes - CHMCA 46 CHMCA Partial Hospitalization Program #7 388 South Main Street Suite 205 Akron OH 44311 Behavorial Health Day Programs CHMCA Montrose Urgent Care #28 4125 Medina Road Akron OH 44333 Urgent Care CHMCA ACHP - New Philadelphia #6 1045 W High Avenue New Philadelphia OH 44663 General Outpatient Services CHMCA ACHP - Green #4 1600 E Turkeyfoot Lake Road Akron OH 44312 General Outpatient Services CHMCA ACHP - Fairlawn #5 701 White Pond Drive Suite 100 Akron OH 44320 General Outpatient Services CHMCA ACHP - Hudson #9 1365 Corporate Drive Suite A Hudson OH 44236 General Outpatient Services CHMCA Hudson Specialties #2 5655 Hudson Drive Hudson OH 44236 Special Outpatient Services CHMCA ACHP - Warren #10 5000 E Market st Suite 30 Warren OH 44484 General Outpatient Services CHMCA ACHP - East Akron #13 891 East Exchange Street Akron OH 44311 General Outpatient Services CHMCA ACHP - Wooster #18 128 E Milltown Road Suite 209 Wooster OH 44691 General Outpatient Services CHMCA ACHP - Medina #16 3443 Medina Road Suite 115 Medina OH 44256 General Outpatient Services CHMCA ACHP - Boardman #11 6505 Market Street Bldg C Suite 210 Boardman OH 44512 General Outpatient Services CHMCA ACHP - Barberton #23 62 Conservatory Dr Bldg D Suite A Barberton OH 44203 General Outpatient Services CHMCA ACHP - Ellet #22 1463 Canton Road Suite A Akron OH 44312 General Outpatient Services CHMCA ACHP - Twinsburg #19 8054 Darrow Road Suite 3 Twinsburg OH 44087 General Outpatient Services CHMCA ACHP - Kent #24 1951 State Rt 59 Kent OH 44240 General Outpatient Services CHMCA ACHP - Ashland #26 2212 Mifflin Avenue Suite 235 Ashland OH 44805 General Outpatient Services CHMCA ACHP - Wadsworth #21 323 High Street Suite A Wadsworth OH 44281 General Outpatient Services CHMCA ACHP - North Canton #8 6046 Whipple Ave NW Bldg B North Canton OH 44720 General Outpatient Services CHMCA ACHP - Tallmadge #30 143 Northeast Ave Bldg D 102 Tallmadge OH 44278 General Outpatient Services CHMCA ACHP - Streetsboro #31 9318 State Rt 14 Streetsboro OH 44241 General Outpatient Services CHMCA Millersburg Hemophilia Clinic #1 1261 Wooster Road Suite 220 Millersburg OH 44654 Single Specialty Outpatient CHMCA ACHP - Ravenna #29 6847 N Chestnut Street Suite 200 Ravenna OH 44266 General Outpatient Services CHMCA Care Center Stark County #15 213 Market Avenue N Suite 200 Canton OH 44702 Single Specialty Outpatient CHMCA ACHP - Brecksville #32 7001 s Edgerton Road Suite 500 Brecksville OH 44141 General Outpatient Services CHMCA ACHP - Alliance #12 1826 S Arch Avenue Alliance OH 44601 General Outpatient Services CHMCA ACHP - Solon #36 34125 Solon Road Solon OH 44139 General Outpatient Services CHMCA Beachwood Specialties #27 23250 Chagrin Blvd Building 5 Beachwood OH 44122 Specialty Outpatient Services CHMCA Boardman Medical Pavilion #3 8423 Market Street Bldg C Suite 30 Boardman OH 44512 General Outpatient Services CHMCA ACHP - Perry #17 125 Whipple Ave S W Canton OH 44708 General Outpatient Services CHMCA Orthopedic Specialty Canton #25 4455 Dressler Road Canton OH 44718 Single Specialty Outpatient CHMCA Aultman Hospital Specialties #37 2600 6th Street SW Canton OH 44710 Specialty Outpatient Services CHMCA Lake Health TriPoint Med Ctr #38 7590 Auburn Road Suite 214 Painesville OH 44077 Single Specialty Group O/P CHMCA Medina Specialties #39 3780 Medina Road Suite 105 Medina OH 44256 Specialty Outpatient Services CHMCA - AGMC Wellness - Rehab #40 4125 Medina Road Akron OH 44333 Physical Rehab Services CHMCA Ctr for Allergy & Immunology #14 130 West Exchange Street Akron OH 44308 Single Specialty Group CHMCA Medina Subspecialties #41 3780 Medina Road Suite 240 Medina OH 44256 Specialty Outpatient Services CHMCA MFM Wooster Community #42 546 Winter St Suite 10 Wooster OH 44691 Single Specialty Outpatient CHMCA Warren Subspecialties #20 5000 E Market St Unit 30 Warren OH 44691 Specialty Outpatient Services CHMCA Norwalk Subspecialties #43 282 Benedict Avenue Norwalk OH 44857 Specialty Outpatient Services CHMCA Life Center Plus #44 5133 Darrow Rd Hudson OH 44236 Single Specialty Outpatient CHMCA Sharon Regional Health Ctr #45 740 E State St Sharon PA 16146 Single Specialty Unit CHMCA ACHP - Ontario #33 2003 W 4th Street Ontario OH 44906 General Outpatient Services CHMCA Mansfield Subspecialties #34 371 Cline Avenue Mansfield OH 44907 Specialty Outpatient Services CHMCA ACHP - Warren West #35 661 Mahoning Avenue NW Warren OH 44483 General Outpstient Services CHMCA MFM Mercy Health #46 1330 Mercy Drive NW Suite 506 Canton OH 447082685 Single Specialty Outpatient Part I, Line 6a - Related Organization For the past several years, the hospital has prepared and filed a community benefit report with the Ohio Hospital Association for the hospital and its affiliates. The CHMCA published Community Benefit Report for Group A - Akron area and associated affiliates as well as for Group B - Mahoning Valley area and associated affiliates was posted to the CHMCA website, making it available to the public. Part I, Line 7, column (f) - Exclusions from % of Total Expenses Bad Debt expenses of $0 are included in the 990, Part IX, Line 25, and excluded from the percentage calculation on Schedule H, Part I, Line 7 (f) and Part II, column (e). Bad Debt expenses have been excluded from the calculations in the 990, Part IX, Line 25. Part I, Line 7 (a) Charity Care @ Cost We believe that applying a cost-to-charge ratio developed for the hospital facility from the Ohio Medicaid cost report to hospital charity charges, as reported in detail schedules used in the preparation of the Audited Consolidated Financial Statements and other information is the most accurate costing methodology to calculate gross charity care at cost for the period. Total hospital costs from the Ohio Medicaid cost report used in this calculation include only allowable and reimbursable costs. The Hospital Care Assurance Program (HCAP) is Ohio's methodology to provide additional payments to hospitals that provide a disproportionate share of uncompensated care to the indigent and uninsured. The estimated HCAP amount applicable to charity care is reported as direct offsetting revenue to charity care expense. Part I, Line 7 (b) Unreimbursed Medicaid & 7 (c) Other Means Tested We believe that reporting program charges, costs and payments directly from CHMCA's Ohio Medicaid cost report along with similar calculations for services rendered by hospital employed physicians and other professional providers and services rendered to out-of-state Medicaid enrollees is the most accurate methodology to calculate unreimbursed Medicaid and other means-tested government program costs. Medicaid costs reported as Total Community Benefit Expense have been reduced by estimated health professions costs included in the Ohio Medicaid cost report and Medicaid revenues reported as direct offsetting revenue has been reduced by estimated Medicaid revenues related to health professions education. To avoid double counting of costs reported elsewhere in this schedule, gross costs for other reportable items have been reduced by the total government payor mix percentage of (55.20%) as reported on our internal payor mix report. Part I, Line 7g - Subsidized Health Services CHMCA is a free-standing children's hospital and an Ohio Medicaid disproportionate share hospital that provides specialty care to pediatric patients in our service area. In addition to providing this care to pediatric patients, CHMCA provides care to both adult and pediatric patients in our Regional Burn Center. As a result, the unreimbursed costs of providing subsidized services to Medicaid enrollees in our neonatal intensive care unit, pediatric intensive care unit, distinct part psychiatric care unit, burn intensive care unit, outpatient End Stage Renal Disease program, as well as our emergency and trauma services are reported as unreimbursed Medicaid costs. The unreimbursed costs of treating Medicare and Medicare Advantage Plan enrollees in our Regional Burn Center and End Stage Renal Disease programs are reported in Part III, Section B, Medicare. Part I, Line 7h - Health Professions Education: The total costs of health professions education is reported as a total community benefit expense and direct offsetting revenues including Medicare and estimated Medicaid revenues related to health professions education. Part II - Community Building Activities Staying true to our mission, everything done by CHMCA is intended to benefit the communities we serve. Our primary benefit to each community is providing access to world-class health care to the children in the regions we serve. Our efforts include: A. Leadership development, under which we support various community-based programs that specifically develop community leaders, including such programs as Leadership Akron (for community leadership) and the Child & Family Leadership Exchange (for clinical and social service leadership). We support and are actively involved in initiatives such as Torchbearers, which is focused on developing and retaining strong community leadership. B. Coalitions and partnerships, in which CHMCA is strongly represented in committees and task forces assigned to address specific health indicators and conditions, as well as, certain divergent populations throughout our region, state, as well as, nationally and internationally. As a teaching hospital, we partner with dozens of higher education institutions in providing training and hands-on instruction and shadowing opportunities for students who embark on health care careers. C. General community support, under which we provide financial and staff support for various community based initiatives, generally related to the healthy development of young people and their families in the service area. D. Community health improvement, under which we support a number of multi-agency and governmental initiatives to encourage fitness activities, health screenings, and related activities. E. Workforce development through initiatives such as Akron Healthcare in Progress (HIP), a collaborative effort of primary, secondary, and higher education, and Akron area hospitals, aimed at exposing and preparing a diverse group of students, representative of the community, for careers in the full range of health care, from skilled trades to medicine and nursing, demonstrate our effort and commitment in developing and retaining continuing leadership. Part III, Line 2 & 4 - Bad Debt Expense Explanation We believe that applying a cost-to-charge ratio developed for the hospital facility from the Ohio Medicaid cost report to CHMCA's provision for bad debts is the most accurate costing methodology to calculate bad debt at cost for the period. Total hospital costs from the Ohio Medicaid cost report used in this calculation include only allowable and reimbursable costs. The Hospital Care Assurance Program (HCAP) is Ohio's methodology to provide additional payments to hospitals that provide a disproportionate share of uncompensated care to the indigent and uninsured. Gross bad debt expense has been reduced by the estimated HCAP amount applicable to bad debt expense. The estimated amount of bad debt at cost attributable to patients eligible under the organization's charity policy is $-0-. Parent/Guarantors that are uninsured and/or underinsured are encouraged to meet with a Financial Counselor. ASSISTANCE IS PROVIDED TO ASSIST WITH THE APPLICATION PROCESS TO OBTAIN MEDICAID OR HCAP. WHERE THE INDIVIDUAL IS OVER THE INCOME THRESHOLD FOR ONE OR BOTH OF THOSE PROGRAMS, THEY ARE SCREENED FOR FINAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE PROGRAM. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AS DESCRIBED IN PART VI, ITEM 3 - PATIENT EDUCATION FOR ASSISTANCE IS PROVIDED. See Pages 12 & 13 to the footnotes to CHMCA's Financial Statements that describe Charity Care and Bad Debt. CHMCA respectively submits that since we accept all patients, regardless of their ability to pay, that bad debts at cost, as reported herein, represent an unreimbursed cost of providing care to the patients we serve. Part III, Line 8 - Medicare Explanation We believe that reporting program charges, costs, and payments directly from CHMCA's Medicare cost report along with similar calculations for services rendered to patients enrolled in Medicare Advantage Plans and patients enrolled in TRICARE is the most accurate methodology to calculate unreimbursed Medicare and other means-tested government program costs. To avoid double counting of costs reported elsewhere in the Schedule, gross costs for other reportable items have been reduced by the total government payor mix percentage (55.20%) as reported on our internal payor mix report. CHMCA respectfully submits that its unreimbursed inpatient costs incurred in excess of the 1982 The Tax Equity and Fiscal Responsibility Act(TEFRA) per discharge limit $600,855, unreimbursed outpatient costs incurred in treating patients qualifying for Medicare End Stage Renal disease(ESRD), composite reimbursement -$80,803, unreimbursed costs of providing care to Medicare Advantage Plan enrollees -$608,443 and unreimbursed costs for Tri Care patients -$48,283 should be treated as community benefit with excess reimbursement treated as negative community benefit. The unreimbursed inpatient costs are costs incurred primarily in the treatment of burn victims who are Medicare enrollees. The unreimbursed ESRD costs are costs incurred in excess of the composite rate reimbursement applicable to patients who receive outpatient maintenance dialysis. Part III, Line 9b - Collection Practices Explanation CHMCA's collection policy describes the events and the timing of the events that lead to self-pay accounts or self-pay balances after insurance payments being turned over to collection. All patients are treated the same under our collection policy. A patient can be identified at any point in time during the revenue cycle process. Once a patient is identified as qualifying for financial assistance, normal collection policies cease and our free care/charity policies are applied. Part VI, Line 2 - Needs Assessment - Group A & B LINE 2 - NEEDS ASSESSMENT - Describes how CHMCA assesses the health care needs of the communities it serves. CHMCA (#1); Children's - Beeghly Campus (#2); Children's @ St. Elizabeth's (#3); Children's SCN @ Summa Akron City (#4); Children's SCN @ AGMC (#5); Children's Pediatric Unit At Aultman(#6); Children's @ Mercy Health St. Joseph's Hospital(#7); Children's @ Wooster Community Hospital (#8). Along with the CHNAs, the hospital performs strategic planning as an ongoing process with annual updates. As part of the annual update, we review population and demographic changes in our larger service area, focusing particularly on children and families. We give attention to the provision of health care services throughout our region, looking at our own and those provided by other health care organizations, using statewide data including all pediatric hospital discharges by zip code of patient residence. We also carefully track the demand for and supply of physicians, nurses and allied health providers. We evaluated the need for primary, secondary and tertiary services throughout our service area. In addition, we engage in multiple efforts to gauge the needs of our community through periodic surveys of the population, focusing on parental awareness and preference of pediatric health care services, and again estimating actual use of services from all providers. We are actively represented in dozens of community groups, and gather input from these groups both by active participation and by collecting and reviewing comprehensive data sets and studies produced by such groups, including school districts, health and human service agencies, and charitable and advocacy groups. We listen to our staff, seeking and receiving feedback from our approximately 5800 staff and thousands of volunteers, who collectively provide a rich source of information regarding community needs and opportunities. Finally, we actively solicit input from our patients and their parents from Parent Advisory Groups as well as gathering feedback through patient survey results and via multiple written and electronic (web-based) tools. Part VI, Line 3-Patient Education of Eligibility for Assistance - A & B CHMCA provides education to patients to inform them that they may qualify for care at no charge or at a reduced charge in a variety of ways: - CHMCA has signage at its registration sites to inform patients that they may qualify for free hospital care. Applications for free care are available at registration sites and throughout the hospital (Required by the Ohio Medicaid Hospital Care Assurance (HCAP) rules). - CHMCA has information regarding eligibility for free care on billing statements mailed to patients and their guarantors. - CHMCA employs financial counselors to explain the hospital's free care, charity care, and the various public assistance programs to uninsured and underinsured patients. - CHMCA's website provides patients with information relating to the hospital's free care, charity care and various public assistance programs available. - CHMCA contracts with an independent vendor to screen patients for public assistance eligibility and completion as well as submission of public assistance applications. Part VI, Line 4 - Community Information - Group A Note: The most recent demographic information was taken during the 2013 CHNA. Medina County There are approximately 173,684 people living in Medina County, which is an increase of 0.8% increase since 2010. 24.7% of this population is under 18 years old. 3.7% of the population in Medina County is non-white with 1.7% classified as Hispanic or Latino. 93.1% of Medina County residents have a high school diploma or higher, and 30.1% have a bachelor's degree or higher. Annual per capita income in Medina County is $30,528, which is higher than the State of Ohio ($25,618), and the percent of Medina County residents living in poverty (7.2%) is lower than that of the State (14.8%). 22.8% of Medina County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. Portage County There are approximately 161,451 people living in Portage County and this number has remained unchanged since 2010. 20.2% of this population is under 18 years old. 7.7% of the population in Portage County is non-white with 1.4% classified as Hispanic or Latino. 90.4% of Portage County residents have a high school diploma or higher, and 24.5% have a bachelor's degree or higher. Annual per capita income in Portage County is $25,483, which is lower than the State of Ohio ($25,618), and the percent of Portage County residents living in poverty (14.3%) is lower than that of the State (14.8%). 36.2% of Portage County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. Stark County There are approximately 374,868 people living in Stark County, which is a 0.2% decrease from 2010. 22.5% of this population is under 18 years old. 10.9% of the population in Stark County is non-white with 1.7% classified as Hispanic or Latino. 88.5% of Stark County residents have a high school diploma or higher, and 20.7% have a bachelor's degree or higher. Annual per capita income in Stark County is $24,212, which is lower than the State of Ohio ($25,618), and the percent of Stark County residents living in poverty (13.6%) is lower than that of the State (14.8%). 43.7% of Stark County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. Summit County There are approximately 540,811 people living in Summit County, although since 2010, the population size has decreased by approximately 0.2%. 22.5% of this population is under 18 years old. 19.2% of the population in Summit County is non-white with 1.7% classified as Hispanic or Latino. 90% of Summit County residents have a high school diploma or higher, and 29.4% have a bachelor's degree or higher. Annual per capita income in Summit County is $27,220, which is higher than the State of Ohio ($25,618), and the percent of Summit County residents living in poverty (14.5%) is lower than that of the State (14.8%). 39.5% of Summit County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. Wayne County There are approximately 114,848 people living in Wayne County, which is an increase of 0.3% since 2010. 25.1% of this population is under 18 years old. 3.9% of the population in Wayne County is non-white with 1.6% classified as Hispanic or Latino. 84.8% of Wayne County residents have a high school diploma or higher, and 19.2% have a bachelor's degree or higher. Annual per capita income in Wayne County is $22,892, which is lower than the State of Ohio ($25,618), and the percent of Wayne County residents living in poverty (10.6%) is lower than that of the State (14.8%). 34% of Wayne County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. Part VI, Line 5 - Promotion of Community Health - Groups A & B CHMCA intends that all of its activities either directly provide health care to all children who request our services or promote the health of the community, both by direct investments in the delivery of pediatric healthcare services and in providing specialized inpatient and outpatient care for patients of all ages throughout northeast Ohio. CHMCA was founded on the principle of serving the needs of the community. Our founding promises: - To care for every child as we would our own; - To treat others as we would like to be treated; - To turn no child away for any reason. CHMCA's governing Board of Directors includes members of the community that makeup the hospital's primary service area. These community board members are neither employees nor independent contractors of the organization. CHMCA extends medical staff privileges to all qualified physicians in the communities we serve. CHMCA's excellent reputation is the result of the skills and experience of our medical staff and the health professionals with whom we collaborate; We value our partnership with primary care physicians and referring providers and work together to coordinate the care of the children. Our efforts include: 1. CHMCA's Paul and Carol David Foundation Burn Institute provides specialized inpatient and outpatient care for burn victims of all ages throughout northeast Ohio. Akron Children's is one of only two pediatric hospitals in the country that treats adult burn patients. 2. The Rebecca D. Considine Research Institute is the hub for research and innovation activity at CHMCA. The institute facilitates sponsored clinical studies as well as internal investigator-initiated research programs across a spectrum of research subjects. The institute also offers research-oriented educational opportunities for fellows, students and faculty from around the globe. 3. Adult Congenital Heart Service provides ongoing monitoring and specialized care for adults with congenital heart disease. As children with congenital heart disease (CHD) become adults, they can access lifetime care through our center. 4. The Cystic Fibrosis (CF) Center provides diagnosis and treatment to children and adults with CF, including respiratory therapy, physical therapy, genetic counseling and nutrition counseling. The center also actively participates in clinical trials to research new drug therapies to manage CF. 5. The Genetic Center offers diagnostic evaluation and medical management of genetic conditions, birth defects and developmental delays, as well as genetic testing and genetic counseling for pediatric and adult patients. Our Maternal Fetal Treatment Center provides Genetic Counseling and Obstetric/delivery services to high risk pregnant women in the region. 6. CHMCA's Neonatology department offers intensive care to sick and premature newborns. On any given day, there are 45 to 50 babies receiving care in Akron Children's Hospital's neonatal intensive care unit (NICU). About 1/4 of these infants have been in utero for fewer than 32 weeks, 5 weeks less than what is considered necessary for full gestation. Some of them are as young as 24 weeks and weigh in at less than a kilogram. CHMCA's neonatal team is committed to providing the most effective and efficient care for our tiny patients, as well as providing parents with the emotional and practical support they need. To this end, CHMCA is part of the Vermont Oxford Network, a collaboration of health professionals from 850 NICUs around the world who focus on research, education and projects that improve the quality and safety of medical care for newborns and their families. CHMCA's neonatal expertise expands beyond the Level III NICU at our Akron campus. We also own and operate newborn special care nurseries at Akron General Medical Center and Summa's Akron City Hospital in Akron; CHMCA's Beeghly campus in Youngstown; and St. Elizabeth Boardman Health Center. 7. A specially equipped ambulance and pediatric transport team handles the transfer of the newborns requiring the Level III neonatal intensive care provided at CHMCA in downtown Akron. 8. CHMCA's School Health Services supports the academic success of children through health promotion, education and child advocacy. School Health serves as a liaison among school staff, family, community and healthcare providers. CHMCA's pediatric registered nurses work closely with school staffs to ensure a comprehensive school health program is in place. With immediate access to pediatric healthcare professionals at CHMCA, schools are assured their program will effectively address the needs of their staff and students. Our School Health Services allows schools to focus on educating students, while we manage their district's medical needs. 9. CHMCA's Beeghly Campus, opened in December 2008is the Mahoning Valley area's only Pediatric Hospital. This 33 bed pediatric hospital offers a full range of pediatric services to the children of the Mahoning and surrounding areas. The hospital provides access to a 24/7 Emergency Department, Laboratory, Radiology, Outpatient Surgical Center, Endocrinology, Rehabilitation and EEG/Echo/EKG services, as well as a Hematology/Oncology Clinic, Infusion Center and Child Advocacy Center. 10. Additionally, CHMCA brings pediatric primary care for babies, chlldren and teens to many Northeast Ohio neighborhoods through our 25 Pediatrician Offices. Each office is staffed with experienced, Board Certified Pediatricians and experienced staff. 11. Also located in Mahoning Valley is the Community Outreach, Education & Support Center, which provides education and support for children and their families. These programs meet specified criteria of Nationally Accredited Disease Management Programs, as well as CHMCA's criteria and monitoring requirements. Our Community Health Outreach includes asthma and diabetes education and support, school programs, disease specific camps and support groups, fitness programs and education programs that touch more than 45,000 individuals annually. 12. Parents and members of CHMCA's Family-Centered Care committee established the Parent Advisory Council (PAC) in 1995. It provides a way for parents and guardians to offer input on issues that impact the care of children. The council includes parents whose children have received care at CHMCA. Advisors will work with hospital liaisons to represent the voice of families as we work together to enhance the delivery of family-centered care. We also make major investments of our funds and other resources in the provision of education for lay and professional persons, and in research that will improve health care for all children. We take an active role in advocating for improved health and improved access to health care for all. Services and activities provided by CHMCA's benefit and/or promote health to the residents in the communities we serve. The primary benefit to our communities is providing health care visits to approximately 895,000 children annually. In addition, we also provide community building activities as depicted in Part II of this schedule. the Parent Advisory Council (PAC) in 1995. It provides a way for parents and guardians to offer input on issues that impact the care of children. The council includes parents whose children have received care at CHMCA. Advisors will work with hospital liaisons to represent the voice of families as we work together to enhance the delivery of family-centered care. We also make major investments of our funds and other resources in the provision of education for lay and professional persons, and in research that will improve health care for all children. We take an active role in advocating for improved health and improved access to health care for all. Services and activities provided by CHMCA's benefit and/or promote health to the residents in the communities we serve. The primary benefit to our communities is providing health care visits for close to 895,000 children annually. In addition, we also provide community building activities as depicted in Part II of this schedule. Part VI, Line 6 - Affiliated Health Care System - Groups A & B N/A Part VI, Line 7 - State Filing of community benefit report - Groups A & B Ohio Part VI Additional Information In addition to the locations listed in Part V, Section A and C, CHMCA has physicians providing a variety of subspecialty services at many other locations throughout Northeast Ohio and Western Pennsylvania. Note: Census and other data reported in Section Part VI is the most recent information available. Part VI, Line 4 - Community Information - Group B CHMCA in the Mahoning Valley has and continues to serve patients and families from many communities across the region. Most people who receive services from the hospital are residents of Mahoning, Trumbull or Columbiana Counties. Prior to the opening of this facility, the Appalachian Regional Development Act of 2008 (S. 496) was signed into law. One of the components of this legislation was addition of Mahoning and Trumbull Counties to the Appalachian Region. Mahoning, Trumbull and Columbiana Counties represent most of the primary service area of the Beeghly Campus, and now, with this act becoming law, all three counties that make up the primary service area of this facility are located within the Appalachian Region. Trumbull, Mahoning, and Columbiana Counties are classified by the Appalachian Regional Commission as being transitional - they have worse economic rates than the national average for one or more of three economic indicators (three-year average unemployment, per capita market income, and poverty) but don't rate low enough to be classified as distressed. The Demographic information provided is from the 2013 CHNA. Trumbull County There are approximately 207,406 people living in Trumbull County, which is a decrease of 1.4% since 2010. 21.5% of this population is under 18 years old. Nearly 8% of the population in Trumbull County is African American and 1.5% is Hispanic or Latino. 87.1% of Trumbull County residents have a high school diploma or higher, and 16.6% have a bachelor's degree or higher. Annual per capita income in Trumbull County is $22,127, which is lower than the State of Ohio ($25,618), and the percent of Trumbull County residents living in poverty (16.4%) is higher than that of the State (14.8%). 39.3% of Trumbull County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. Mahoning County There are approximately 235,145 people living in Mahoning County, which is a decrease of 1.5% since 2010. 20.9% of this population is under 18 years old. 16% of the population in Mahoning County is African American and 5% is Hispanic or Latino. 87.9% of Mahoning County residents have a high school diploma or higher, and 20.9% have a bachelor's degree or higher. Annual per capita income in Mahoning County is $23,261, which is lower than the State of Ohio ($25,618), and the percent of Mahoning County residents living in poverty (17.1%) is higher than that of the State (14.8%). 44.3% of Mahoning County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. Columbiana County There are approximately 106,507 people living in Columbiana County, which is a decrease of 1.2% since 2010. 21.2% of this population is under 18 years old. 2.4% of the population in Columbiana County is African American and 1.4% is Hispanic or Latino. 85.7% of Columbiana County residents have a high school diploma or higher, and 13% have a bachelor's degree or higher. Annual per capita income in Columbiana County is $20,691, which is lower than the State of Ohio ($25,618), and the percent of Columbiana County residents living in poverty (15.9%) is higher than that of the State (14.8%). 42.5% of Columbiana County's child population is enrolled in Medicaid, which is lower than the Ohio rate of 44.6%. true AKRON CHILDREN'S HOSPITAL FOUNDATION ONE PERKINS SQUARE AKRON OH 44308 237114013 501(c)(3) 794047 GENL SUPPORT 1 X X true true X X X X false true false false false false false true false WILLIAM CONSIDINE PRESIDENT & CEO 1371975 240000 484573 -61700 15529 2050377 0 SHAWN LYDEN EXECUTIVE VP 612129 106000 4919 18550 19496 761094 0 MICHAEL TRAINER CHIEF FINANCIAL OFFICER 478040 82000 5974 18550 10406 594970 0 GRACE WAKULCHIK CHIEF OPERATING OFFICER 501137 87000 6094 22704 10748 627683 0 JOHN CROW MD CHAIRMAN,PEDIATRIC SURGERY 1132430 3612 15900 21284 1173226 0 NORMAN CHRISTOPHER MD CHAIRMAN, DEPT OF PEDS 416168 70000 5738 17092 21025 530023 0 ROBERT MCGREGOR MD CHIEF MEDICAL OFFICER 455936 76000 6589 18550 14126 571201 0 AMY MANEKER CHIEF MEDICAL INFO OFFICER 361731 1504 15900 1884 381019 0 MARY LINK GENERAL COUNSEL/ASST SECRETARY 332975 58000 3055 15900 12280 422210 0 THOMAS OGG CHIEF INFORMATION OFFICER 345601 62000 789 15900 13745 438035 0 LISA AURILIO VP, PATIENT SERVICES 312440 55000 693 31923 7709 407765 0 LINDA GENTILE VP, SUPPORT SERVICES 258203 45500 1544 82615 14519 402381 0 WALTER SCHWOEBLE VP, HUMAN RESOURCES 338924 58500 3096 18450 13665 432635 0 CYNTHIA DORMO VP, DEPT OF PEDS 271418 48000 1084 86339 7536 414377 0 SHARON HRINA VP, MAHONING VALLEY ENTERPRISE 262872 47000 3063 84908 7494 405337 0 CRAIG MCGHEE VP, SURGICAL SUBSPECIALTY 209389 37500 917 14512 11776 274094 0 TSULEE CHEN MD DIRECTOR, NEUROSURGERY 708836 129721 617 13250 8379 860803 0 ANTON MILO MD DIRECTOR OF ENT 1394159 4002 15900 20044 1434105 0 MARK MCCOLLUM MD GENERAL PEDIATRIC SURGEON 1239242 92500 1260 15900 21284 1370186 0 PHILIP SMITH MD DIRECTOR OF HEART CENTER 1044967 70000 7482 25976 21284 1169709 0 ROBERT PARRY PEDIATRIC GENERAL SURGEON 885816 72001 7482 18550 19618 1003467 0 PETER C WHITE PRESIDENT, MEDICAL STAFF 284682 25000 3168 46627 13226 372703 0 LINDA HETSON VP PROFESSIONAL SERVICES 194713 32000 1997 130765 7540 367015 0 Part I, Line 1a - Fringe or Expense Explanation William Considine, CEO and Shawn Lyden, Executive VP, had a 2015 country club membership that was used by CHMCA for business purposes. William Considine also received grossed up payments for his automobile, life and other insurance payments made by CHMCA. Part I, Line 4 - Severance, Nonqualified, and Equity Based Payments William Considine is a participant in the Supplemental Executive Retirement Plan as of January 1, 2010. The Plan is a nonqualified deferred compensation plan. It is an unfunded plan maintained primarily for the purpose of providing deferred compensation benefits. The participant receives credits in the plan for each full calendar year of service and he is 100% vested. The non-qualified deferred payment to William Considine in 2015 was $312,000. Part I, Line 7 - Non Fixed Payments Provided CHMCA does have contracts with certain physicians that earn bonuses based on Work Relative Value Units (WRVU's). Physicians work RVU: the relative level of time, skill, training and intensity to provide a given service. Each Current Procedural Terminology (CPT) code is targeted for review at least every five years to determine the work RVU for a particular service. A code with a higher RVU work takes more time, more intensity or some combination of the two. Part II, Column (C) Included in retirement and deferred compensation is the change in the present value of the accrued benefits from the pension plan of Children's Hospital Medical Center of Akron. For William Considine, the present value as of December 31, 2015 was less than the present value as of December 31, 2014. A AKRON BATH AND COPLEY JOINT TWSP HOSP DISTRICT 341448680 009730MY5 2012-05-15 102559004 REFUND PRIOR ISSUE TO CONSTRUCT NE false false false B AKRON BATH AND COPLEY JOINT TWSP HOSP DISTRICT 341448680 009730NB4 2013-05-15 101377818 CONSTRUCTION OF CRITICAL CARE TOWE false false false C AKRON BATH AND COPLEY JOINT TWSP HOSP DISTRICT 341448680 000000000 2013-11-14 27405000 REFUND PRIOR ISSUE false false false A 80432291 0 102539004 0 1010250 0 1116463 0 0 20000000 0 0 2013 true false true true B 0 0 101377818 0 10229217 0 1148601 0 0 90000000 0 0 2015 false false false true C 0 0 0 27405000 280035 0 0 0 0 0 27124925 0 2013 true false true true A false false true true false 0 false false false true B false false false false 0 false false false true C false false true true false 0 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true C false true false false false false 0 false 0 false true A true B true C true PART 1(f)A OF THE $102,559,004 BOND PROCEEDS, $80,432,921 WAS USED TO REFUND THE SERIES 2001 BONDS AND $21,000,000 WAS USED FOR CONSTRUCTION OF A NEW PARKING GARAGE ON THE AKRON CAMPUS CONTAINING APPROXIMATELY 1200 SPACES AND CONNECTED TO THE NEW CRITICAL CARE TOWER. PART 1(f)B $101,377,818 WAS USED TO CONSTRUCT AN APPROXIMATELY 366,000 SQUARE FOOT CRITICAL CARE TOWER ON THE AKRON CAMPUS. PART 1(f)C $27,405,000 OF BOND PROCEEDS REFUNDED THE SERIES 2003 BONDS. THE BONDS WERE SOLD IN A PRIVATE OFFERING TO KEY GOVERNMENT FINANCE, INC. CATHRYN O'MALLEY FAMILY MEMBER OF CURR DIR 95526 COMPENSATION false LAURIE SCHUELER FAMILY MEMBER OF CURR DIR 39333 COMPENSATION false SCHEDULE L, PART IV CATHRYN O'MALLEY IS THE DAUGHTER OF WILLIAM CONSIDINE, PRESIDENT AND CEO. LAURIE SCHUELER IS THE DAUGHTER OF DUANE ISHAM, BOARD MEMBER. Form 990, Part III, Line 4d - All Other Accomplishments Children's Hospital Medical Center of Akron ("CHMCA") operates one of the largest pediatric primary care networks in nine different counties including Summit, Columbiana, Cuyahoga, Mahoning, Medina, Stark, Wayne, Tuscawaras and Portage. The pediatricians and staff at Akron Children's Hospital Pediatrics ("ACHP") maintain cooperative relationships with many area health providers, including several hospitals. Patient care is available 24 hours a day through the physician office; Children's After Hours, a 24-hour nurse triage phone line; and CHMCA. By sharing information between our offices and with area health care providers, we ensure that all children receive the finest care - from preventative checkups to treatment for chronic health problems. ACHP visits were 383,180 and 364,633 for 2015 and 2014 respectively. The Surgical Services Department at CHMCA performs approximately 15,000 general and specialized surgical procedures each year--ranging from uncomplicated tonsillectomies to neurosurgery, open heart, orthopedic, and plastic and reconstructive surgery. The entire staff at CHMCA, from pediatric surgeons to pediatric anesthesiologists and nurses are carefully trained in meeting the unique surgical needs and concerns of children and their families. The pediatric anesthesiologists are experienced at helping a child go to sleep with as little anesthesia as possible. They understand the medical differences between children and adults. Special equipment and techniques suited to the size of the patient, from infants to young adults, help assure successful outcomes to the surgery and anesthesia. In addition, child life specialists give pre-surgery tours once a week to prepare children (and parents) for what they expect to see, hear, feel, taste or smell. CHMCA has nine state-of-the-art operating rooms. Two are dedicated to minimally invasive surgery with a voice activated system to control the operating rooms. There are also operating suites dedicated to neurosurgery and heart surgery. Between 75-80% of surgeries are done on an outpatient basis, which has proven to be not only medically safe but psychologically beneficial for children. Form 990, Part VI, Line 6 - Classes of Members or Stockholders The duly elected, qualified and acting Directors and the active members of the Women's Board of Akron Children's Hospital are members of the Corporation. Form 990, Part VI, Line 7a - Election of Members and Their Rights The number of the Directors of CHMCA shall be set by the members. Five of the members shall consist of the Women's Board of CHMCA. The President of the Medical Staff shall be a member of the Board of Directors. The remaining members of the Board of Directors shall be elected by the members of CHMCA. A director shall be elected for a three-year term, but a person may be nominated for and elected to a shorter term so that the terms of approximately one-third of the directors shall expire each year. Each director shall serve until his successor is elected and qualified. Upon unanimous resolution of the members, a person who has rendered long and outstanding service to the Hospital may be elected to a life term as a director. The directors responsibilities include: (1) to ensure the Hospital is meeting the community's health needs and is informed about the availability of the Hospital's services; (2) believe strongly in the Hospital's mission and serve as active public advocates for the Hospital; (3) establish goals and policies for the Hospital; (4) work with the Hospital President to develop and update long-range plans and provide for financial stability; (5) identify, recruit and select new Directors; (6) periodically evaluate the performance of Director Committees, individual Directors and Board of Directors performance as a whole; (7) select and evaluate the President as Chief Executive Officer; (8) approve Medical Staff appointments and privileges; (9) maintain authority for the overall functioning and support of a Hospital-wide quality assurance program; and (10) participate in and provide leadership for Hospital fund-raising programs. The Corporate powers, property, and affairs of CHMCA shall be exercised, conducted, and controlled by the Directors. The Directors shall elect the members of the Executive Committee of the Board. Form 990, Part VI, Line 7b - Decisions Subject to Approval of Members Subject to the direction and control of the Directors, or the Executive Committee of the Board, the management of the Hospital shall be vested in the President as Chief Executive Officer. The President shall, in all matters pertaining to Hospital administration, directly represent the Executive Committee of the Board of Directors and shall be responsible to them respectively for the proper performance of his duties. It shall be the duty of the President to make known and enforce all rules and regulations which shall be made by and under the authority of the Directors or the Executive Committee of the Board. In all cases of disputed authority, or uncertainty as to the meaning of these regulations, the decision of the President is absolute until a ruling is rendered by the Executive Committee of the Board of Directors. Form 990, Part VI, Line 11b - Organization's Process to Review Form 990 The Form 990 is provided to the Audit Committee and Chairman of the Board of Directors of CHMCA for review and discussion prior to filing the return with the Internal Revenue Service. The Audit Committee is a Committee of the Board of Directors and empowered to complete the review on behalf of the Board of Directors. Form 990, Part VI, Line 12c - Enforcement of Conflicts Policy It is CHMCA's policy that all employees disclose real and apparent conflicts of interest as a condition of employment with CHMCA. CHMCA also requires that each employee disclose in writing, annually, to the President a list of all businesses or other organizations in which he/she is an officer, member, owner, shareholder, trustee or employee for which he/she acts as an agent or might reasonably in the future enter into a relationship or transaction in which the employee could have a duality of interest. If a situation arises in which there is a duality of interest, or a question of duality of interest, and, as such, potential for a conflict of interest, it is the primary responsibility of the individual directly involved and responsibility of other personnel, to the extent that they become aware of a duality of interest, to make immediate and complete disclosure to the appropriate Vice President. He/she will review the situation with the Vice President of Corporate Services who will present it to the President or his designee. It is the responsibility of the President or his designee to evaluate any circumstances in which a duality of interest exists, (if known, when disclosed or undisclosed), to determine whether such conflict is so substantial that it is deemed to be detrimental to CHMCA. Any employee who is directly or indirectly involved in a situation which represents a duality of interest, and as such, a potential conflict of interest, will abide by the following policies: (1) Individual will not be permitted access to any information which may provide an unfair advantage to that individual or the firm he/she represents. (2) Individual will be required to withdraw from any meeting in which the matter is discussed. (3) Individual will not be permitted to participate in deliberation or vote on the matter and will be required to leave the room during voting. (4) Any employee is expressly prohibited from releasing any "sensitive information" regarding a decision made or being considered to any person who may have a duality of interest, and as such, a potential conflict of interest. (5) Any attempt on the part of an employee to unfairly influence or impact the decision making process in favor of personal interest may be considered breach of trust and may be cause for removal from his/her position of responsibility or other disciplinary action up to and including discharge. Form 990, Part VI, Line 15a-Compensation Process for Top Official CHMCA's executive total compensation program is governed by the Compensation Committee (Committee) of the Board of Directors. Key Committee responsibilities include: (a) ensure executive total compensation is appropriate in light of CHMCA's mission and values, and (b) approve an executive compensation philosophy, the associated programs, and all compensation actions for individual executives. The Committee is comprised of independent members of CHMCA's Board who have no personal interest in any executive compensation transaction. Should a potential conflict of interest be identified, the Committee determines the extent of the conflict and the means to address it. In certain cases, a Committee member may be asked not to participate in discussions of, or vote on, a particular compensation transaction. The Committee governs CHMCA's executive total compensation for all senior executives who are deemed to be disqualified persons. The Committee follows all steps required by the Internal Revenue Service to qualify for the safe harbor under the Intermediate Sanctions regulations. The Committee reviews market compensation data for comparable positions at similar organizations which are compiled by an independent consultant. The Committee uses the data to make executive decisions and documents its compensation deliberations and decisions in a timely manner. An independent salary survey was completed in 2015 and recommendations were provided and presented by the independent consultant to the Committee for approval. Form 990, Part VI, Line 15b - Compensation Process for Officers An independent salary survey was completed in 2015 and recommendations were provided and presented by the independent consultant to the Committee for approval. Form 990, Part VI, Line 19 - Governing Documents Disclosure Explanation CHMCA makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. In addition, the governing documents are located on the Ohio Secretary of State's website. The financial statements are also disclosed on the EMMA (Electronic Municipal Market Access) website. Form 990, Part XI, Line 9 - Reconciliation of Other Changes in Net Assets Hospital's Investment in Foundation -20,087,920 Adjustment - ASC - OPEB 2,185,269 Adjustment - ASC - Pension 19,911,275 Hemophilia Treatment Center Deposit 1,573,239 Equity transfer from Children's Home Care -1,666,893 Other 1,250 Partnership Loss 39,136 TOTAL $ 1,955,356 AKRON CHILDREN'S HOSPITAL FOUNDATION ONE PERKINS SQUARE AKRON OH 44308 237114013 FOUNDATION OH 501(c)(3) 7 CHMCA true CHILDREN'S HOME CARE GROUP ONE PERKINS SQUARE AKRON OH 44308 341575266 HOME CARE OH 501(c)(3) 11a CHMCA true CHILD DIMENSIONS INSURANCE COMPANY ONE PERKINS SQUARE AKRON OH 44308 030317160 INSURANCE OH 501(c)(3) 11a CHMCA true false true true false false false false false false false false false false true true true true false false CHILDREN'S HOME CARE GROUP O 8780968 ACTUAL PER GL CHILDREN'S HOME CARE GROUP Q 8804723 ACTUAL PER GL AKRON CHILDREN'S HOSPITAL FOUNDATION P 33056739 ACTUAL PER GL AKRON CHILDREN'S HOSPITAL FOUNDATION C 6892945 ACTUAL PER GL AKRON CHILDREN'S HOSPITAL FOUNDATION C 22688388 ACTUAL PER GL AKRON CHILDREN'S HOSPITAL FOUNDATION O 3976296 ACTUAL PER GL AKRON CHILDREN'S HOSPITAL FOUNDATION B 794047 ACTUAL PER GL CHILDREN'S HOME CARE GROUP N 728853 ACTUAL PER GL