2016-11-14T07:27:31-06:00 2015-12-31 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2015-01-01 341887844 SUMMA HEALTH SUMM 2343125867 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 BRIAN K DERRICK SR VP, CFO, TREASURER 2343125867 2016-11-10 1 ZACK FORTSCH P00052725 3126343400 2015 2017-02-10 21:41:12Z THOMAS MALONE MD 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 135637959 0 X WWW.SUMMAHEALTH.ORG X 1999 OH THE MISSION OF SUMMA HEALTH IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO PATIENTS AND MEMBERS AND CONTRIBUTE TO A HEALTHIER COMMUNITY. 14 10 875 12 190969 -195774 0 0 110370152 127794485 3670360 7287481 651254 555993 114691766 135637959 377174 437500 0 0 57742197 57928031 0 0 0 49929603 73624727 108048974 131990258 6642792 3647701 782429963 788256582 357381597 360286906 425048366 427969676 THE MISSION OF SUMMA HEALTH IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO PATIENTS AND MEMBERS AND CONTRIBUTE TO A HEALTHIER COMMUNITY. 0 0 101183454 437500 123557711 SUMMA HEALTH DIRECTS THE ACTIVITIES OF THE SYSTEM SO THAT ALL SYSTEM RESOURCES AND ASSETS ARE BEST ALLOCATED AND UTILIZED FOR THE BENEFIT OF THE COMMUNITY. SUMMA HEALTH REPRESENTS THE COLLABORATIVE EFFORTS OF HEALTH CARE PROVIDERS TO BETTER ADMINISTER, MANAGE, PROVIDE AND PLAN FOR THE DELIVERY OF A FULL-RANGE OF HEALTH CARE SERVICES TO ALL PERSONS WITHIN THE COMMUNITIES SERVED BY SUMMA HEALTH WITHOUT REGARD TO THE RACE, SEX, CREED, COLOR, NATIONAL ORIGIN OR ECONOMIC STATUS OF SUCH PERSONS. SEE SUMMA HEALTH GROUP RETURN (EIN 90-0640432) FOR FURTHER DETAILS. 3582213 4045805 SUMMA HEALTH NETWORK, LLC, A DISREGARDED ENTITY OF SUMMA HEALTH, PARTNERS WITH COMMUNITY PHYSICIANS, REGIONAL AND NATIONAL PAYERS TO IMPROVE THE CLINICAL QUALITY AND EFFICIENCY OF CARE, LOWER THE COST OF CARE TO PATIENTS AND EMPLOYERS AND ASSIST PHYSICIANS WITH TECHNOLOGY AND RESOURCES NECESSARY TO ACHIEVE THESE GOALS. 104765667 1 0 0 1 0 0 0 0 0 1 1 0 1 1 0 1 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 719 0 1 875 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 14 10 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X X BRIAN K DERRICK 2343125871 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 NICHOLAS BROWNING TREASURER (TERM AS TREAS ENDED 2/15) 2.00 2.00 X X 0 0 0 JAMES MCILVAINE CHAIRMAN 2.00 4.00 X X 0 0 0 NORMAN WELLS JR DIRECTOR 4.00 2.00 X 0 0 0 DARYL CAMERON DIRECTOR 2.00 2.00 X 0 0 0 JAMES GRAVELL JR DIRECTOR (END 11/2015) 2.00 2.00 X 0 0 0 MICHAEL HUGHES MD DIRECTOR 2.00 48.00 X 0 665564 25912 JAMES KRAVEC MD DIRECTOR 2.00 2.00 X 0 0 0 ANTHONY LOCKHART DIRECTOR 2.00 2.00 X 0 0 0 RICHARD MARSH DIRECTOR 2.00 2.00 X 0 0 0 THERESA PROENZA DIRECTOR (END 10/2015) 2.00 2.00 X 0 0 0 BRIAN SMITH DIRECTOR 2.00 2.00 X 0 0 0 R DOUGLAS TROCHELMAN MD DIRECTOR (END 7/2015) 2.00 48.00 X 0 711774 26338 LEILA VESPOLI DIRECTOR 2.00 2.00 X 0 0 0 VIVIAN VON GRUENIGEN MD DIRECTOR 2.00 48.00 X 0 455940 27867 THOMAS MALONE MD PRESIDENT & CEO 4.00 46.00 X X 1285333 0 22545 LYNN HAMRICH MD DIRECTOR 2.00 2.00 X 0 0 0 DONALD KLINE DIRECTOR 2.00 2.00 X 0 0 0 BRIAN DERRICK TREASURER, SR VP, CFO 46.00 4.00 X 945036 0 23552 ROBERT A GERBERRY SECRETARY/GENERAL COUNSEL 46.00 4.00 X 475922 0 6307 ERIC HUMPHREY SR. VP, HR (END 2/15) 50.00 0.00 X 273219 0 7682 KATHLEEN JOBE VP, CNO 4.00 46.00 X 0 236402 22379 GREG KALL SR. VP, CIO 50.00 0.00 X 522983 0 25382 UNHEE KIM SR. VP, CLINICAL SERVICES 4.00 46.00 X 825869 0 8202 THOMAS P O'NEILL VP, CFO SHS 4.00 46.00 X 555666 0 18277 ERIK STEELE DO CMO, SUMMA HOSPITALS 4.00 46.00 X 755289 0 7950 MARK TERPYLAK DO PRESIDENT, SUMMA ACO 4.00 46.00 X 0 503019 1637 MARY WARD SR. VP, CNO 4.00 46.00 X 676427 0 10309 VALERIE GIBSON RN CHIEF OPERATING OFFICER SUMMA HEALTH SYSTEM 4.00 46.00 X 544477 0 19810 BENJAMIN P SUTTON SR. VP STRATEGY & PERFORMANCE 50.00 0.00 X 312917 0 31952 ROB WHITEHOUSE SR. VP MARKETING & COMMUNICATION 50.00 0.00 X 201827 0 17002 ED FRIEDL VP, CONSTRUCTION 50.00 0.00 X 268845 0 28917 JOSEPH ZARCONI MD FACP ATTENDING NEPHROLOGY 0.00 50.00 X 897420 0 19462 JASON NIEHAUS SR. VP SYS HOSP OPS 4.00 46.00 X 582187 0 23616 DAVID P JOHNSON SR. VP REVENUE CYCLE 4.00 46.00 X 321986 0 13155 JEFFREY R PRICE VP PAYER STRATEGY 4.00 46.00 X 266379 0 27201 THOMAS J STRAUSS FORMER PRESIDENT & CEO 0.00 8.00 X 544652 0 3570 WILLIAM A POWEL III FORMER OFFICER 0.00 0.00 X 163138 0 1864 ROBERT D HARRIGAN FORMER OFFICER 0.00 0.00 X 215100 0 3874 PATRICE LANGE FORMER SR. VP 0.00 0.00 X 111769 0 808 CHARLES ROSS MD FORMER CMI 0.00 0.00 X 414808 0 2399 ROXIA BOYKIN FORMER VP, COMM BENEFIT & DIVERSI 0.00 0.00 X 313193 0 2303 11474442 2572699 430272 65 1 1 0 MERCY HEALTH 4600 MCAULEY PL CINCINNATI OH 45242 IT & EMR SERVICES 11528895 PROFESSIONAL ANESTHESIA SERVICE 190 NORTH UNION STREET AKRON OH 44304 MEDICAL SERVICES 7174761 HEALTHSPAN LLC 225 PICTORIA DRIVE SUITE 320 CINCINNATI OH 45246 PROFESSIONAL SERVICES 5347376 ALLSCRIPTS HEALTHCARE LLC THREE RAVINIA DRIVE ATLANTA GA 30346 IT & EMR SERVICES 4844153 PATIENT CENTERED COLLABORATIVE 275 SPRINGSIDE DRIVE STE 100 AKRON OH 44333 MEDICAL SERVICES 4544940 102 CORPORATE ALLOCATION FEES 900099 119227164 119227164 HEALTHCARE REVENUE 524298 4045805 4045805 RENTAL INCOME FROM AFFILIATES 900099 2310903 2120419 190484 PROGRAM RELATED INVESTMENTS 900099 2210613 2210128 485 127794485 7193558 7193558 93923 0 93923 93923 93923 MISCELLANEOUS INCOME 900099 350295 350295 PURCHASE DISCOUNTS/FEES EARNED 900099 205698 205698 555993 135637959 127603516 190969 7843474 X 437500 437500 7573545 3933699 3639846 41576051 34923883 6652168 669382 562281 107101 5118975 4299939 819036 2990078 2511666 478412 47770 40127 7643 3442007 3442007 926007 926007 84787 84787 23000 23000 20592391 17297609 3294782 4434720 3725165 709555 5988810 5030600 958210 24245438 20366168 3879270 3468041 2913154 554887 209218 175743 33475 274416 230509 43907 607140 509998 97142 7260085 6098471 1161614 7607 6390 1217 MEDICAL SUPPLIES 492939 414069 78870 DUES & LICENSES 412825 412825 TAX EXPENSE 64823 64823 RECRUITMENT 57220 48065 9155 985483 827806 157677 131990258 104765667 27224591 0 76662559 85920722 1010542 2960318 126732 250086 3510131 2408786 3618109 3883545 85844291 36468222 28682353 49376069 453924933 517165254 79321704 54179218 135572900 72112584 782429963 788256582 341054379 345272849 2209204 1959204 458437 494271 13659577 12560582 357381597 360286906 X 425048366 427969676 425048366 427969676 782429963 788256582 X 3647701 -42533386 41806995 X 0 1 X 1 1 1 X X 3 SUMMA HEALTH SYSTEM 340714755 3 0 0 0 SUMMA BARBERTON CITIZENS HOSPITAL 261375072 3 0 0 0 SUMMA FOUNDATION 341219001 7 1 0 0 3 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION A, LINE 1: SUMMA FOUNDATION IS DESIGNATED AS SUPPORTED ORGANIZATIONS BY NAME. THE ARTICLES OF INCORPORATION DESIGNATES THE OTHER SUPPORTED ORGANIZATIONS, BY CLASS AND PURPOSE, TO INCLUDE ANY OTHER HOSPITAL, HEALTH CARE PROVIDER OR OTHER ENTITY THAT QUALIFIES AS A PUBLICLY SUPPORTED ORGANIZATION WITHIN THE MEANING OF SECTIONS 509(A)(1) OR 509(A)(2) OF THE INTERNAL REVENUE CODE, THAT IS AFFILIATED WITH THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OPERATED AND MANAGED BY SUMMA HEALTH, AND THAT IS RELATED TO SUMMA HEALTH IN A MANNER DESCRIBED IN SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE. PART IV, SECTION A, LINE 5A: THE WADSWORTH AREA HOSPITAL ASSOCIATION, EIN 34-6549371, WAS REMOVED BECAUSE THE ORGANIZATION MERGED OUT OF EXISTENCE WITH THE SURVIVING ENTITY BEING SUMMA BARBERTON CITIZENS HOSPITAL, EIN 26-1375072, WHICH CONTINUES TO BE LISTED AS A SUPPORTED ORGANIZATION. THE MERGER WAS CONDUCTED UNDER THE AUTHORITY OF THE OHIO REVISED CODE. PART IV, SECTION A, LINE 6: IN 2015 SUMMA HEALTH PROVIDED SUPPORT TO THE UNIVERSITY OF AKRON, THE AKRON AREA YMCA, THE AMERICAN HEART ASSOCIATION AND PROVIDED A GRANT TO OPPORTUNITY PARISH ECUMENICAL NEIGHBORHOOD MINISTRY, A PUBLIC CHARITY, FOR A FREE CLINIC. PART IV, SECTION C, LINE 1: THE MANAGEMENT OF THE SUPPORTING AND THE SUPPORTED ORGANIZATIONS RESIDES IN THE SAME MANAGEMENT GROUP. THOMAS MALONE, M.D. IS SYSTEM PRESIDENT AND CEO AND AN OFFICER AND DIRECTOR FOR BOTH ORGANIZATIONS, BRIAN DERRICK IS SYSTEM CFO AND AN OFFICER FOR BOTH ORGANIZATIONS, AND ROBERT GERBERRY SERVED AS SECRETARY AND GENERAL COUNSEL AND AN OFFICER FOR BOTH ORGANIZATIONS. 0 1 1 268 0 1 500 0 1 72075 1 11941 0 84784 0 PART II-B, LINE 1: IN 2015, SUMMA HEALTH BOARD MEMBERS, MANAGEMENT, PHYSICIANS AND STAFF INTERACTED WITH ELECTED OFFICIALS TO INFORM THEM OF THE IMPORTANCE OF POPULATION HEALTH MANAGEMENT, MAINTAINING EXPANDED COVERAGE UNDER THE MEDICAID PROGRAM IN OHIO, COMBAT THE TWIN SCOURGES OF OPIOID ADDICTION AND INFANT MORTALITY, MOVE TO VALUEBASED CONTRACTING IN THE MEDICAID PROGRAM, THE IMPORTANCE OF CENTERING PREGNANCY AND THE STATE CAPITAL BUDGET. SUMMA HEALTH CONDUCTED ITS FIRST POPULATION HEALTH SYMPOSIUM AND LUNCHEON TO INFORM ELECTED OFFICIALS OF THE OPPORTUNITIES AND POTENTIAL IN ACCOUNTABLE CARE ORGANIZATIONS. PUBLICATIONS AND MEDIA ADVERTISEMENTS INCLUDE THE COSTS OF MAINTAINING A WEBSITE FOR THE AKRON CANTON MEDICAID COALITION. 19966435 313575 -559200 19720810 17564266 1927171 474998 19966435 16730853 70706 762707 17564266 15896469 347618 486766 16730853 15633840 113108 149521 15896469 1.00000 0 0 1157140 1157140 12345692 1278975 11066717 19978 19978 0 60831847 35159547 25672300 11489634 9722 11479912 49376069 OHIO HEALTH CHOICE, INC 3685678 F MIDDLEBURY ASSURANCE COMPANY 16161138 F SUMMACARE, INC. 1000000 C SUMMA INSURANCE COMPANY 25226327 C SUMMA INTEGRATED SERVICES ORG 8086075 F OPA, LLC 20000 F 54179218 RECEIVABLES FROM AFFILIATES 69903380 UNIVERSITY OF AKRON PLEDGE 2209204 72112584 X PART V, LINE 4: ENDOWMENT FUNDS PROVIDE INCOME TO BE USED TO FULFILL THE TAX-EXEMPT PURPOSES OF SUMMA FOUNDATION. PART X, LINE 2: SUMMA HEALTH AND MOST OF ITS SUBSIDIARIES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. SUMMA ALSO HAS CERTAIN SUBSIDIARIES THAT ARE TAXABLE FOR FEDERAL INCOME TAX PURPOSES. SUMMA CARE ("SC"), TOGETHER WITH AFFILIATES OF SUMMA HEALTH SYSTEM CORPORATION ("SHSC"), FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN IN ACCORDANCE WITH A TAX SHARING AGREEMENT DATED JANUARY 1, 2010. THE ENTITIES UTILIZE A CONSOLIDATED APPROACH TO THE ALLOCATION OF FEDERAL INCOME TAXES, WHEREAS SHSC'S TAX SHARING AGREEMENT WITH ITS SUBSIDIARIES ALLOWS IT TO MAKE CERTAIN CODE ELECTIONS IN ITS CONSOLIDATED FEDERAL TAX RETURN. IN THE EVENT SUCH CODE ELECTIONS ARE MADE, ANY BENEFIT OR LIABILITY IS THE RESPONSIBILITY OF SHSC AND IS ACCRUED AND PAID BY THE PARTICIPATING SUBSIDIARIES. SC IS NOT SUBJECT TO STATE INCOME TAXES AND IT IS LICENSED AS A HEALTH INSURANCE COMPANY UNDER CHAPTER 1751 OF THE OHIO REVISED CODE. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THE RESPECTIVE TAX BASIS AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT OF DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN INCOME IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. SUMMA RECOGNIZES INTEREST INCOME, INTEREST EXPENSE, AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS WITH THE PROVISION FOR INCOME TAX. CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES SELF INSURANCE 57201789 0 0 0 0 0 0 57201789 0 57201789 1 0 1 0 0 0 PART I, LINE 3: METHOD TO ACCOUNT FOR EXPENDITURES ON ORGANIZATION'S FINANCIAL STATEMENTS: CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL SCHEDULE F, PART I, LINE 3(F) PROGRAM SERVICE ACTIVITY: $56,509,825 INVESTMENTS 691,964 EXPENSES $57,201,789 TOTAL 1 UNIVERSITY OF AKRON 302 BUCHTEL COMMON AKRON OH 44301 346002924 GOVERNMENTAL 250000 EDUCATIONAL YMCA OF AKRON 50 SOUTH MAIN STREET STE LL 100 AKRON OH 44308 340714727 501(C)(3) 160000 MISSION SUPPORT AMERICAN HEART ASSOCIATION 3505 EMBASSY PARKWAY STE 100 AKRON OH 44333 135613797 501(C)(3) 25000 RESEARCH AND EDUCATION 3 PART I, LINE 2: THE PROCEDURE FOR MONITORING GRANT FUNDS IS BASED ON THE CRITERIA ESTABLISHED PRIOR TO AWARDING THE GRANT OR ASSISTANCE. ONCE THE CRITERIA IS MET, A PAYMENT WILL BE MADE TO THE UNIVERSITY OR AGENCY UTILIZING THE FUNDS. X 1 1 X X X X 1 1 0 0 0 0 0 1 0 MICHAEL HUGHES MD DIRECTOR 0 640801 0 22573 0 2190 0 7950 0 17962 0 691476 0 0 R DOUGLAS TROCHELMAN MD DIRECTOR (END 7/2015) 0 654484 0 55100 0 2190 0 9275 0 17063 0 738112 0 0 VIVIAN VON GRUENIGEN MD DIRECTOR 0 454350 0 0 0 1590 0 3130 0 24737 0 483807 0 0 THOMAS MALONE MD PRESIDENT & CEO 796996 0 250000 0 238337 0 5608 0 16937 0 1307878 0 0 0 BRIAN DERRICK TREASURER, SR VP, CFO 540515 0 143655 0 260866 0 6625 0 16927 0 968588 0 55878 0 ROBERT A GERBERRY SECRETARY/GENERAL COUNSEL 350682 0 59706 0 65534 0 4846 0 1461 0 482229 0 0 0 ERIC HUMPHREY SR. VP, HR (END 2/15) 34308 0 28573 0 210338 0 3347 0 4335 0 280901 0 0 0 KATHLEEN JOBE VP, CNO 0 179937 0 15756 0 40709 0 6994 0 15385 0 258781 0 0 GREG KALL SR. VP, CIO 298479 0 52196 0 172308 0 9224 0 16158 0 548365 0 51320 0 UNHEE KIM SR. VP, CLINICAL SERVICES 21395 0 94413 0 710061 0 3612 0 4590 0 834071 0 68184 0 THOMAS P O'NEILL VP, CFO SHS 291048 0 70000 0 194618 0 9275 0 9002 0 573943 0 32825 0 ERIK STEELE DO CMO, SUMMA HOSPITALS 493506 0 90963 0 170820 0 7950 0 0 0 763239 0 11381 0 MARK TERPYLAK DO PRESIDENT, SUMMA ACO 0 324035 0 75185 0 103799 0 505 0 1132 0 504656 0 0 MARY WARD SR. VP, CNO 357702 0 102331 0 216394 0 7950 0 2359 0 686736 0 67624 0 VALERIE GIBSON RN CHIEF OPERATING OFFICER SUMMA HEALTH 428586 0 0 0 115891 0 0 0 19810 0 564287 0 0 0 BENJAMIN P SUTTON SR. VP STRATEGY & PERFORMANCE 228649 0 57157 0 27111 0 8999 0 22953 0 344869 0 0 0 ROB WHITEHOUSE SR. VP MARKETING & COMMUNICATION 163714 0 0 0 38113 0 0 0 17002 0 218829 0 0 0 ED FRIEDL VP, CONSTRUCTION 208622 0 21659 0 38564 0 5600 0 23317 0 297762 0 0 0 JOSEPH ZARCONI MD FACP ATTENDING NEPHROLOGY 158039 0 49541 0 689840 0 7771 0 11691 0 916882 0 63647 0 JASON NIEHAUS SR. VP SYS HOSP OPS 319850 0 143334 0 119003 0 1313 0 22303 0 605803 0 0 0 DAVID P JOHNSON SR. VP REVENUE CYCLE 240594 0 36000 0 45392 0 5264 0 7891 0 335141 0 0 0 JEFFREY R PRICE VP PAYER STRATEGY 219614 0 24355 0 22410 0 5250 0 21951 0 293580 0 0 0 THOMAS J STRAUSS FORMER PRESIDENT & CEO 86438 0 294381 0 163833 0 0 0 3570 0 548222 0 148461 0 WILLIAM A POWEL III FORMER OFFICER 0 0 87754 0 75384 0 0 0 1864 0 165002 0 69249 0 ROBERT D HARRIGAN FORMER OFFICER 0 0 0 0 215100 0 0 0 3874 0 218974 0 0 0 PATRICE LANGE FORMER SR. VP 0 0 60693 0 51076 0 0 0 808 0 112577 0 46643 0 CHARLES ROSS MD FORMER CMI 0 0 54415 0 360393 0 0 0 2399 0 417207 0 34672 0 ROXIA BOYKIN FORMER VP, COMM BENEFIT & DIVERSI 2033 0 43233 0 267927 0 493 0 1810 0 315496 0 25155 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: SUMMA HEALTH GROSSED UP TAXES FOR SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS PAID TO THREE OFFICERS, ONE FORMER OFFICER, TWELVE KEY EMPLOYEES, TWO FORMER EMPLOYEES AND THREE HIGHEST COMPENSATED EMPLOYEES. THE AMOUNT OF THE GROSS UP IS RECOGNIZED AS ADDITIONAL TAXABLE COMPENSATION. PART I, LINES 4A-B PART I, LINE 4A SEVERANCE OR CHANGE-OF-CONTROL PAYMENT: IN 2015, THE FOLLOWING LISTED PERSONS RECEIVED SEVERANCE PAYMENTS AND BENEFITS FROM THE ORGANIZATION OR FROM A RELATED ORGANIZATION: THOMAS J. STRAUSS $15,372, PATRICE LANGE $4,121, WILLIAM POWEL, III $5,725; CHARLES ROSS, MD $237,680; ROBERT D. HARRIGAN $158,378; ERIC HUMPHREY $148,635; UNHEE KIM $401,704; ROXIA BOYKIN $183,436; JOSEPH ZARCONI, MD, FACP $331,305. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: SUMMA HEALTH HAS A 457(F) PROGRAM WHICH REWARDS CERTAIN OFFICERS, DIRECTORS, KEY AND HIGHEST COMPENSATED EMPLOYEES FOR MEETING LONG TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. AMOUNTS INCLUDABLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS, DUE TO PLAN PARTICIPATION IN THE REPORTING YEAR, WERE AS FOLLOWS: THOMAS MALONE, MD $39,675, BRIAN K. DERRICK $114,825, GREG KALL $86,356, UNHEE KIM $68,184, THOMAS P. O'NEILL $55,117, ERIK STEELE, DO $41,374, MARK TERPYLAK, DO $6,879, MARY WARD $109,424, JOSEPH ZARCONI, MD $100,871, JASON NIEHAUS $ 6,452, PATRICE LANGE $46,643, WILLIAM POWELL, III $69,249, CHARLES ROSS, MD $34,672, THOMAS STRAUSS $148,461, ROXIA BOYKIN $ 25,155. PART I, LINE 7 THE SUMMA HEALTH MANAGEMENT INCENTIVE PROGRAM IS DESIGNED TO REWARD EMPLOYEES FOR MEETING QUALITY, PERFORMANCE AND FINANCIAL TARGETS. THESE TARGETS INCLUDE CLINICAL QUALITY, PATIENT SATISFACTION, EMPLOYEE/PHYSICIAN SATISFACTION, OPERATING MARGIN AND THE STRENGTHENING OF THE BALANCE SHEET. PAYMENT IS BASED ON A FACTOR OF BASE COMPENSATION AND IS SUBJECT TO REVIEW AND APPROVAL BY SUMMA'S COMPENSATION COMMITTEE. CYNTHIA BROWNING FAMILY MEMBER OF NICHOLAS BROWNING, SUMMA HEALTH BOARD MEMBER. 51704 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS: RICHARD MARSH, LEILA VESPOLI, AND ANTHONY LOCKHART - BUSINESS RELATIONSHIP. THOMAS MALONE, M.D., THOMAS P. O'NEILL AND ERIK N. STEELE, D.O. - BUSINESS RELATIONSHIP. THOMAS P. O'NEILL AND UNHEE KIM - BUSINESS RELATIONSHIP. BRIAN DERRICK, THOMAS MALONE, M.D., JAMES MCILVAINE, AND ERIC N. STEELE, D.O. - BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES IN GOVERNING DOCUMENTS: SUMMA HEALTH: THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS WERE AMENDED IN MARCH 2015 TO CHANGE THE NAME OF THE CORPORATION FROM SUMMA HEALTH SYSTEM TO SUMMA HEALTH. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: THE MEMBERS OF SUMMA HEALTH ARE SUMMA HEALTH SYSTEM COMMUNITY ("SUMMA MEMBER") AND HEALTHSPAN PARTNERS ("COMMUNITY MEMBER"). SUMMA MEMBER'S INTEREST IS 70%; COMMUNITY MEMBER'S INTEREST IS 30%. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY: THE MEMBERS OF THE CORPORATION ARE SUMMA HEALTH SYSTEM COMMUNITY ("SUMMA MEMBER") AND HEALTHSPAN PARTNERS ("COMMUNITY MEMBER"). THE MEMBERS HAVE THE FOLLOWING POWERS: 1. COMMUNITY MEMBER TO ELECT 5 DIRECTORS (AT LEAST 1 TO BE A RESIDENT OR COMMUNITY LEADER ACTIVE IN SUMMA'S MARKET AREA AND AT LEAST 1 TO BE A PHYSICIAN; THESE MAY BE SAME INDIVIDUAL) 2. SUMMA MEMBER TO ELECT 10 DIRECTORS (7 ELECTED LAY DIRECTORS AND 3 PHYSICIAN DIRECTORS) A DIRECTOR MAY ONLY BE REMOVED BY THE MEMBER WHICH ELECTED SUCH DIRECTOR, AND IF A MEMBER REMOVES A DIRECTOR ELECTED BY SUCH MEMBER, THEN THAT MEMBER MAY ELECT A DIRECTOR TO FILL THE VACANCY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS: THE FOLLOWING ARE RESERVED POWERS FOR THE MEMBERS OF THE CORPORATION: 1. ACTIONS THAT WOULD ADVERSELY IMPACT THE TAX-EXEMPT STATUS OF THE CORPORATION OR MERCY HEALTH 2. APPOINTMENT OF A NEW CEO 3. DISSOLUTION, MERGER, CONVERSION, OR CONSOLIDATION OF THE CORPORATION, OR SALE/LEASE/DISPOSITION OF SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS 4. SALE, LEASE, DISPOSITION OF CORPORATION'S CORE OPERATING ASSETS AS DEFINED IN DEFINITIVE AGREEMENT 5. ADDITION OF A NEW CORPORATE MEMBER OF THE CORPORATION 6. AMENDMENT TO THE STATEMENT OF COMMON VALUES 7. AMENDMENT TO THE ARTICLES OF INCORPORATION OR CODE OF REGULATIONS RESERVED POWERS 1, 3, 4, 5, 6, AND 7 REQUIRE THE APPROVAL OF EACH OF THE MEMBERS FORM 990, PART VI, SECTION B, LINE 11 REVIEW OF FORM 990 BY GOVERNING BODY: THE RETURN WAS REVIEWED IN DETAIL BY A COMMITTEE CONSISTING OF INTERNAL LEGAL COUNSEL, FINANCIAL MANAGEMENT, AND AN EXTERNAL AUDITOR. THE REVIEW COMMITTEE INCLUDED THE SENIOR VICE PRESIDENT, FINANCE & CFO AND THE SENIOR VICE PRESIDENT, LEGAL SERVICES & GENERAL COUNSEL. THIS DETAILED REVIEW OCCURRED IN OCTOBER 2016. FOLLOWING THIS REVIEW AND INCORPORATION OF CHANGES RECOMMENDED BY THIS COMMITTEE, THE RETURN WAS PROVIDED TO THE SUMMA HEALTH COMMITTEE ON GOVERNANCE PRIOR TO ITS OCTOBER 2016 MEETING FOR FURTHER REVIEW. THE COMMITTEE ON GOVERNANCE IS A STANDING COMMITTEE APPOINTED BY THE SUMMA HEALTH BOARD OF DIRECTORS AND INCLUDES MEMBERS OF THE BOARD OF DIRECTORS. AFTER THESE REVIEWS BY THE COMMITTEE ON GOVERNANCE AND THE COMMUNITY BENEFITS COMMITTEE, AND PRIOR TO FILING WITH THE IRS, AN EMAIL WAS SENT TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS. THIS EMAIL INCLUDED INSTRUCTIONS AND A LINK TO A PASSWORD-PROTECTED WEB SITE ON WHICH THE ENTIRE FORM 990 WAS AVAILABLE FOR VIEWING, PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST PROCESS SUMMARY: A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT ANNUALLY TO ALL SUMMA HEALTH ENTITIES' BOARDS OF DIRECTORS, KEY EMPLOYEES, SENIOR MANAGERS, MEDICAL DIRECTORS, EMPLOYED PHYSICIANS, CONTRACTED PHYSICIANS, ADMINISTRATIVE DIRECTORS, EXECUTIVE DIRECTORS, DEPARTMENT HEADS, MANAGERS, SUPERVISORS, AND MEMBERS OF PURCHASING COMMITTEES FOR COMPLETION. RESPONSES ARE INDIVIDUALLY REVIEWED FOR DETERMINATION OF POTENTIAL CONFLICTS. THOSE RESPONSES DEEMED TO PRESENT POTENTIAL CONFLICTS ARE THEN PRESENTED TO THE COMMITTEE ON GOVERNANCE (SUB-COMMITTEE OF THE SUMMA HEALTH BOARD OF DIRECTORS). THE COMMITTEE ON GOVERNANCE REVIEWS EACH RESPONSE THAT PRESENTS A POTENTIAL CONFLICT AND DETERMINES WHETHER ADDITIONAL ACTION IS REQUIRED TO ELIMINATE OR MITIGATE THE POTENTIAL CONFLICT. THIS ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE PROCESS IS MANAGED BY THE CORPORATE COMPLIANCE DEPARTMENT PURSUANT TO THE SUMMA HEALTH POLICY ON CONFLICT OF INTEREST AS APPROVED BY THE SUMMA HEALTH BOARD OF DIRECTORS. IN ADDITION TO THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, THE CONFLICT OF INTEREST POLICY IMPOSES A DUTY TO DISCLOSE CONFLICTING INTERESTS ON AN ONGOING BASIS. FORM 990, PART VI, SECTION B, LINE 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OTHER EMPLOYEES: EXECUTIVE COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUMMA HEALTH BOARD OF DIRECTORS MEETS AT LEAST TWICE EACH YEAR TO REVIEW AND APPROVE BASE COMPENSATION AND TOTAL REMUNERATION FOR EXECUTIVE STAFF. EACH VOTING MEMBER OF THE COMPENSATION COMMITTEE IS AN INDEPENDENT DIRECTOR AND IS NOT AFFILIATED WITH MANAGEMENT. THE COMPENSATION COMMITTEE ENGAGES OUTSIDE CONSULTING SUPPORT TO PROVIDE INDEPENDENT MARKET DATA, ADVICE AND COUNSEL TO THE COMPENSATION COMMITTEE. FOR THE PAST SIX YEARS, THE COMPENSATION COMMITTEE HAS USED HAY GROUP, A NATIONALLY RECOGNIZED CONSULTING FIRM, TO ASSIST THEIR EFFORTS. THE HAY GROUP PROVIDES THE FOLLOWING SERVICES TO THE COMPENSATION COMMITTEE: (A) EDUCATION OF COMMITTEE MEMBERS REGARDING EXECUTIVE COMPENSATION TRENDS AND BEST PRACTICES IN HEALTHCARE ORGANIZATIONS; (B) ASSESSMENT OF THE MARKET COMPETITIVENESS AND REASONABLENESS OF SUMMA'S EXECUTIVE COMPENSATION PROGRAMS INCLUDING BASE SALARY, INCENTIVE COMPENSATION, CORE AND EXECUTIVE BENEFITS, AS WELL AS THEIR ALIGNMENT WITH THE MISSION AND FUTURE PERFORMANCE EXPECTATIONS; (C) WRITTEN, DETAILED EVALUATION OF THE MARKET REASONABLENESS OF SUMMA'S EXECUTIVE COMPENSATION AND BENEFITS PROGRAM; AND (D) ONGOING SUPPORT AND INDEPENDENT ADVICE TO THE COMPENSATION COMMITTEE ON MATTERS RELATED TO EXECUTIVE COMPENSATION. EACH YEAR THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION FOR THE FOLLOWING POSITIONS: SUMMA HEALTH PRESIDENT & CEO SENIOR VICE PRESIDENT, FINANCE & CFO SENIOR VICE PRESIDENT, LEGAL SERVICES & GENERAL COUNSEL SENIOR VICE PRESIDENT, IT&S & CIO SENIOR VICE PRESIDENT, PLANNING & MARKETING SENIOR VICE PRESIDENT & CHIEF NURSING OFFICER SENIOR VICE PRESIDENT, HUMAN RESOURCES SENIOR VICE PRESIDENT, CHIEF MEDICAL OFFICER CHIEF OPERATING OFFICER PRESIDENT, SUMMACARE FORM 990, PART VI, SECTION C, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC: SUMMA HEALTH MAKES ITS CONFLICTS OF INTEREST POLICY AVAILABLE UPON REQUEST. THE ARTICLES OF INCORPORATION OF SUMMA HEALTH AND ITS RELATED ENTITIES ARE AVAILABLE ON THE WEBSITE OF THE OHIO SECRETARY OF STATE (WWW.SOS.STATE.OH.US). SUMMA HEALTH MAKES ITS FINANCIAL STATEMENTS AVAILABLE ON ITS WEBSITE (WWW.SUMMAHEATLH.ORG). THE FINANCIAL STATEMENTS ARE ALSO AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS. (WWW.EMMA.MSRB.ORG). FORM 990, PART IX, LINE 11G NON-BILLABLE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,566,627. MANAGEMENT AND GENERAL EXPENSES 2,584,119. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,150,746. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 3,677,009. MANAGEMENT AND GENERAL EXPENSES 700,383. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,377,392. HEALTH SCREENING: PROGRAM SERVICE EXPENSES 53,973. MANAGEMENT AND GENERAL EXPENSES 10,280. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64,253. FORM 990, PART XI, LINE 9: TRANSFERS TO/FROM AFFILIATES 61,644,000. POST RETIREMENT BENEFIT ADJUSTMENT 39,752. OTHER ADJUSTMENTS 107,696. OTHER NET ASSETS ADJUSTMENTS -19,984,453. 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