2016-11-14T07:26:47-06:00 2015-12-31 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2015-01-01 900640432 SUMMA HEALTH GROUP RETURN 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 1116133051 1 1 5864 X WWW.SUMMAHEALTH.ORG X THE MISSION OF SUMMA HEALTH IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO PATIENTS AND MEMBERS AND CONTRIBUTE TO A HEALTHIER COMMUNITY. X 43 37 7923 1115 9342904 0 8525120 5313648 1002586876 1036977973 10685360 7422791 28711727 18594038 1050509083 1068308450 354193 245767 0 0 457028302 454148546 0 0 3255164 541818043 552725056 999200538 1007119369 51308545 61189081 1165798880 1139746498 687554548 672875229 478244332 466871269 X SUMMA HEALTH'S MISSION IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO PATIENTS AND MEMBERS AND CONTRIBUTE TO A HEALTHIER COMMUNITY. 0 0 373883716 529583648 OUTPATIENT SERVICES FOR 2015: SUMMA HEALTH SYSTEM, SUMMA BARBERTON CITIZENS HOSPITAL AND SUMMA PHYSICIANS, INC. PROVIDED MORE THAN 1.5 MILLION OCCASIONS OF SERVICE, INCLUDING 166,170 EMERGENCY DEPARTMENT VISITS, 14,193 OBSERVATION PATIENTS, 13,744 SURGICAL OPERATIONS, AND MORE THAN 1.3 MILLION OTHER OUTPATIENT VISITS. 301609680 427211852 INPATIENT SERVICES FOR 2015: SUMMA HEALTH SYSTEM AND SUMMA BARBERTON CITIZENS HOSPITAL HAD APPROXIMATELY 700 BEDS IN SERVICE, ADMITTED 37,286 ADULT PATIENTS, AND DELIVERED 3,700 NEWBORNS. THE ADULT PATIENTS RECEIVED 169,245 DAYS OF CARE, INPATIENT SURGERIES TOTALED 7,109, EMERGENCY ADMISSIONS TOTALED 25,967 AND THE AVERAGE LENGTH OF STAY WAS 4.54 DAYS. 55085130 12749024 RESEARCH/EDUCATION FOR 2015: SUMMA HEALTH HAS A HISTORY OF SPONSORING AND SUPPORTING BASIC AND CLINICAL RESEARCH TO UNDERSTAND DISEASES AND TREATMENT. CENTERS, PROGRAMS AND LABS FACILITATE RESEARCH IN A NUMBER OF MEDICAL FIELDS. SUMMA HEALTH FOSTERS A LEARNING ENVIRONMENT FOR THE NEXT GENERATION OF CAREGIVERS. AT SUMMA HEALTH'S HOSPITALS, APPROXIMATLY 250 MEDICAL SCHOOL GRADUATES TRAIN IN 19 ACCREDITED RESIDENCY PROGRAMS. SUMMA HEALTH PROVIDES CLINICAL LEARNING EXPERIENCES TO MORE THAN 250 NURSING AND ALLIED HEALTH STUDENTS. PART III LINE 4D - OTHER PROGRAM SERVICES: SUMMA HEALTH IS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT PROVIDES COORDINATED, VALUE-BASED CARE ACROSS THE CONTINUUM FOR THE PEOPLE AND POPULATIONS WE SERVE. WE HOLD OURSELVES CLINICALLY AND FINANCIALLY ACCOUNTABLE FOR HEALTH OUTCOMES IN OUR COMMUNITIES.SUMMA HEALTH SERVES MORE THAN ONE MILLION PATIENTS EACH YEAR IN COMPREHENSIVE EMERGENCY, ACUTE, CRITICAL, OUTPATIENT AND LONG-TERM/HOMECARE SETTINGS AND REPRESENTS MORE THAN 1,300 REGISTERED, INPATIENT BEDS ON THE CAMPUSES OF SUMMA HEALTH SYSTEM, SUMMA BARBERTON CITIZEN'S HOSPITAL, SUMMA REHAB HOSPITAL*, AND WESTERN RESERVE HOSPITAL*. IN ADDITION, OUTPATIENT CARE IS PROVIDED IN MORE THAN 20 COMMUNITY HEALTH CENTERS AND EMERGENCY DEPARTMENTS (EDS), SOME INTEGRATED IN THE HEALTHCARE FACILITIES, OTHERS ARE FREE-STANDING. *SUMMA REHAB HOSPITAL AND * WESTERN RESERVE HOSPITAL ARE JOINT VENTURES IN WHICH SUMMA HEALTH HAS AN INTEREST, AND ARE REFERENCED IN THIS DOCUMENT FOR THE PURPOSE OF IDENTIFYING ALL ENTITIES AFFILIATED WITH SUMMA HEALTH. SUMMA'S PROPORTIONATE INTEREST OF THESE JOINT VENTURES' CHARITY CARE AND OTHER COMMUNITY BENEFITS ARE INCLUDED ON SCHEDULE H OF SUMMA HEALTH'S IRS FORM 990 GROUP RETURN.PROVIDING SUPERIOR, MULTI-SPECIALTY PATIENT CARE, MEDICAL RESEARCH AND CONTINUING MEDICAL EDUCATION, SUMMA HEALTH RANKS AS A HIGHLY RECOGNIZED HEALTHCARE PROVIDER IN SEVERAL DISCIPLINES INCLUDING: BARIATRIC SURGERY, CARDIOVASCULAR, EMERGENCY, ONCOLOGY, ORTHOPAEDIC SURGERY, PRIMARY CARE SPORTS MEDICINE, STROKE AND NURSING BY PRESTIGIOUS ORGANIZATIONS SUCH AS:AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCERAMERICAN HEART ASSOCIATIONAMERICAN STROKE ASSOCIATIONNATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERSAMERICAN NURSING CREDENTIALING CENTERCENTERS FOR MEDICARE AND MEDICAID SERVICESPREMIER HEALTHCARE ALLIANCEOHIO PATIENT SAFETY INSTITUTEUS NEWS AND WORLD REPORTAMERICAN COLLEGE OF RADIATIONNURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERSAMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY: CENTER OF EXCELLENCEMETABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAMTHE JOINT COMMISSIONBABY-FRIENDLY THE LEAPFROG GROUPSUMMA HEALTH IS SUMMIT COUNTY'S LARGEST EMPLOYER AND A LEADING ECONOMIC ENGINE FOR THE REGION. SUMMA HEALTH INCLUDES THE FOLLOWING:SUMMA HEALTH SYSTEM:SUMMA HEALTH SYSTEM IS A SINGLE LEGAL ENTITY THAT INCLUDES THREE INPATIENT HOSPITAL CAMPUSES AND SEVERAL AMBULATORY LOCATIONS. SUMMA HEALTH SYSTEM OPERATES THE INPATIENT HOSPITAL LOCATIONS AS WELL AS THE HOSPITAL-BASED OFF-SITE LOCATIONS UNDER THE SAME MEDICARE PROVIDER NUMBER.SUMMA HEALTH EMPLOYS MORE THAN 9,000 INDIVIDUALS WITH SUMMA HEALTH SYSTEM ACCOUNTING FOR APPROXIMATELY 6,000 OF THESE EMPLOYEES. SUMMA HEALTH SYSTEM HAS A MEDICAL STAFF OF MORE THAN 1,000 PROFESSIONALS WORKING ON ITS CAMPUSES. SUMMA HEALTH SYTSEM HAS 1,320 REGISTERED BEDS. THE BUILDINGS AND FACILITIES ON ALL CAMPUSES TOTAL APPROXIMATELY 2.2 MILLION SQUARE FEET.SUMMA HEALTH SYSTEM- AKRON CAMPUS OFFERS GENERAL MEDICAL, SURGICAL, OBSTETRICAL, TRAUMA AND CRITICAL CARE SERVICES. THE AKRON CAMPUS PROVIDES ACUTE CARE SERVICES AND A WIDE RANGE OF OUTPATIENT SERVICES ON A CAMPUS OF APPROXIMATELY 60 ACRES. SUMMA HEALTH SYSTEM RECEIVED THE FOLLOWING RECOGNITION IN 2015: SUMMA AKRON CITY & ST. THOMAS HOSPITALS RANKED 13TH BEST HOSPITAL IN OHIO BY U.S. NEWS & WORLD REPORT. IT IS RANKED AS HIGH PERFORMING IN 7 ADULT SPECIALTIES: DIABETES AND ENDOCRINOLOGY; GASTROENTEROLOGY AND GASTROINTESTINAL SURGERY; GERIATRICS; NEPHROLOGY; NEUROLOGY & NEUROSURGERY; PULMONOLOGY; AND UROLOGY. SUMMA HEALTH SYSTEM- ST. THOMAS CAMPUS PROVIDES VARIOUS DIAGNOSTIC SERVICES ALONG WITH BEHAVIORAL HEALTH AND SUBSTANCE ABUSE CARE. SUMMA HEALTH SYSTEM- ST. THOMAS CAMPUS WAS ONE OF THE FIRST IN THE COUNTRY TO RECOGNIZE THE MEDICAL ASPECTS OF ALCOHOLISM AS A DISEASE AND IS THE FOUNDING LOCATION OF ALCOHOLICS ANONYMOUS. THE HOSPITAL OPENED THE NATION'S FIRST ALCOHOLISM TREATMENT WARD AND CONTINUES ITS LONGSTANDING DEDICATION TO THIS PROGRAM TODAY.AS A LEADER IN MEDICAL EDUCATION, SUMMA HEALTH SYSTEM SUPPORTS THE EDUCATION OF ITS PHYSICIANS AND HEALTHCARE PROFESSIONALS. THE AKRON AND ST. THOMAS CAMPUSES ARE TEACHING AFFILIATES OF THE NORTHEAST OHIO MEDICAL UNIVERSITY (NEOMED) AND INCLUDE A STAFF OF PHYSICIANS AND ACCREDITED RESIDENCY AND FELLOWSHIP PROGRAMS THAT FOSTER A DYNAMIC MEDICAL ENVIRONMENT. APPROXIMATELY 80 RESIDENTS AND FELLOWS GRADUATE FROM THE AKRON CAMPUS'S MEDICAL EDUCATION PROGRAMS EACH YEAR. THE BARBERTON CAMPUS HAS A FAMILY PRACTICE RESIDENCY PROGRAM AFFILIATED WITH NEOMED ALONG WITH PROVIDING EDUCATIONAL ROTATIONS FOR MEDICAL STUDENTS.SUMMA HEALTH SYSTEM- BARBERTON CAMPUSSUMMA HEALTH SYSTEM- BARBERTON CAMPUS IS A 500,000 SQUARE FOOT ACUTE CARE TEACHING HOSPITAL LOCATED ON NEARLY 16 ACRES, LOCATED APPROXIMATELY 10 MILES SOUTHWEST OF AKRON, OHIO. THE HOSPITAL HAS MORE THAN 1,600 EMPLOYEES AND HAS A MEDICAL STAFF OF MORE THAN 1,510 PROFESSIONALS. IT HAS 271 LICENSEDBEDS. THE BARBERTON CAMPUS PROVIDES THE COMMUNITY WITH EASY ACCESS TO COMPREHENSIVE, HIGH-QUALITY CANCER SERVICES AT THE COMMISSION ON CANCER ACCREDITED PARKVIEW PAVILION, AS WELL AS THE FULL SPECTRUM OF CARDIOVASCULAR DISEASE CARE INCLUDING DIAGNOSTIC, INTERVENTIONAL AND SURGICAL SERVICES, ALONG WITH A VARIETY OF OUTPATIENT SERVICES. PART III LINE 4D - OTHER PROGRAM SERVICES - CONTINUED:CHARITY CAREIN 2015, SUMMA HEALTH PROVIDED CHARITY CARE AT AN ESTIMATED NET COST OF NEARLY $8.1 MILLION. THIS AMOUNT REPRESENTS THE NET COST ASSOCIATED WITH PROVIDING THE CARE AND DOES NOT INCLUDE BAD DEBT. PATIENTS WITH INCOME UP TO 200% OF THE FEDERAL POVERTY INCOME GUIDELINES OR WHO HAVE A HOSPITAL BILL THAT EXCEEDS 25% OF THEIR GROSS ANNUAL FAMILY INCOME ARE ELIGIBLE TO APPLY FOR FULLY DISCOUNTED CHARITY CARE ASSISTANCE. IN ADDITION, THERE IS A SLIDING SCALE DISCOUNT PROGRAM FOR THOSE WITH INCOMES BETWEEN 200% AND 400% OF THE FEDERAL POVERTY INCOME GUIDELINES. IN 2015, THE CHARITY CARE PROGRAM (INCLUDING HOSPITAL CARE ASSURANCE PROGRAM) BENEFITED APPROXIMATELY 27,000 PATIENT ENCOUNTERS.MEDICAID SHORTFALLHISTORICALLY, OHIO MEDICAID REIMBURSEMENTS HAVE NOT COVERED THE COST OF PROVIDING THE CARE TO PROGRAM BENEFICIARIES, CREATING A BUDGETARY SHORTFALL. AS ONE OF NORTHEAST OHIO'S TOP PROVIDERS OF HOSPITAL CARE FOR MEDICAID PATIENTS, SUMMA HEALTH'S UNPAID COSTS FOR MEDICAID TOTALED MORE THAN $16.3 MILLION.BAD DEBTSUMMA HEALTH IS COMMITED TO PROVIDING QUALITY AND ACCESSIBLE HEALTHCARE. THIS INCLUDES COVERING THE EXPENSE OF PAYMENTS THAT WERE EXPECTED BUT NOT RECEIVED. WHILE SUMMA HEALTH RECOGNIZES BAD DEBT IS PART OF DOING BUSINESS, IT AGREES WITH THE OHIO HOSPITAL ASSOCIATION THAT IT IS IMPORTANT TO REPORT THESE COSTS TO SHOW THE TOTAL PICTURE OF CARE SUMMA HEALTH PROVIDES TO THE COMMUNITY WITHOUT FULL REIMBURSEMENT. IN 2015, THE COST FOR PROVIDING CARE WRITTEN OFF AS A BAD DEBT EXPENSE WAS APPROXIMATELY $16 MILLION.COMMUNITY HEALTH IMPROVEMENT SERVICESAN IMPORTANT PART OF SUMMA HEALTH'S MISSION IS OFFERING A PREVENTION AND WELLNESS PROGRAM TO BUILD A HEALTHIER COMMUNITY. IN 2015, SUMMA HEALTH PROVIDED MORE THAN $3.2 MILLION TO HELP FUND HEALTH IMPROVEMENT ACTIVITIES SUCH AS FREE AND LOW-COST HEALTH SCREENING, HEALTH EDUCATION SERVICES AND WELLNESS PROGRAMMING. SUBSIDIZED HEALTH SERVICES SUMMA HEALTH IS COMMITTED TO PROVIDING SUBSIDIZED HEALTH SERVICES - CLINICIAL SERVICES THAT MEET AN IDENTIFIED COMMUNITY NEED AND ARE PROVIDED DESPITE FINANCIAL LOSS. VITAL SERVICES SUCH AS THE CENTER FOR SENIOR HEALTH, CARE CENTER FOR PATIENTS WITH HIV OR AIDS, AND DIABETES EDUCATION ARE OFFERED, EVEN THOUGH THEY ARE NOT PROFITABLE. INCOME FROM OTHER SERVICES IS USED TO COVER THESE COSTS. IN 2015, THE COST FOR SUBSIDIZED SERVICES WAS APPROXIMATELY $26 MILLION.FINANCIAL AND IN-KIND DONATIONSANNUALLY, SUMMA HEALTH CONTRIBUTES FINANCIAL ASSISTANCE AND IN-KIND SERVICES TO SUPPORT COMMUNITY ORGANIZATIONS THAT PROMOTE HEALTH, WELLNESS, AND AN IMPROVED QUALITY OF LIFE. FROM THE LOCAL CHAPTERS OF NATIONAL GROUPS SUCH AS UNITED WAY, THE AMERICAN HEART ASSOCIATION AND THE AMERICAN CANCER SOCIETY, TO AXESSPOINTE COMMUNITY HEALTH CENTER SUMMA HEALTH PARTICIPATES IN NUMEROUS COMMUNITY PROGRAMS AND HELPS OTHER NONPROFITS FULFILL THEIR MISSIONS. IN 2015, THESE CONTRIBUTIONS WERE MORE THAN $1.1 MILLION.RESEARCH AND INNOVATIONSUMMA HEALTH'S QUALITY MEDICAL CARE IS DERIVED IN PART FROM ITS ABILITY TO TRANSLATE RESULTS FROM CAREFULLY PLANNED AND EXECUTED RESEARCH INTO EFFECTIVE PATIENT CARE STRATEGIES. RESEARCH AND INNOVATION IS AN INTEGRAL FOCUS OF THE ACADEMIC AND CLINICAL ENVIRONMENT AT SUMMA HEALTH AND HELPS SET THE HIGHEST STANDARDS FOR MEDICAL CARE IN THE COMMUNITY. SUMMA HEALTH'S REPUTATION FOR EXCELLENCE IN SUCH CRITICAL SPECIALITIES AS CARDIOLOGY, DIABETES, EMERGENCY SERVICES, ORTHOPAEDICS, ONCOLOGY, SENIOR HEALTH, SURGERY, AND WOMEN'S HEALTH CONTINUES TO GROW THROUGH RESEARCH AND INNOVATION. SUMMA HEALTH INVESTED MORE THAN $4.8 MILLION IN RESEARCH IN 2015. IN ADDITION TO SUPPORT FROM SUMMA FOUNDATION, MAJOR RESEARCH PROGRAMS ARE SUPPORTED BY GRANTS FROM THE NATIONAL INSTITUTES OF HEALTH, THE DEPARTMENT OF DEFENSE AND INDUSTRY SPONSORS.EDUCATION SUMMA HEALTH SUPPORTS THE EDUCATION OF PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS. SUMMA HEALTH SYSTEM IS THE LARGEST OF THE MAJOR TEACHING AFFILIATES OF THE NORTHEST OHIO MEDICAL UNIVERSITY (NEOMED, A CONSORTIUM OF THE UNIVERSITY OF AKRON, KENT STATE UNIVERSITY AND YOUNGSTOWN STATE UNIVERSITY), AND OFFERS EDUCATION TO NEOMED'S COLLEGES OF MEDICINE AND PHARMACY STUDENTS, AS WELL AS TO MEDICAL STUDENTS FROM SCHOOLS AROUND THE COUNTRY. IN ADDITION, SUMMA HEALTH OFFERS 19 ACCREDITED RESIDENCY TRAINING PROGRAMS IN NUMEROUS SPECIALTIES, TRAINING THE NEXT GENERATION OF PRIMARY CARE AND SPECIALTY PHYSICIANS FOR THE REGION AND BEYOND. NURSING EDUCATION ALSO IS OFFERED IN COLLABORATION WITH LOCAL AND NATIONAL UNIVERSITY PARTNERS. IN 2015, APPROXIMATELY 250 RESIDENTS AND FELLOWS TRAINED AT SUMMA HEALTH'S THREE MAIN HOSPITALS. ON AVERAGE, APPROXIMATELY 40% OF THESE RESIDENTS REMAIN IN OUR LOCAL AND SURROUNDING COMMUNITIES. SUMMA HEALTH'S 2015 INVESTMENT IN HEALTH PROFESSIONS EDUCATION TOTALED $36 MILLION. PART III LINE 4D - OTHER PROGRAM SERVICES - CONTINUED:SUMMA HEALTH SERVICES:FOLLOWING IS A DESCRIPTION OF SUMMA HEALTH'S NOTABLE ACCOMPLISHMENTS BY PRIMARY SERVICE LINES IN 2015: BARIATRIC CARE- METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP): SUMMA HEALTH HAS ACHIEVED REACCREDITATION THROUGH THE MBSAQIP, WHICH WORKS TO ADVANCE SAFE, HIGH-QUALITY CARE FOR BARIATRIC SURGERY PATIENTS THROUGH THE ACCREDITATION OF BARIATRIC SURGICAL CENTERS A BARIATRIC SURGICAL CENTER ACHIEVES ACCREDITATION FOLLOWING A RIGOROUS REVIEW PROCESS DURING WHICH IT PROVES THAT IT CAN MAINTAIN CERTAIN PHYSICAL RESOURCES, HUMAN RESOURCES AND STANDARDS OF PRACTICE.CARDIOVASCULAR - SUMMA HEALTH SYSTEM- AKRON CAMPUS IMPLANTED A BREAKTHROUGH MEDICAL DEVICE INTO TWO PATIENTS WHO SUFFER FROM ATRIAL FIBRILLATION (AF). THE DEVICE, KNOWN AS THE "WATCHMAN LEFT ATRIAL APPENDAGE CLOSURE (LAAC) IMPLANT," PROVIDES AN ALTERNATIVE FOR AF PATIENTS WHO PREVIOUSLY RELIED ON BLOOD THINNING MEDICATIONS, SUCH AS WARFARIN (COUMADIN) TO REDUCE THEIR RISK OF STROKE. THE AKRON CAMPUS WAS ONE OF ONLY TWO HOSPITALS IN OHIO TO OFFER WATCHMAN. SUMMA HEALTH SYSTEM EARNED THE AMERICAN HEART ASSOCIATION (AHA) DESIGNATION AS A MISSION: LIFELINE HEART ATTACK RECEIVING CENTER.THE (AHA)/AMERICAN STROKE ASSOCIATION RECOGNIZED SUMMA HEALTH SYSTEM- AKRON CAMPUS AS A GOLD ACHIEVEMENT HOSPITAL FOR SUCCESSFULLY IMPLEMENTING A HIGHER STANDARD OF CARE FOR HEART FAILURE PATIENTS THROUGH THE GET WITH THE GUIDELINES -HEART FAILURE QUALITY IMPROVEMENT PROGRAM.NEUROSCIENCE - SUMMA HEALTH INTRODUCED THE TELEMEDICINE PROGRAM FOR STROKE THAT INCLUDES ADVANCED INTOUCH HEALTH ROBOTS AT EMERGENCY DEPARTMENTS AT SUMMA HEALTH SYSTEM- AKRON AND BARBERTON CAMPUSES. THE ROBOTS ALLOW STROKE NEUROLOGISTS TO REMOTELY PERFORM LIVE, REAL-TIME AUDIOVISUAL CONSULTATIONS WITH THE PATIENT AND EMERGENCY MEDICINE TEAM TO SPEED THE DELIVERY OF CLOT-BUSTING DRUGS CRUCIAL TO HALT AND REVERSE STROKE DAMAGE. SUMMA HEALTH SYSTEM- AKRON CAMPUS HAS BEEN CERTIFIED AS AN ADVANCED PRIMARY STROKE CENTER BY THE JOINT COMMISSION SINCE 2007. OUR CENTER FOR STROKE CARE WAS RECOGNIZED NATIONALLY TO RECEIVE THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD FOR THE SIXTH YEAR IN A ROW.ONCOLOGY - IN 2015, SUMMA HEALTH SYSTEM- AKRON CAMPUS OPENED A NEW BREAST CENTER AND BECAME THE ONLY HEALTHCARE SYSTEM IN THE REGION TO OFFER 3D AND 2D SCREENING AND DIAGNOSTIC MAMMOGRAMS AT ALL OF ITS IMAGING LOCATIONS.RESPIRATORY - EXPANDED ITS SMOKING CESSATION PROGRAM ACROSS THE SYSTEM.WOMEN'S SERVICES - IN AN EFFORT TO SUPPORT A HEALTHY BEGINNING FOR ALL MOTHERS AND BABIES, SUMMA HEALTH SYSTEM- AKRON CAMPUS PURSUED AND EARNED RECOGNITION AS A BABY-FRIENDLY DESIGNATED BIRTH FACILITY. BABY-FRIENDLY HOSPITALS HELP PROVIDE THE EXTRA EDUCATION AND SUPPORT NEW MOMS NEED TO SUCCESSFULLY BREASTFEED THEIR BABIES. CURRENTLY THERE ARE NEARLY 300 ACTIVE BABY-FRIENDLY HOSPITALS AND BIRTH CENTERS IN THE U.S. THE AKRON CAMPUS IS THE ONLY FACILITY IN SUMMIT COUNTY TO EARN THIS DESIGNATION. SUMMA HEALTH RECEIVED A MONETARY AWARD FROM AMERICAN EXCESS INSURANCE EXCHANGE (AEIX) FOR THE CENTERING PREGNANCY FOR THE OPIATE ADDICTED PREGNANT WOMAN INITIATIVE TAKING PLACE WITHIN THE HOSPITAL SYSTEM. THE CENTERING GROUP CARE (CGC) PROGRAM AT SUMMA HEALTH SYSTEM OFFERS AN APPOINTMENT OPTION FOR WOMEN, WITH DEDICATED CLASSES FOR PREGNANT WOMEN BATTLING ADDICTION. THIS HIGH-RISK GROUP VISIT MODEL ASSISTS OPIATE-ADDICTED PREGNANT WOMEN TO ENSURE A HEALTHY BABY AND REDUCE THE ADMISSIONS AND LENGTH OF STAY IN THE NEONATAL INTENSIVE CARE UNIT (NICU).SYSTEM- SUMMA HEALTH'S ACCOUNTABLE CARE ORGANIZATION, NEWHEALTH COLLABORATIVE, WAS RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR ACHIEVING SIGNIFICANT MULTI-MILLION DOLLAR SAVINGS IN THE MEDICARE SHARED SAVINGS PROGRAM.FOR THE 12TH CONSECUTIVE YEAR, SUMMA HEALTH WAS NAMED AS ONE OF THE 99 BEST WORKPLACES IN NORTHEAST OHIO, AS DETERMINED IN THE ANNUAL NORTHCOAST 99 AWARDS, SPONSORED BY THE EMPLOYERS RESOURCE COUNCIL.FOR THE FIFTH CONSECUTIVE YEAR, SUMMA HEALTH WAS NAMED ONE OF "HEALTHCARE'S MOST WIRED ORGANIZATIONS BY HOSPITALS & HEALTH NETWORKS (H&HN) FOR ACHIEVEMENT IN THE USE OF HEALTHCARE IT. 42183247 245767 59750016 PART III LINE 4D - OTHER PROGRAM SERVICES - FINAL SECTION:SUMMARYALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF SUMMA HEALTH, NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. SUMMA HEALTH PROVIDED SERVICES TO ALL PATIENTS ON A NON-DISCRIMINATORY BASIS AND WITHOUT REGARD TO ANY PATIENT'S ABILITY TO PAY FOR SUCH SERVICES OR THE INDIVIDUAL'S PARTICIPATION IN A GOVERNMENT-SPONSORED OR SUBSIDIZED HEALTHCARE SYSTEM.PATIENTS WERE ENCOURAGED TO APPLY FOR UNCOMPENSATED CARE AND, DEPENDING ON THEIR LEVEL OF INCOME AND NUMBER OF DEPENDENTS, ALL (OR A PORTION) OF THEIR BILL WAS REDUCED. GROSS ANNUAL FAMILY INCOME WAS COMPARED USING A SLIDING SCALE BASED ON THE FEDERAL POVERTY INCOME GUIDELINES TO DETERMINE THE CHARITY DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. IN 2015, SUMMA HEALTH PROVIDED CHARITY CARE TO THE INDIGENT (INCLUDING UNREIMBURSED MEDICAID) AT THE COST OF APPROXIMATELY $ 24 MILLION. THIS AMOUNT DOES NOT INCLUDE SERVICES PROVIDED WRITTEN OFF AS BAD DEBT.IN ADDITON TO UNCOMPENSATED MEDICAL CARE, SUMMA HEALTH PROVIDED WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS AND SPECIAL PROGRAMS FOR THE ELDERLY, PERSONS WITH DISABILITIES AND THE MEDICALLY UNDERSERVED. SUMMA HEALTH ALSO OPERATED A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THESE PROGRAMS WERE OFFERED AT A REDUCED PRICE OR PROVIDED TO THE COMMUNITY FREE OF CHARGE. SUMMA HEALTH OPERATES ITS FACILITIES IN A MANNER CONSISTENT WITH THE COMMUNITY BENEFIT REQUIREMENTS OF REV. RULE 69-545 AND SUBSEQUENT CASE LAW AND IRS GUIDELINES. SUMMA HEALTH'S HOSPITALS PROVIDE EMERGENCY SERVICES WHICH ARE OPEN AND AVAILABLE TO ALL PERSONS OF THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. THE BOARD OF DIRECTORS CONSISTED OF PERSONS WHO ARE BROADLY REPRESENTATIVE OF THE COMMUNITY AND MEDICAL STAFF.SUMMA PHYSICIANS INC. - PROGRAM SERVICE ACCOMPLISHMENTSSUMMA PHYSICIANS INC. (SPI), A SUMMA HEALTH ENTITY, IS A MULTI-SPECIALTY GROUP OF PHYSICIANS AND PHYSICIAN PRACTICES. IN TOTAL, SPI EMPLOYS NEARLY 300 PHYSICIANS AND MORE THAN 700 SUPPORT STAFF IN MORE THAN 30 SPECIALTIES AND SUB-SPECIALTIES. SPI PROMOTES STRONG AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIAN SERVICES ARE MET. IN 2015, SPI CONTINUED ITS DELVELOPMENT OF PRIMARY CARE PODS AND THE MEDICAL HOME MODEL OF CARE, TO FURTHER ENHANCE THE FOCUSED PATIENT CARE MODEL, BETTER COMMUNICATE QUALITY INITIATIVES AND ENHANCE PHYSICIAN RECRUITMENT.SUMMA HEALTH FOUNDATION - PROGRAM SERVICE ACCOMPLISHMENTSTHROUGH PHILANTHROPY, SUMMA HEALTH FOUNDATION SUPPORTS PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. SUMMA HEALTH FOUNDATION OFFERS A SPECTRUM OF PHILANTHROPIC OPTIONS FOR DONORS DESIGNED TO CREATE A POSITIVE IMPACT ON SUMMA HEALTH'S OPERATIONS, PROGRAMS, PROJECTS AND PERCEPTIONS AND TO AFFECT POSITIVE CHANGE IN THE COMMUNITIES SUMMA HEALTH SERVES. PHILANTHROPIC COMMITMENTS TO THE SUMMA HEALTH FOUNDATION IN 2015 TOTALED $5.5 MILLION.COMMUNITY BENEFIT AND DIVERSITY THIS DEPARTMENT LEADS EFFORTS TO ADDRESS HEALTH DISPARITIES AND OTHER IMPORTANT COMMUNITY NEEDS AND RAISE AWARENESS OF HEALTH AND HEALTHCARE ISSUES AFFECTING THE COMMUNITIES SERVED BY SUMMA HEALTH. COMMUNITY BENEFIT AND DIVERSITY PROVIDE WELLNESS AND EDUCATIONAL TOOLS, FACILITATE ECONOMIC DEVELOPMENT PROGRAMS, DEVELOP COMMUNITY PARTNERSHIPS, COMMUNICATE SUMMA HEALTH'S BENEFIT TO THE COMMUNITY AND ENGAGE THE COMMUNITY AND ITS WORKFORCE WITHIN THE SYSTEM AND THROUGHOUT THE REGION.GOVERNMENT RELATIONS THIS DEPARTMENT IS DEDICATED TO ELEVATING SUMMA HEALTH AS A CREDIBLE LEADER AND PARTNER IN THE HEALTH POLICY PLANNING PROCESS. THIS DEPARTMENT COLLABORATES WITH NUMEROUS DEPARTMENTSTO BEST POSITION SUMMA EDUCATION, RESEARCH AND CLINICAL INNOVATION PRIORITIES WITH PUBLIC SECTOR FUNDING OPPORTUNITIES. 42183247 245767 59750016 772761773 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 1 1 1 1 0 0 1 0 0 7923 1 1 1 0 0 0 0 1 1 0 0 0 0 X 43 37 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH FL X X BRIAN K DERRICK 2343125871 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 X THOMAS CLARK DIRECTOR/CHAIR SF 4.00 0.00 X X 0 0 0 DANIEL FINELLI MD DIR./VICE CHAIR SHS,SBH (END 10/15) 4.00 0.00 X X 0 0 0 ROBERT A GERBERRY DIR.SPI(END'15),SECTY SHS/SBH,GEN.COUNSEL 4.00 46.00 X X 0 475922 6307 SCOTT HONNOLD DIRECTOR/TREAS SF 2.00 0.00 X X 0 0 0 MONA SARKAR DIRECTOR/SECTY SF 2.00 0.00 X X 0 0 0 STEPHEN WILT DIRECTOR/VICE CHAIR SF 2.00 0.00 X X 0 0 0 KEN BABBY DIRECTOR SF 2.00 0.00 X 0 0 0 SUSAN BAKER DIR. SHS(END 10/15),SBH(END 5/15) 2.00 0.00 X 0 0 0 DANIELLE BARRAN DIRECTOR SF 2.00 0.00 X 0 0 0 WILLIAM BAUMAN MD DIR.SHS(END'15)SBH(END'15)SPI(END'15) 50.00 0.00 X 662465 0 26667 JULIA BIANCHI DIRECTOR SF 2.00 0.00 X 0 0 0 JASON BUTTERWORTH DIRECTOR SF 2.00 0.00 X 0 0 0 CANDACE CAMPBELL-JACKSON DIR.SHS(END 10/15)SBH(END 5/15) 2.00 0.00 X 0 0 0 GEORGE DAVERIO JR DIRECTOR SF 2.00 0.00 X 0 0 0 ROBERT DEBSKI MD DIR. SHS(END 10/15),SBH(END 5/15) 50.00 0.00 X 174045 0 17042 R JAMES DOM DERA MD DIR.SHN,DIR.SHS(END 10/15),SBH(END 5/15) 2.00 0.00 X 0 0 0 C GORDON EWERS DIRECTOR SF 2.00 0.00 X 0 0 0 STEVEN GAICH MD DIRECTOR SPI(END 12/15) 50.00 0.00 X 320829 0 10352 SAMIR GIBARA DIRECTOR SF 2.00 0.00 X 0 0 0 MARK GOLDFARB DIRECTOR SF 2.00 0.00 X 0 0 0 IRIS HARVEY DIRECTOR SF 2.00 0.00 X 0 0 0 ROBERT HEMPHILL MD DIRECTOR SF 2.00 0.00 X 0 0 0 MARY ANN JACKSON DIRECTOR SF 2.00 0.00 X 0 0 0 PHILIP KAUFMANN DIRECTOR SF 2.00 0.00 X 0 0 0 JOSEPH KOENIG MD DIRECTOR SPI(END 12/15) 50.00 0.00 X 676935 0 23110 MARK KROHN DIRECTOR SF 2.00 0.00 X 0 0 0 DAVID LIEBERTH DIR.SHS(END 10/15),SBH(END 5/15) 2.00 0.00 X 0 0 0 HITESH MAKKAR MD DIR.SHS(END 10/15),SBH(END 5/15) 2.00 0.00 X 0 0 0 DALE MURPHY MD DIR.SPI (END 12/15) 2.00 0.00 X 0 0 0 CHARLES PARSONS DIR.SHS(END 2/15),SBH(END 2/15) 2.00 0.00 X 0 0 0 JONATHON PAVLOFF DIRECTOR SF 2.00 0.00 X 0 0 0 KATHLEEN RAYNOR DIRECTOR SF 2.00 0.00 X 0 0 0 ERIK STEELE DO DIR.SHS,SBH(END 5/15),SYS. CMO 46.00 4.00 X 0 755289 7950 GEORGE STRICKLER DIRECTOR SF 2.00 0.00 X 0 0 0 SUSAN TAFT DIR.SHS(END 10/15),SBH(END 5/15) 2.00 0.00 X 0 0 0 PAUL TESTA DIRECTOR SF 2.00 0.00 X 0 0 0 SCOTT WEINER MD DIR.SHS(END 10/15),SBH(END 5/15) 50.00 0.00 X 917380 0 34610 THOMAS MALONE MD PRES.&CEO SHS & SBH,DIR.SHS & SF 46.00 4.00 X X 0 1285333 22545 KAREN BUDD DIRECTOR SF 2.00 0.00 X 0 0 0 VIVIAN VON GRUENIGEN MD DIR./CHAIR SHS(END10/15),CHAIR SBH(END 5/15) 48.00 2.00 X X 455940 0 27867 MICHAEL HUGHES MD DIR.SHS(CHR.END5/15),DIR.SBH(END5/15) 48.00 2.00 X X 665564 0 25912 JAMES MCILVAINE DIR./CHR. SHS, DIR./CHR. SPI 4.00 2.00 X X 0 0 0 REBECCA ANGERSTEIN RN DIR.SHS(END 10/15),DIR.SBH(END 5/15) 2.00 0.00 X 0 0 0 NICHOLAS BROWNING DIR. SHS, DIR. SPI 2.00 2.00 X 0 0 0 DARYL CAMERON DIRECTOR SHS 2.00 2.00 X 0 0 0 BETSY CLARK DIRECTOR SF 2.00 0.00 X 0 0 0 JAMES GRAVELL JR DIRECTOR SHS (END 11/15) 2.00 2.00 X 0 0 0 LYNN HAMRICH MD DIRECTOR SHS 2.00 2.00 X 0 0 0 THOMAS HARNDEN DIR.SHS(END 10/15),DIR.SBH(END 5/15) 2.00 0.00 X 0 0 0 DONALD KLINE DIRECTOR SHS 2.00 2.00 X 0 0 0 JAMES KRAVEC MD DIRECTOR SHS 2.00 2.00 X 0 0 0 ANTHONY LOCKHART DIRECTOR SHS 2.00 2.00 X 0 0 0 JEANNINE MARKS DIRECTOR SF 2.00 0.00 X 0 0 0 RICHARD MARSH DIRECTOR SHS 2.00 2.00 X 0 0 0 MAXWELL MEHLMAN PH D DIR.SHS(END 10/15),DIR.SBH(END 5/15) 2.00 0.00 X 0 0 0 THERESA PROENZA DIRECTOR SHS (END 11/15) 2.00 2.00 X 0 0 0 ROBERT RICE DIRECTOR SF 2.00 0.00 X 0 0 0 BRIAN SMITH DIR. SHS, DIR. SPI 2.00 2.00 X 0 0 0 LEILA VESPOLI DIRECTOR SHS 2.00 2.00 X 0 0 0 NORMAN WELLS JR DIRECTOR SHS 2.00 4.00 X 0 0 0 BRIAN DERRICK TREAS SHS/SBH, ASSIST. TREAS SF, CFO 4.00 46.00 X 0 945036 23552 PHYLIS FERRARA PRESIDENT & CDO, SF 50.00 0.00 X 461198 0 16345 JAY WILLIAMSON MD PRESIDENT,SPI (END 10/15) 50.00 0.00 X 257036 0 13656 LYDIA COOK PRESIDENT SPI 50.00 0.00 X 256278 0 40298 VALERIE GIBSON RN PRESIDENT SHS, SBH (END 5/15), COO 46.00 4.00 X 0 544477 19810 KATHLEEN JOBE VP, CNO, SBH(END 5/15) 46.00 4.00 X 236402 0 22379 JASON NIEHAUS SVP HOSP. OPS & SITE ADMIN 46.00 4.00 X 0 582187 23616 THOMAS P O'NEILL CFO, SHS; DIR. SPI(END 2015) 46.00 4.00 X 0 555666 18277 MARY WARD SVP CNO 46.00 4.00 X 0 676427 10309 JOSEPH ZARCONI MD FACP SYS. VP, MED ED & CHF ACADEMIC OFFICER(END 6/15) 50.00 0.00 X 0 897420 19462 DAVID CUSTODIO MD SHS CMO 50.00 0.00 X 445347 0 32637 TAMMY SCARBOROUGH COO, SPI 50.00 0.00 X 0 253354 6380 MATTHEW WAYNE MD CMO, SPI 50.00 0.00 X 205386 0 3407 MARK POZSGAY DO BARIATRIC SURGERY 50.00 0.00 X 1133449 0 36411 JOHN G ZOGRAFAKIS MD BARIATRIC SURGERY 50.00 0.00 X 1053418 0 38404 ADRIAN G DAN MD BARIATRIC SURGERY 50.00 0.00 X 867617 0 30650 ERIC T MILLER MD ORTHOPAEDIC SURGERY 50.00 0.00 X 871454 0 12052 R DOUGLAS TROCHELMAN MD MEDICAL DIR. ONCOLOGY 48.00 2.00 X 711774 0 26338 WILLIAM A POWEL III FRMR DIR-SPI/SECTY SHS/SBH, COUNSEL 0.00 2.00 X 0 163138 1864 THOMAS J STRAUSS FORMER DIR SF, SYSTEM PRES/CEO 8.00 0.00 X 0 544652 3570 THOMAS DEBORD FORMER PRESIDENT SBH 0.00 0.00 X 251588 0 12807 ROBERT D HARRIGAN FORMER OFFICER 0.00 0.00 X 0 215100 3874 STEVE SCHMIDT FORMER OFFICER 0.00 0.00 X 282358 0 2008 BRYAN FREDERICKS FORMER COO, SPI 0.00 0.00 X 184109 0 12304 11090572 7894001 632772 410 1 1 1 0 1200818 145227 1057430 2910173 1226311 5313648 NET PATIENT REVENUE 621110 956229233 956001529 227704 PROGRAM RELATED INVESTMENTS 900099 12058874 11677222 381652 REFERENCE LAB 621500 7074077 7074077 RENTAL INCOME FROM AFFILIATES 900099 4672647 4672647 ARRA MEANINGFUL USE 900099 872175 872175 56070967 56070967 1036977973 1607597 1607597 4791 4791 7798428 6758276 1040152 1040152 1040152 46196074 40385671 5810403 5810403 5810403 139418 1200818 680654 -541236 -541236 CAFETERIA SALES 721210 5441424 174179 5267245 PARKING 812930 1635384 1635384 11018314 1485292 9533022 18095122 1068308450 1029294540 9342904 24357358 X 167971 167971 77796 77796 4825383 4048496 776887 525498 525498 369991664 308600884 59319842 2070938 6665770 5592581 1073189 47804107 39734935 7624940 444232 24336124 20418008 3918116 2834417 2378076 456341 28453 28453 196815 196815 22675 22675 150 150 277247201 138828907 138307490 110804 548312 439222 84285 24805 13414627 11039127 2118354 257146 2379252 1978573 379679 21000 28514983 23924071 4590912 1456266 1215411 233232 7623 1529444 1282324 246072 1048 13745708 11532649 2213059 46048693 38634853 7413840 5144613 4316330 828283 MEDICAL SUPPLIES 151453854 151408809 45045 LICENSES, DUES, MEMBERS 4038606 3355079 643823 39704 TAXES 1752748 1470556 282192 RECRUITMENT 319961 268447 51514 2048278 1523170 292289 232819 1007119369 772761773 231102432 3255164 72162 93309 322575306 301098262 9308859 7720160 159136952 151756363 15155310 11451568 10757612 11012611 6462851 4351869 1189052832 771261606 426043017 417791226 135242113 82850601 11806000 12937471 34220043 41370447 2345714 2228740 32672941 95083871 1165798880 1139746498 106690047 89946402 1762007 1535914 348796530 378662903 16861900 0 213444064 202730010 687554548 672875229 X 429271710 422063212 28611311 24717317 20361311 20090740 478244332 466871269 1165798880 1139746498 X 61189081 -10125939 -62436205 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 22675 0 0 0 22675 0 PART II-B, LINE 1: THE AMOUNT ON LINE 1(F) REPRESENTS THE PORTION OF ANNUAL DUES TO ORGANIZATIONS SUCH AS AHA AND OHA ALLOCABLE TO LOBBYING ACTIVITIES. 19966435 313575 -559200 19720810 17564267 1927170 474998 19966435 16730854 70706 762707 17564267 15896470 347618 486766 16730854 15633841 113108 149521 15896470 1.00000 0 0 69133188 69133188 655032375 418726818 236305557 3800486 2108881 1691605 439822051 331167283 108654768 21264732 19258624 2006108 417791226 MALPRACTICE FUND 15192679 DEFERRED PENSION & COMP 289787 NON-PERF ASSET AIR RIGHTS 1124370 BENEFICIAL INTEREST IN PERP. TR 4913965 OTHER ACCOUNTS RECEIVABLE 102404 BENEFICIAL INTEREST IN PROPERTY 2991004 DUE FROM RELATED ORGANIZATIONS 70469662 95083871 LEASE ESCALATION LIABILITY 267950 CAPITAL LEASE OBLIGATIONS 25177247 ASSET RETIREMENT OBLIGATION FI 2580880 INTEREST RATE SWAP 13214216 POST RETIREMENT BENEFITS 958193 CONTINGENT LIABILITIES 1124370 MALPRACTICE LIABILITY 13472771 UNSECURED PAYABLES 141187676 PURCHASE OPTION LIABILITY 4746707 202730010 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 (CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM ALSO HAS CERTAIN SUBSIDIARIES THAT ARE TAXABLE FOR FEDERAL INCOME TAX PURPOSES. SUMMACARE ("SC"), TOGETHER WITH AFFILIATES OF SUMMA HEALTH SYSTEM CORPORATION ("SHSC"), FILE 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 1 0 PROGRAM SERVICES SELF INSURANCE 10316615 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 260349 1 0 0 0 1 0 10576964 0 10576964 1 0 1 0 1 0 PART I, LINE 3: CENTRAL AMERICAN AND THE CARIBBEAN: ACCRUAL PART I, LINE 3(F): EXPENDITURES: INSURANCE PREMIUMS PAID $10,316,615 GALA 1079456 993681 85775 0 0 44709 128051 204220 176955 GOLF OUTING 210822 164112 46710 0 6935 0 21441 56293 31863 1 49958 43025 6933 0 350 2748 200 1000 5889 1340236 1200818 139418 7285 47457 149692 261513 214707 680654 -541236 1 1 X 1 X 1 X 1 1 0 1 1 24465611 16308233 8157378 0.00770 156126969 139810270 16316699 0.01540 180592580 156118503 24474077 0.02310 3182164 113556 3068608 0.00290 48828702 12957192 35871510 0.03390 26495902 26495902 0.02500 5690350 860931 4829419 0.00460 1184605 1184605 0.00110 85381723 13931679 71450044 0.06750 265974303 170050182 95924121 0.09060 16666 16666 0.00000 7084 7084 0.00000 121488 121488 0.00010 145238 145238 0.00010 1 15698321 198599541 211075542 -12476001 X 1 1 1 SUMMA WESTERN RESERVE HOSPITAL LLC GENERAL HOSPITAL 0.40000 0.00000 0.60000 2 OHIO SLEEP DISORDERS LLC SLEEP MEDICINE 0.66670 0.00000 0.33330 3 DIGESTIVE HEALTH CENTER LLC DIGESTIVE DISEASE 0.05000 0.00000 0.44000 4 MEDINA-SUMMIT ASC LLC AMBULATORY SURGERY CENTER 0.20000 0.00000 0.70000 4 1 SUMMA HEALTH SYSTEM 525 EAST MARKET STREET AKRON OH 44304 WWW.SUMMAHEALTH.ORG 1275 X X X X X A 2 SUMMA BARBERTON CITIZENS HOSPITAL 155 FIFTH STREET NE AKRON OH 44203 WWW.SUMMAHEALTH.ORG 1280 X X X X X A 3 SUMMA WESTERN RESERVE HOSPITAL LLC 1900 23RD STREET CUYAHOGA FALLS OH 44223 WWW.WESTERNRESERVEHOSPITAL.ORG 1280 X X X X A 4 SUMMA REHAB HOSPITAL LLC 29 NORTH ADAMS STREET AKRON OH 44304 WWW.SUMMAREHABHOSPITAL.COM 1503 X X REHABILITATION B FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 13 1 1 1 1 X SEE SUPPLEMENTAL INFORMATION X 1 13 1 SEE SUPPLEMENTAL INFORMATION 0 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE ATTACHED SUPPLEMENTAL INFORMATION X SEE ATTACHED SUPPLEMENTAL INFORMATION X SEE ATTACHED SUPPLEMENTAL INFORMATION X X X X 1 X 0 X X X X 1 X 0 0 FACILITY REPORTING GROUP - B 0 0 1 X X X X X X X X X 13 1 1 1 1 X SEE SUPPLEMENTAL INFORMATION X 1 13 1 SEE SUPPLEMENTAL INFORMATION 0 0 1 X 200.000000000000 400.000000000000 0 1 X X X 0 1 X 0 X 0 X X 0 0 PART V, SECTION B, LINE 7A HTTP://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENT2013 PART V, SECTION B, LINE 10A HTTP://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENT2013 PART V SECTION B LINE 16A HTTP://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/FINANCIALASSISTANCEPOLICY PART V SECTION B LINE 16B HTTP://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/FINANCIALASSISTANCEPOLICY PART V SECTION B LINE 16C HTTP://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/FINANCIALASSISTANCEPOLICY PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: SUMMA HEALTH SYSTEM, - FACILITY 2: SUMMA BARBERTON CITIZENS HOSPITAL, - FACILITY 3: SUMMA WESTERN RESERVE HOSPITAL, LLC FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT BROAD INTERESTS OF COMMUNITY SERVED:SUMMA HEALTH SYSTEM, SUMMA BARBERTON CITIZENS HOSPITAL, SUMMA WESTERN RESERVE HOSPITAL, LLC (GROUP A):INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS IN MARCH-APRIL 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 SOLICIT SUGGESTIONS ON WHAT THE HOSPITALS CAN DO TO ADDRESS THE PRIORITIZED 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. LEADERS FROM THE FOLLOWING COMMUNITY ORGANIZATIONS WERE CONSULTED DURING THIS CHNA: SUMMIT COUNTY JOB AND FAMILY SERVICES, DIRECTOR AKRON PUBLIC SCHOOLS, EXECUTIVE DIRECTOR FOR BUSINESS AFFAIRS PORTAGE COUNTY JOB AND FAMILY SERVICES, ADMINISTRATOR MEDINA CITY SCHOOL DISTRICT, NURSING DIRECTOR FOR THE MEDINA COUNTY EDUCATIONAL SERVICE CENTER MEDINA COUNTY JOB AND FAMILY SERVICES, MEDICAID ELIGIBILITY SERVICES ADMINISTRATOR PORTAGE COUNTY MENTAL HEALTH AND RECOVERY BOARD, EXECUTIVE DIRECTOR PORTAGE COUNTY HEALTH DEPARTMENT, HEALTH COMMISSIONER ROBINSON MEMORIAL HOSPITAL, VICE PRESIDENT FOR BUSINESS DEVELOPMENT SUMMIT COUNTY PUBLIC HEALTH, DEPUTY HEALTH COMMISSIONER FOR PLANNING KENT CITY SCHOOL DISTRICT, DIRECTOR OF BUSINESS SERVICES MEDINA COUNTY HEALTH DEPARTMENT, HEALTH COMMISSIONER COUNTY OF SUMMIT ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH SERVICES BOARD, EXECUTIVE DIRECTOR FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS IN APRIL-MAY 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 60 PEOPLE PARTICIPATED IN THE COMMUNITY RESIDENT FOCUS GROUPS. ADDITIONAL DETAIL CAN BE FOUND ON THE SUMMA HEALTH WEBSITE AT HTTP://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENT2013. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE OTHER HOSPITAL FACILITIES:SUMMA HEALTH SYSTEM, SUMMA BARBERTON CITIZENS HOSPITAL, SUMMA WESTERN RESERVE HOSPITAL, LLC (GROUP A): SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF EACH OF ITS FOUR HOSPITAL FACILITIES LISTED IN PART V, SECTION A. IN ADDITION, SUMMA HEALTH COLLABORATED WITH AKRON GENERAL HEALTH SYSTEM AND AKRON CHILDREN'S HOSPITAL IN CONDUCTING THE CHNA. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:SUMMA HEALTH SYSTEM, SUMMA BARBERTON CITIZENS HOSPITAL, SUMMA WESTERN RESERVE HOSPITAL, LLC (GROUP A):KENT STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: HOW THE HOSPITAL FACILITY IS ADDRESSING NEEDS IDENTIFIED IN ITS CHNA:SUMMA HEALTH SYSTEM, SUMMA BARBERTON HOSPITAL, SUMMA WESTERN RESERVE HOSPITAL (GROUP A):THE ADULT HEALTH NEEDS PERTAINING TO ASTHMA, CANCER, CARDIOVASCULAR DISEASE, DIABETES, MENTAL HEALTH, SUBSTANCE ABUSE, LIFESTYLE FACTORS, ACCESS TO CARE FACTORS, AND QUALITY OF CARE FACTORS WILL BE ADDRESSED BY SUMMA HEALTH SYSTEM. THE HEALTH NEEDS PERTAINING TO ASTHMA, CANCER AND DIABETES ARE BEING ADDRESSED THROUGH INCREASING CONSUMER KNOWLEDGE BASE OF RISK FACTORS, RISK BEHAVIORS, AND GENETIC CONSIDERATIONS WHICH LEAD TO ASTHMA AND/OR ASTHMA RELATED DISEASE DEVELOPMENT. INCREASE KNOWLEDGE OF THE SIGNS AND SYMPTOMS OF ASTHMA AND ASTHMA RELATED DISEASES. ANOTHER OBJECTIVE IS TO INCREASE THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES. THE HEALTH NEEDS PERTAINING TO MENTAL HEALTH IS BEING ADDRESSED BY IMPROVING IDENTIFICATION, DIAGNOSIS, AND TREATMENT OF DEPRESSION; IMPROVING IDENTIFICATION AND TREATMENT OF PATIENTS WITH SUICIDAL TENDENCIES; AND INCREASING THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES. THE HEALTH NEEDS PERTAINING TO SUBSTANCE ABUSE IS BEING ADDRESSED BY DECREASING ADULT ALCOHOL ABUSE; DECREASING ADULT PRESCRIPTION DRUG ABUSE; AND ATTEMPTING TO DECREASE ADULT OPIOID DRUG ABUSE. THE HEALTH NEEDS PERTAINING TO LIFESTYLE FACTORS IS BEING ADDRESSED BY DECREASING SMOKING AND TOBACCO USE IN ADULTS AND INCREASING THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES. THE HEALTH NEEDS PERTAINING TO ACCESS TO CARE FACTORS IS BEING ADDRESSED BY INCREASING THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES; INCREASING ACCESS TO PRIMARY CARE PROVIDERS; INCREASING ACCESS TO DENTAL CARE PROVIDERS; AND INCREASING ACCESS TO MENTAL HEALTH PROVIDERS. THE HEALTH NEEDS PERTAINING TO QUALITY OF CARE FACTORS IS BEING ADDRESSED BY DECREASING HOSPITAL READMISSIONS; INCREASING THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES; INCREASING CONSUMER KNOWLEDGE BASE OF RISK FACTORS, RISK BEHAVIORS, AND GENETIC CONSIDERATIONS WHICH LEAD TO INCREASED INCIDENCE OF DIABETES; AND INFORMING THE COMMUNITY AND CREATING COMMUNITY AWARENESS OF THE HEALTH CARE NEEDS AND ISSUES OF SENIORS. A DETAILED DESCRIPTION OF THE ACTIONS BEING TAKEN TO ADDRESS THE HEALTH NEEDS IDENTIFIED ABOVE CAN BE FOUND ON THE SUMMA HEALTH IMPLEMENTATION STRATEGY AVAILABLE AT: HTTP://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENT2013. DUE TO COMMUNITY RESOURCES AVAILABLE TO ASSIST INDIVIDUALS IN OBTAINING HEALTHY FOOD, INCLUDING THE AKRON CANTON REGIONAL FOOD BANK, SUMMA HEALTH HOSPITAL FACILITIES CHOSE NOT TO ADDRESS THIS ENVIRONMENTAL FACTOR HEALTH NEED. IN ADDITION, THE COMMUNITY RESOURCES AVAILABLE TO ASSIST CHILDREN, SPECIFICALLY AKRON CHILDREN'S HOSPITAL, IN THE AREAS OF CHILDHOOD CHRONIC DISEASE, CHILD DEVELOPMENT, CHILD LIFESTYLE RISK FACTORS, CHILD MENTAL HEALTH AND SUBSTANCE ABUSE, CHILD SAFETY, CHILD ACCESS TO CARE FACTORS AND CHILD ENVIRONMENTAL RISK FACTORS, LED TO THE DETERMINATION BY SUMMA HEALTH HOSPITAL FACILITIES TO NOT ADDRESS THESE CHILD HEALTH NEEDS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 22D: HOW AMOUNTS CHARGED TO FAP-ELIGIBLE PATIENTS WERE DETERMINED:SUMMA HEALTH SYSTEM, SUMMA BARBERTON CITIZENS HOSPITAL, SUMMA WESTERN RESERVE HOSPITAL, LLC (GROUP A):PATIENTS WHOSE INCOME IS EQUAL TO OR LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES, ADJUSTED FOR NUMBER DEPENDENTS, RECEIVE A 100% DISCOUNT FOR CHARITY CARE. IF THE PATIENT'S INCOME EXCEEDS 200% OF THE FEDERAL POVERTY GUIDELINES AND UP TO 400% OF THE FEDERAL POVERTY GUIDELINES A SLIDING SCALE CHARITY CARE DISCOUNT OF EITHER 20%, 60% OR 80% OF BILLED CHARGES IS APPLIED. THIS SLIDING SCALE CHARITY CARE DISCOUNT POLICY IS BEING REEVALUATED TO BE EFFECTIVE JANUARY, 2016 WHEREBY THE CHARITY CARE DISCOUNT PERCENTAGE WOULD BE APPLIED TO THE AVERAGE ALLOWED AMOUNTS FOR COMMERCIALLY INSURED PATIENTS. PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 4: SUMMA REHAB HOSPITAL, LLC FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT BROAD INTERESTS OF COMMUNITY SERVED:SUMMA REHABILITATION HOSPITAL (GROUP B):INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS IN MARCH-APRIL 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 SOLICIT SUGGESTIONS ON WHAT THE HOSPITALS CAN DO TO ADDRESS THE PRIORITIZED 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. LEADERS FROM THE FOLLOWING COMMUNITY ORGANIZATIONS WERE CONSULTED DURING THIS CHNA: SUMMIT COUNTY JOB AND FAMILY SERVICES, DIRECTOR AKRON PUBLIC SCHOOLS, EXECUTIVE DIRECTOR FOR BUSINESS AFFAIRS PORTAGE COUNTY JOB AND FAMILY SERVICES, ADMINISTRATOR MEDINA CITY SCHOOL DISTRICT, NURSING DIRECTOR FOR THE MEDINA COUNTY EDUCATIONAL SERVICE CENTER MEDINA COUNTY JOB AND FAMILY SERVICES, MEDICAID ELIGIBILITY SERVICES ADMINISTRATOR PORTAGE COUNTY MENTAL HEALTH AND RECOVERY BOARD, EXECUTIVE DIRECTOR PORTAGE COUNTY HEALTH DEPARTMENT, HEALTH COMMISSIONER ROBINSON MEMORIAL HOSPITAL, VICE PRESIDENT FOR BUSINESS DEVELOPMENT SUMMIT COUNTY PUBLIC HEALTH, DEPUTY HEALTH COMMISSIONER FOR PLANNING KENT CITY SCHOOL DISTRICT, DIRECTOR OF BUSINESS SERVICES MEDINA COUNTY HEALTH DEPARTMENT, HEALTH COMMISSIONER COUNTY OF SUMMIT ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH SERVICES BOARD, EXECUTIVE DIRECTOR FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS IN APRIL-MAY 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 60 PEOPLE PARTICIPATED IN THE COMMUNITY RESIDENT FOCUS GROUPS. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE OTHER HOSPITAL FACILITIES:SUMMA REHABILITATION HOSPITAL (GROUP B):SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF ITS FOUR HOSPITAL FACILITIES LISTED IN PART V, SECTION A. IN ADDITION, SUMMA HEALTH COLLABORATED WITH AKRON GENERAL HEALTH SYSTEM AND AKRON CHILDREN'S HOSPITAL IN CONDUCTING THE CHNA. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:SUMMA REHABILITATION HOSPITAL (GROUP B):KENT STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 11: HOW THE HOSPITAL FACILITY IS ADDRESSING NEEDS IDENTIFIED IN ITS CHNA:SUMMA REHABILITATION HOSPITAL (GROUP B):DUE TO THE NATURE OF THE ADULT REHABILITATION SPECIALTY SERVICES PROVIDED BY SUMMA REHAB HOSPITAL, LLC, THE ADULT IDENTIFIED HEALTH NEED OF QUALITY OF CARE FACTORS-HOSPITAL READMISSIONS WILL BE THE ONLY HEALTH NEED ADDRESSED BY SUMMA REHAB HOSPITAL, LLC. THE HEALTH NEED OF QUALITY OF CARE FACTORS-HOSPITAL READMISSIONS IS BEING ADDRESSED BY DECREASING HOSPITAL READMISSIONS BY IMPROVING POST-OPERATIVE OUTCOMES FOR PATIENTS UNDERGOING JOINT REPAIRS AND INCREASING CONSUMER KNOWLEDGE OF ASPECTS OF PREOPERATIVE CARE THAT IMPROVES POST-OPERATIVE OUTCOMES AND DECREASING INCIDENCE OF HOSPITAL READMISSIONS. A DETAILED DESCRIPTION OF THE ACTIONS BEING TAKEN TO ADDRESS THE HEALTH NEEDS IDENTIFIED ABOVE CAN BE FOUND ON THE SUMMA HEALTH IMPLEMENTATION STRATEGY AVAILABLE AT:HTTP://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENT2013. THE COMMUNITY RESOURCES PROVIDED BY A VARIETY OF INSTITUTIONS AND AGENCIES INCLUDING AKRON CHILDREN'S HOSPITAL AND SUMMA HEALTH SYSTEM, SUMMA BARBERTON HOSPITAL, AND SUMMA WADSWORTH-RITTMAN HOSPITAL LED TO THE DETERMINATION BY SUMMA REHAB HOSPITAL, LLC TO NOT ADDRESS ANY OTHER IDENTIFIED HEALTH NEEDS. 20 1 - SUMMA HEALTH CNTR AT WADSWORTH-RITTMAN 195 WADSWORTH ROAD WADSWORTH OH 44281 OUTPATIENT SERVICES 2 - SUMMA HEALTH CENTER AT LAKE MEDINA 3780 MEDINA ROAD MEDINA OH 44256 LAB, IMAGING, THERAPY, SLEEP MEDICINE, RADIATION ONCOLOGY & OUTPATIENT SURGE 3 - REHABILITATION SVCS AT GREEN FAMILY 3838 MASSILLON ROAD UNIONTOWN OH 44685 LAB, IMAGING, REHAB., THERAPY AND OTHER HEALTH SERVICES. 4 - SUMMA HEALTH CENTER AT WHITE POND 1 PARK WEST BLVD SUITE 130 AKRON OH 44320 LAB, IMAGING, AND OTHER SPECIALTY HEALTH PROGRAMS. 5 - SUMMA HEALTH CENTER AT WESTERN RESERVE 5655 HUDSON DRIVE SUITE 200 HUDSON OH 44236 LAB, IMAGING, REHABILITATION, WOUND CARE & SPORTS MEDICINE 6 - SUMMA HOME INFUSION 2743 GILCHRIST ROAD STE 200 AKRON OH 44305 HOME CARE & INFUSION SERVICES 7 - SUMMA NEUROSCIENCE CENTER AT WHITE POND 701 WHITE POND DR SUITE 210 AKRON OH 44320 NEUROLOGY SERVICES 8 - SUMMA HEALTH CNTR AT HERITAGE CROSSING 1835 FRANKS PARKWAY UNIONTOWN OH 44685 LAB, IMAGING, AND OTHER SPECIALTY HEALTH PROGRAMS. 9 - SUMMA SLEEP MEDICINE CENTER - GREEN 1700 BOETTLER ROAD STE 215 UNIONTOWN OH 44685 SLEEP AND NEUROLOGY SERVICES 10 - SUMMA HEALTH CENTER AT ANNA DEAN 28 CONSERVATORY DR STE A BARBERTON OH 44203 OUTPATIENT REHAB AND THERAPY 11 - SUMMA HEALTH CENTER AT CUYAHOGA FALLS 1860 STATE ROAD CUYAHOGA FALLS OH 44223 LAB AND IMAGING SERVICES 12 - SUMMA REHABILITATION SVCS AT WHITE POND 750 WHITE POND DR STE 500 AKRON OH 44320 OCCUPATIONAL & REHAB SERVICES 13 - SUMMA WELLNESS INSTITUTE 5625 HUDSON DRIVE HUDSON OH 44236 MEDICAL-BASED FITNESS PROGRAMS REHABILITATION & THERAPY 14 - SUMMA HEALTH CENTER AT LAKE ANNA 500 WEST HOPOCAN AVENUE BARBERTON OH 44203 THERAPY, REHABILITATION, AND SPORTS MEDICINE 15 - SUMMA REHAB SERVICES AT TALLMADGE 46 NORTH MUNROE ROAD TALLMADGE OH 44278 PHYSICAL THERAPY AND SPORTS HEALTH 16 - IGNATIA HALL SOUTH 3730 WHIPPLE AVE NW STE 5 CANTON OH 44718 OUTPATIENT ADDICTION MEDICINES 17 - SUMMA CTR AT NEW SEASONS-HEALTH EQUITY 1493 S HAWKINS AVENUE AKRON OH 44320 CHRONIC DISEASE MANAGEMENT, HEALTH, NUTRITION, EXERCISE & EDUCATION SERVICES 18 - SUMMA SERVICES-WADSWORTH COMMUNITY CTR 621 SCHOOL DRIVE WADSWORTH OH 44281 IMAGING, REHABILITATION, AND ORTHOPAEDIC SPORTS MEDICINE 19 - NATATORIUM REHABILITATION AND WELLNESS 2345 4TH STREET CUYAHOGA FALLS OH 44221 ORTHOPAEDIC & SPORTS THERAPY 20 - SUMMA REHAB SVCS AT UNIVERSITY PARK YMCA 477 EAST MARKET ST STE 100 AKRON OH 44304 THERAPY, REHABILITATION, AND SPORTS MEDICINE PART I, LINE 6A: NAME OF RELATED ORGANIZATION THAT PREPARED THE COMMUNITY BENEFIT REPORT:SUMMA HEALTH PART I, LINE 7: EXPLANATION OF COST METHODOLOGY USED FOR CALCULATING LINE 7 TABLE:COST OF FINANCIAL ASSISTANCE AT COST WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. THE COST RELATED TO MEDICAID PATIENTS WAS DETERMINED USING SUMMA HEALTH'S COST ACCOUNTING SYSTEM. FOR SUBSIDIZED SERVICES SUMMA HEALTH'S COST ACCOUNTING SYSTEM IS USED TO DETERMINE COST RELATED TO SPECIFIC SERVICES EXCLUDING TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PATIENTS. COSTS FOR CHARITY AND BAD DEBT ACCOUNTS ARE DEDUCTED USING A RATIO OF COST TO CHARGE SPECIFIC TO THAT SUBSIDIZED SERVICE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS. PART I, LINE 7G: DESCRIBE SUBSIDIZED HEALTH SERVICE COSTS FROM PHYSICIAN CLINIC ON LINE 7G:THE AMOUNT OF SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7(G) ATTRIBUTABLE TO SUMMA PHYSICIANS, INC. ("SPI") IS $13,481,094. PART II, COMMUNITY BUILDING ACTIVITIES: DESCRIBE HOW COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY:SUMMA HEALTH ADDRESSES VARIOUS COMMUNITY CONCERNS INCLUDING HEALTH IMPROVEMENT, POVERTY, WORKFORCE DEVELOPMENT, AND ACCESS TO HEALTH CARE.SUMMA HEALTH HOSPITALS CONDUCT COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH FAIRS AND SCREENINGS FOR THE COMMUNITIES SERVED. SUMMA HEALTH HOSPITALS WORK WITH STATE AND LOCAL LEADERSHIP TO ADDRESS COMMUNITY NEEDS AND PROVIDE HEALTHCARE SERVICES TO THE POOR AND UNDERSERVED.SUMMA HEALTH HOSPITALS PROVIDE PROGRAMS TO IMPROVE THE PHYSICAL SURROUNDINGS AND HOUSING IN THE COMMUNITIES SERVED. INADEQUATE HOUSING HAS A NEGATIVE IMPACT ON THE HEALTH OF RESIDENTS IN THE AREA BY LEADING TO VIOLENCE IN THE NEIGHBORHOODS. A ROBUST ECONOMY POSITIVELY IMPACTS RESIDENTS COVERED BY HEALTH INSURANCE AND IMPROVES THE CAPACITY OF THE COMMUNITY TO SUPPORT HEALTH SERVICES. PART III, LINE 2: A COST-TO-CHARGE RATIO IS USED TO DETERMINE THE AMOUNT REFLECTED ON LINE 2. FOR A DESCRIPTION OF THE ACCOUNTING FOR BAD DEBT, SEE "NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE" ON PAGE 12 OF THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS UNDER FOOTNOTE 2, "SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES." PART III, LINE 4: FOOTNOTE IN ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBING BAD DEBT EXPENSE:SUMMA HEALTH'S AUDITED FINANCIAL STATEMENTS CONTAIN A FOOTNOTE THAT DESCRIBES THE PROVISION FOR DOUBTFUL ACCOUNTS. SUMMA HEALTH HAS ADOPTED ASU 2011-07 WHICH RESULTS IN BAD DEBT EXPENSE BEING REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AN OPERATING EXPENSE. NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, 1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE (PAGE 12) STATES SUMMA HEALTH MAINTAINS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EXPECTED COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE. THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGES, AND OTHER COLLECTION INDICATORS. PART III, LINE 8: DESCRIBE EXTENT ANY SHORTFALL FROM LINE 7 TREATED AS COMMUNITY BENEFIT AND COSTING METHOD USED:MEDICARE ALLOWABLE COST ARE BASED ON INFORMATION PROVIDED ON WORKSHEET B, PART I, COLUMN 26, LINE 118 FROM THE VARIOUS HOSPITALS' MEDICARE COST REPORTS. COSTING METHOD USED WAS TOTAL ALLOWABLE COST LESS ALL COSTS DEEMED NON-ALLOWABLE BY MEDICARE REGULATIONS. ANY MEDICARE SHORTFALL INCURRED BY SUMMA HEALTH IS NOT REPORTED AS A COMMUNITY BENEFIT. PART III, LINE 9B: DID COLLECTION POLICY CONTAIN PROVISIONS ON COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR ASSISTANCE:SUMMA WILL NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST ANY PATIENT WHO IS WITHOUT ACCESS TO HEALTH INSURANCE AND WITHOUT OTHER SIGNIFICANT INCOME OR NET WORTH. BEFORE INITIATING LEGAL ACTION FOR NON-PAYMENT, OUR HOSPITALS WILL, IN CONJUNCTION WITH THE PATIENT, MAKE SURE THAT THE PATIENT IS NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM AND DOES NOT QUALIFY UNDER THE HOSPITALS' CHARITY CARE POLICY. PART VI, LINE 2: NEEDS ASSESSMENT:IN ADDITION TO THE CHNA DESCRIBED IN PART V, SECTION B, THE HEALTH CARE NEEDS OF THE COMMUNITY ARE COLLABORATIVELY ASSESSED BY SURVEY PROCESSES CONDUCTED BY SUMMA HEALTH, SUMMIT COUNTY PUBLIC HEALTH, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON, THE UNITED WAY, SOCIAL SERVICES ADVISORY BOARD OF SUMMIT COUNTY, AND CLEVELAND CLINIC -AKRON GENERAL MEDICAL CENTER. PART VI, LINE 3: PATIENT EDUCATION:IN ACCORDANCE WITH THE RULES SET FORTH BY OHIO ADMINISTRATIVE CODE SECTION 2101:3-2-07.17 NOTICES, SUMMA HEALTH SYSTEM, AND SUMMA BARBERTON CITIZENS HOSPITAL HAVE NOTICES POSTED IN THE EMERGENCY ROOM, ADMISSION AREAS, CASHIER'S OFFICE, AND OTHER APPROPRIATE AREAS. THE NOTICES SPECIFY THE RIGHTS OF INDIVIDUALS TO RECEIVE WITHOUT CHARGE, BASIC MEDICALLY NECESSARY HOSPITAL-LEVEL SERVICES. A FINANCIAL COUNSELOR WHO IS ASSIGNED TO PATIENTS AT THE POINT OF ADMISSION REVIEWS THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS AND ASSISTS WITH THE APPLICATION IF REQUESTED. THE SUMMA WEBSITE PROVIDES INFORMATION REGARDING FINANCIAL ASSISTANCE. CUSTOMER SERVICE REPRESENTATIVES PROVIDE FINANCIAL COUNSELING WITH EXPLANATION OF ASSISTANCE PROGRAMS TO PATIENTS WHO CALL. EACH STATEMENT SENT TO THE PATIENT CONTAINS AN EXPLANATION OF THE FREE CARE PROGRAM AS WELL AS AN APPLICATION ON THE BACK SIDE OF THE STATEMENT. PART VI, LINE 4: COMMUNITY INFORMATION:BASED ON 2015 PATIENT ADMISSION DATA, SUMMA HEALTH CARE DELIVERY IS PRIMARILY IN SUMMIT COUNTY. SUMMIT COUNTY REPRESENTS 75.32% OF THE 2015 ADMISSIONS FROM SUMMA HEALTH. WHILE SUMMA ALSO TREATS PATIENTS FROM MEDINA, NOTHERN STARK, AND WAYNE COUNTIES, MOST PATIENTS COME FROM SUMMIT COUNTY. THERE ARE 541,968 PEOPLE LIVING IN SUMMIT COUNTY. SINCE 2010, THE POPULATION HAS INCREASED SLIGHTLY, BY LESS THAN A PERCENT. THERE ARE 31 CITIES, VILLAGES, AND TOWNSHIPS IN SUMMIT COUNTY, WITH THE LARGEST BEING THE CITY OF AKRON. COMPARED TO THE STATE OF OHIO, SUMMIT COUNTY HAS A SLIGHTLY SMALLER PROPORTION OF CHILDREN (UNDER 18 YEARS OLD) AND A SLIGHTLY HIGHER PROPORTION OF OLDER ADULTS. IN SUMMIT COUNTY 20.5% PERCENT OF THE POPULATION IS NON WHITE, COMPARED TO 17.3% IN THE STATE. EDUCATIONAL ATTAINMENT IS SLIGHTLY HIGHER IN SUMMIT COUNTY THANT THE STATE OF OHIO, WITH 90.7% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 29.9% HAVING A BACHELOR'S DEGREE OR HIGHER. SIMILARLY, ANNUAL PER CAPITA INCOME IN SUMMIT COUNTY IS SLIGHLTY HIGHER THAN THE STATE OF OHIO, THE PERCENT OF SUMMIT COUNTY RESIDENTS LIVING IN POVERTY IS 2.2% LOWER THAN THAT OF THE STATE. MORE THAN 50% OF THE HOUSEHOLDS IN SUMMIT COUNTY MAKE LESS THAN $50,000 ANNUALLY AND 15.0% AND 14.5% OF HOUSEHOLDS MAKE LESS THAN $15,000 ANNUALLY RESPECTIVELY. FOR THE CALENDAR YEAR 2015, THE AVERAGE MONTHLY UNEMPLOYMENT RATE FOR SUMMIT COUNTY WAS 4.9% RESPECTIVELY. LOW INCOMES AND AN ESSENTIALLY STAGNANT UNEMPLOYMENT RATE ADD TO SUMMA'S BURDEN FOR CHARITY CARE. DESPITE THESE CHALLENGES, DEMAND FOR SUMMA'S SERVICES IN THESE COMMUNITIES IS PROJECTED TO GROW. WHILE THE TOTAL POPULATION OF SUMMIT COUNTY IS EXPECTED TO DECLINE (BY -1.2%), OVER THE 5-YEAR PERIOD 2013-2018. MORE IMPORTANTLY, THE AGE GROUP THAT DEMAND HEALTHCARE SERVICES THE MOST (AGE 65 AND OLDER) IS EXPECTED TO GROW SIGNIFICANTLY. THIS AGE GROUP IS EXPECTED TO INCREASE 16.0% IN SUMMIT COUNTY OVER THE FIVE YEAR PERIOD. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:AMONG THE WAYS THE HOSPITALS WITHIN SUMMA HEALTH PROMOTE THE HEALTH OF THE COMMUNITY ARE BY MAINTAINING AN OPEN MEDICAL STAFF AND A COMMUNITY ENGAGEMENT COMMITTEE (COMMUNITY BENEFIT COMMITTEE). SUMMA'S HOSPITALS ADDRESS HEALTH DISPARITIES THROUGH PRACTICE, RESEARCH, EDUCATION AND COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS. CONTRIBUTIONS, BOTH FINANCIAL AND IN-KIND, ARE MADE TO INITIATIVES AND PROGRAMMING (I.E. FEDERALLY QUALIFIED HEALTH CENTER, OPEN M, CENTER FOR COMMUNITY HEALTH IMPROVEMENT) THAT ARE DEEMED TO PROMOTE THE HEALTH, WELLNESS AND IMPROVED QUALITY OF LIFE FOR THE COMMUNITIES SUMMA HEALTH SERVES. PART VI, LINE 6: DESCRIPTION OF AFFILIATED GROUP:SUMMA HEALTH IS ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN OHIO, ENCOMPASSING A NETWORK OF HOSPITALS, COMMUNITY-BASED HEALTH CENTERS, A HEALTH PLAN, A PHYSICIAN-HOSPITAL ORGANIZATION, RESEARCH AND MEDICAL EDUCATION AND A FOUNDATION. SUMMA HEALTH IS RENOWNED FOR EXCELLENCE IN PATIENT CARE AND FOR EXCEPTIONAL APPROACHES TO HEALTHCARE DELIVERY. DURING 2015, SUMMA HEALTH PROVIDED INPATIENT CARE THROUGH FACILITIES LOCATED ON SIX CAMPUSES AND IN ADDITION, OUTPATIENT CARE IS EXTENDED THROUGHOUT THE REGION IN A NUMBER OF OUTPATIENT CENTERS, BOTH HOSPITAL-BASED AND FREESTANDING. SUMMA HEALTH SYSTEM'S AKRON CITY HOSPITAL TERTIARY CAMPUS IS LOCATED IN DOWNTOWN AKRON, OHIO AND HAS SERVED, TOGETHER WITH SUMMA HEALTH, AS THE LARGEST SAFETY-NET HOSPITAL IN THE COMMUNITY FOR MANY YEARS. SUMMA BARBERTON HOSPITAL (SBH) IS A 249-BED GENERAL ACUTE CARE COMMUNITY HOSPITAL THAT OFFERS INPATIENT SERVICES, OUTPATIENT SERVICES AND COMMUNITY OUTREACH PROGRAMS. SBH IS LOCATED IN THE CITY OF BARBERTON IN SOUTHERN SUMMIT COUNTY. THE OPERATIONS OF SBH WERE MERGED INTO SUMMA HEALTH SYSTEM IN MAY 2015. SUMMA WESTERN RESERVE HOSPITAL, LLC ("SWRH") IS A JOINT VENTURE BETWEEN SUMMA HEALTH SYSTEM AND THE WESTERN RESERVE HEALTH PARTNERS AND PROVIDES A FULL RANGE OF ACUTE MEDICAL SERVICES. SWRH PROVIDES ITS HOSPITAL OPERATIONS ON THE CAMPUS OF SUMMA CUYAHOGA FALLS GENERAL HOSPITAL. SWRH PROVIDES A RANGE OF SERVICES INCLUDING A 24-HOUR EMERGENCY ROOM, AMBULATORY SURGERY, DIAGNOSTIC TESTING, ETC. AND ADHERES TO THE CHARITY CARE POLICY OF SUMMA HEALTH. SUMMA REHAB HOSPITAL, LLC, A JOINT VENTURE BETWEEN SUMMA HEALTH SYSTEM AND VIBRA HEALTHCARE, OPENED ON THE CAMPUS OF SUMMA AKRON CITY HOSPITAL IN 2012. THIS 60-BED FACILITY PROVIDES INPATIENT REHABILITATION CARE AND SERVICES AND ADHERES TO SUMMA'S CHARITY CARE POLICY. ESTABLISHED IN 1993, SUMMACARE OFFERS HEALTH CARE COVERAGE TO MEMBERS INCLUDING MEMBERS INSURED THROUGH ITS STATUS AS A MEDICARE ADVANTAGE ORGANIZATION. SUMMACARE IS RECOGNIZED BY THE HEALTH INDUSTRY RESEARCH COMPANY AS A HEALTH PLAN WITH EFFECTIVE DISEASE MANAGEMENT PROGRAMS FOR ASTHMA, HEALTH FAILURE AND DIABETES. SUMMACARE, ALONG WITH ITS THIRD PARTY ADMINISTRATIVE SERVICES PRODUCTS COVERS APPROXIMATELY 120,000 MEMBERS. SUMMA FOUNDATION IS A NONPROFIT ORGANIZATION ADVANCING TRANSFORMATIONAL PHILANTHROPY, COMMUNITY UNDERSTANDING AND GOODWILL FOR THE PROGRAMS AND PRIORITIES OF SUMMA HEALTH. SUMMA HEALTH NETWORK, LLC IS THE INTEGRATED PHYSICIAN-HOSPITAL ORGANIZATION AFFILIATED WITH SUMMA HEALTH. WITH MORE THAN 1,400 PHYSICIANS PARTICIPATING, SUMMA HEALTH NETWORK OVERSEES MUTUALLY BENEFICIAL CONTRACTS WITH INSURANCE COMPANIES, PREFERRED PROVIDER ORGANIZATIONS, THIRD-PARTY ADMINISTRATORS AND OTHER PAYORS ON BEHALF OF ITS PHYSICIANS AND HOSPITAL MEMBERS. SUMMA ACCOUNTABLE CARE ORGANIZATION (D/B/A NEWHEALTH COLLABORATIVE ("NHC")) IS A CLINICIAN-LED COLLABORATIVE, ORGANIZED TO COMPASSIONATELY CARE FOR AND SERVE PATIENTS IN AN ACCOUNTABLE, VALUE AND EVIDENCE-BASED MANNER. IN ACCORDANCE WITH THE AFFORDABLE CARE ACT, NHC CREATES INCENTIVES FOR PROVIDERS TO FURTHER ENHANCE THE QUALITY OF CARE. OHIO HEALTH CHOICE, INC. (OHC) IS OHIO'S OLDEST PREFERRED PROVIDER ORGANIZATION (PPO) NETWORK IN THE STATE. OHC IS CO-OWNED BY SUMMA HEALTH AND MERCY MEDICAL CENTER, AND IS COMPRISED OF APPROXIMATELY 200 HOSPITALS, 8,000 PRIMARY CARE PROVIDERS, 18,000 SPECIALISTS, COVERING MEMBERS ACROSS ALL 88 COUNTIES IN OHIO. SUMMA PHYSICIANS, INC. ("SPI") IS A MULTI-SPECIALTY PHYSICIAN PRACTICE. EMPLOYING CLOSE TO 300 PHYSICIANS IN MULTIPLE SPECIALTIES. SPI PROMOTES STRONGER AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIANS SERVICES ARE MET. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT:THE STATE OF OHIO DOES NOT REQUIRE THE FILING OF THE COMMUNITY BENEFIT REPORT. HOWEVER, INFORMATION FROM THE COMMUNITY BENEFIT REPORT IS SHARED ANNUALLY WITH THE OHIO HOSPITAL ASSOCIATION. 1 AMERICAN HEART ASSOCIATION 3505 EMBASSY PARKWAY STE 100 AKRON OH 44333 135613797 501(C)(3) 105000 RESEARCH AND EDUCATION THE UNIVERSITY OF AKRON 302 BUCHTEL COMMON AKRON OH 44301 346002924 GOVERNMENTAL 7000 EDUCATIONAL SUSAN G KOMEN FOR THE CURE 26210 EMERY RD CLEVELAND OH 44128 751835298 501(C)(3) 10000 CANCER WELLNESS SUPPORT DIVERSITY & LEADERSHIP INC PO BOX 891212 HOUSTON TX 772891212 204317404 5500 DIVERSITY & LEADERSHIP AMERICAN CANCER SOCIETY 525 NORTH BROAD STREET CANFIELD OH 44406 251798733 501(C)(3) 20000 CANCER RESEARCH 4 1 SUMMASHARES 7 5457 DIABETES PROGRAM 9 7981 MAMMOGRAM SCREENS 604 64358 PART I, LINE 2: THE PROCEDURES FOR MONITORING THE USE OF 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 ORGANIZATION UTILIZING THE FUNDS. X X 1 1 1 1 0 0 0 0 0 1 0 ROBERT A GERBERRY DIR.SPI(END'15),SECTY SHS/SBH,GEN.CO 0 350682 0 59706 0 65534 0 4846 0 1461 0 482229 0 0 WILLIAM BAUMAN MD DIR.SHS(END'15)SBH(END'15)SPI(END'15 636691 0 22573 0 3201 0 7950 0 18717 0 689132 0 0 0 ROBERT DEBSKI MD DIR. SHS(END 10/15),SBH(END 5/15) 166925 0 7120 0 0 0 0 0 17042 0 191087 0 0 0 STEVEN GAICH MD DIRECTOR SPI(END 12/15) 295314 0 25070 0 445 0 7950 0 2402 0 331181 0 0 0 JOSEPH KOENIG MD DIRECTOR SPI(END 12/15) 633868 0 40877 0 2190 0 9275 0 13835 0 700045 0 0 0 ERIK STEELE DO DIR.SHS,SBH(END 5/15),SYS. CMO 0 493506 0 90963 0 170820 0 7950 0 0 0 763239 0 11381 SCOTT WEINER MD DIR.SHS(END 10/15),SBH(END 5/15) 831637 0 83553 0 2190 0 9275 0 25335 0 951990 0 0 0 THOMAS MALONE MD PRES.&CEO SHS & SBH,DIR.SHS & SF 0 796996 0 250000 0 238337 0 5608 0 16937 0 1307878 0 0 VIVIAN VON GRUENIGEN MD DIR./CHAIR SHS(END10/15),CHAIR SBH(E 454350 0 0 0 1590 0 3130 0 24737 0 483807 0 0 0 MICHAEL HUGHES MD DIR.SHS(CHR.END5/15),DIR.SBH(END5/15 640801 0 22573 0 2190 0 7950 0 17962 0 691476 0 0 0 BRIAN DERRICK TREAS SHS/SBH, ASSIST. TREAS SF, CFO 0 540515 0 143655 0 260866 0 6625 0 16927 0 968588 0 55878 PHYLIS FERRARA PRESIDENT & CDO, SF 286900 0 72100 0 102198 0 9275 0 7070 0 477543 0 4730 0 JAY WILLIAMSON MD PRESIDENT,SPI (END 10/15) 135432 0 33331 0 88273 0 5052 0 8604 0 270692 0 0 0 LYDIA COOK PRESIDENT SPI 192716 0 23836 0 39726 0 23868 0 16430 0 296576 0 0 0 VALERIE GIBSON RN PRESIDENT SHS, SBH (END 5/15), COO 0 428586 0 0 0 115891 0 0 0 19810 0 564287 0 0 KATHLEEN JOBE VP, CNO, SBH(END 5/15) 179937 0 15756 0 40709 0 6994 0 15385 0 258781 0 0 0 JASON NIEHAUS SVP HOSP. OPS & SITE ADMIN 0 319850 0 143334 0 119003 0 1313 0 22303 0 605803 0 0 THOMAS P O'NEILL CFO, SHS; DIR. SPI(END 2015) 0 291048 0 70000 0 194618 0 9275 0 9002 0 573943 0 32825 MARY WARD SVP CNO 0 357702 0 102331 0 216394 0 7950 0 2359 0 686736 0 67624 JOSEPH ZARCONI MD FACP SYS. VP, MED ED & CHF ACADEMIC OFFIC 0 158039 0 49541 0 689840 0 7771 0 11691 0 916882 0 63647 DAVID CUSTODIO MD SHS CMO 343173 0 34313 0 67861 0 9275 0 23362 0 477984 0 0 0 TAMMY SCARBOROUGH COO, SPI 0 221250 0 0 0 32104 0 0 0 6380 0 259734 0 0 MATTHEW WAYNE MD CMO, SPI 181731 0 0 0 23655 0 0 0 3407 0 208793 0 0 0 MARK POZSGAY DO BARIATRIC SURGERY 762963 0 369316 0 1170 0 6750 0 29661 0 1169860 0 0 0 JOHN G ZOGRAFAKIS MD BARIATRIC SURGERY 704530 0 347538 0 1350 0 9275 0 29129 0 1091822 0 0 0 ADRIAN G DAN MD BARIATRIC SURGERY 655790 0 210627 0 1200 0 7875 0 22775 0 898267 0 0 0 ERIC T MILLER MD ORTHOPAEDIC SURGERY 714594 0 155690 0 1170 0 3694 0 8358 0 883506 0 0 0 R DOUGLAS TROCHELMAN MD MEDICAL DIR. ONCOLOGY 654484 0 55100 0 2190 0 9275 0 17063 0 738112 0 0 0 WILLIAM A POWEL III FRMR DIR-SPI/SECTY SHS/SBH, COUNSEL 0 0 0 87754 0 75384 0 0 0 1864 0 165002 0 69249 THOMAS J STRAUSS FORMER DIR SF, SYSTEM PRES/CEO 0 86438 0 294381 0 163833 0 0 0 3570 0 548222 0 148461 THOMAS DEBORD FORMER PRESIDENT SBH 0 0 55723 0 195865 0 0 0 12807 0 264395 0 0 0 ROBERT D HARRIGAN FORMER OFFICER 0 0 0 0 0 215100 0 0 0 3874 0 218974 0 0 STEVE SCHMIDT FORMER OFFICER 2112 0 19556 0 260690 0 268 0 1740 0 284366 0 0 0 BRYAN FREDERICKS FORMER COO, SPI 0 0 13298 0 170811 0 0 0 12304 0 196413 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: SUMMA HEALTH SYSTEM GROSSED UP TAXES FOR SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS PAID TO ONE DIRECTOR, ONE OFFICER, NINE KEY EMPLOYEES, TWO FORMER EMPLOYEES AND FOUR FORMER OFFICERS. THE AMOUNT OF THE GROSS UP IS RECOGNIZED AS ADDITIONAL TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: SOCIAL CLUB DUES WERE PAID ON BEHALF OF ONE OFFICER. ANY PERSONAL USE IS RECOGNIZED AS ADDITIONAL TAXABLE COMPENSATION. PART I, LINE 3 ARRANGEMENTS USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: THE COMPENSATION OF THE PRESIDENT AND CEO IS ESTABLISHED BY SUMMA HEALTH, THE RELATED PARENT ORGANIZATION FOR ALL MEMBERS IN THE SUMMA HEALTH SYSTEM GROUP RETURN. SUMMA HEALTH HAS A COMPENSATION COMMITTEE THAT USES AN INDEPENDENT COMPENSATION CONSULTANT, MARKET SURVEYS, AND AN ANNUAL REVIEW PROCESS TO ESTABLISH COMPENSATION FOR THE POSITION OF PRESIDENT AND CEO. 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, WILLIAM POWEL, III $5,725, BRYAN FREDERICKS $148,344, ROBERT D. HARRIGAN $158,378, THOMAS DEBORD $161,741, STEVEN SCHMIDT $205,205, 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 INCLUDIBLE AS TAXABLE COMPENSATION FOR LISTED INDIVIDUALS, DUE TO PLAN PARTICIPATION IN THE REPORTING YEAR, WERE AS FOLLOWS: THOMAS MALONE, MD $39,675, ERIK STEELE, DO $41,374, BRIAN K. DERRICK $114,825, PHYLIS FERRARA $20,505, JAY WILLIAMSON, MD $31,240, JASON NIEHAUS $6,452, THOMAS P. O'NEILL $55,117, MARY WARD $109,424, JOSEPH ZARCONI, MD $100,871, WILLIAM POWELL, III $69,249, THOMAS STRAUSS $148,461. PART I, LINE 7 NON-FIXED PAYMENTS: THE SUMMA HEALTH SYSTEM 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. FORM 990 PART VII, SECTION A, LINE 5 INFORMATION PERSON RECEIVING COMPENSATION FROM AN UNRELATED ORGANIZATION FOR SERVICES RENDERED TO THE ORGANIZATION: SUMMA HEALTH SYSTEM PAYS HEALTHSPAN PARTNERS, AND UNRELATED ORGANIZATION, FOR THE COMPENSATION LISTED FOR LYDIA COOK IN THE AMOUNTS LISTED ON FORM 990 PART VII AND SCHEDULE J PART II. A OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 67756AY89 2001-05-11 180125341 SEE PART VI 0 0 0 B AKRON BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT 341448680 2012-07-25 32509635 SEE PART VI 0 0 0 C SEE SCHEDULE K PART VI 341448680 2014-10-02 145250000 SEE PART VI 0 0 0 D AKRON BATH AND COPLEY JT TWP HOSP DIST 341448680 2015-12-16 42255000 SEE PART VI 0 0 0 A 180162106 18196607 3004911 4929857 154030731 2012 1 0 1 1 B 9222622 32509635 32509635 2012 1 0 1 1 C 5980000 145250000 795890 144454110 2008 1 0 1 1 D 42255000 255000 37789920 4213757 2015 0 0 1 1 A 0 1 1 1 1 1 0.01600 0.00120 0.01720 0 0 1 B 0 0 0 0 0 0 1 C 0 1 1 1 1 1 0.10490 0.00260 0.10750 0 0 1 D 0 0 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 1 MORGAN STANLEY & COMPANY 2.200000000000 1 0 1 B 0 0 1 0 1 1 RBS CITIZENS BANK 12.000000000000 0 0 0 0 1 C 0 0 1 0 1 1 SEE SCHEDULE K VI 20.000000000000 0 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 05/11/2013 SCHEDULE K, PART I, COLUMN (A), LINE C ISSUER NAME: THE 2014 BONDS CONSIST OF THE FOLLOWING THREE SERIES OF BONDS, WHICH ARE TREATED AS A SINGLE ISSUE OF BONDS FOR FEDERAL INCOME TAX PURPOSES: (1) AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT, OHIO HOSPITAL FACILITIES REFUNDING REVENUE BONDS, SERIES 2014A (SUMMA HEALTH SYSTEM OBLIGATED GROUP) ISSUED IN THE ORIGINAL PRINCIPAL AMOUNT OF $93,685,000, (2) AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT, OHIO HOSPITAL FACILITIES REFUNDING REVENUE BONDS, SERIES 2014B (SUMMA HEALTH SYSTEM OBLIGATED GROUP) ISSUED IN THE ORIGINAL PRINCIPAL AMOUNT OF $37,890,000, AND (3) DEVELOPMENT FINANCE AUTHORITY OF SUMMIT COUNTY PORT FACILITIES REVENUE REFUNDING BONDS, SERIES 2014 (SUMMA HEALTH SYSTEM OBLIGATED GROUP PROJECT) ISSUED IN THE ORIGINAL PRINCIPAL AMOUNT OF $13,675,000. THE SERIES 2014A BONDS AND THE DEVELOPMENT FINANCE AUTHORITY BONDS WERE EACH ISSUED ON OCTOBER 2, 2014, AND THE SERIES 2014B BONDS WERE ISSUED ON NOVEMBER 18, 2014. THE AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT'S EIN IS 34-1448680, AND THE DEVELOPMENT FINANCE AUTHORITY'S EIN IS 34-1765940. SCHEDULE K, PART I, LINE A, COLUMN (F) OHIO HIGHER EDUCATIONAL FACILITY COMMISSION SERIES 2010 BONDS: THE PURPOSES OF THE SERIES 2010 BONDS WERE TO (1) CURRENTLY REFUND A TAXABLE LOAN TO SUMMA BARBERTON CITIZENS HOSPITAL UNDER A LINE OF CREDIT, THE PROCEEDS OF WHICH WERE USED TO ACQUIRE HOSPITAL FACILITIES, (2) CURRENTLY REFUND A TAXABLE LOAN TO SUMMA AKRON CITY AND ST. THOMAS HOSPITALS, THE PROCEEDS OF WHICH WERE USED FOR CERTAIN CAPITAL EXPENDITURES, (3) CONSTRUCT AND EQUIP HOSPITAL FACILITIES, (4) ACQUIRE, CONSTRUCT, AND EQUIP PARKING FACILITIES, NURSING FACILITIES, ADMINISTRATIVE FACILITIES, AMBULATORY CARE FACILITIES, AND MEDICAL EQUIPMENT, AND (5) PAY ISSUANCE COSTS. SCHEDULE K, PART I, LINE B, COLUMN (F) AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT BONDS: THE PURPOSES OF THE SERIES 2012 BONDS WERE TO (1) CURRENTLY REFUND THE HOSPITAL FACILITIES REVENUE BONDS, SERIES 1998A ISSUED ON DECEMBER 23, 1998 IN THE ORIGINAL AMOUNT OF $50,000,000, AND (2) PAY THE COSTS OF ISSUANCE OF THE SERIES 2012 BONDS. SCHEDULE K, PART I, LINE C, COLUMN (F) SERIES 2014A, SERIES 2014B, AND SERIES 2014 BONDS: THE PURPOSE OF THE SERIES 2014A BONDS WAS TO CURRENTLY REFUND THE SERIES 2004B BONDS, WHICH WERE ISSUED TO (1) CONSTRUCT AND EQUIP A CRITICAL CARE PAVILION, (2) CONSTRUCT AND EQUIP OTHER HOSPITAL FACILITIES, (3) REFUND PRIOR ISSUES WITH THE FOLLOWING ISSUE DATES (A) DECEMBER 22, 1992 AND (B) JUNE 10, 1993, (4) PAY THE INITIAL COSTS OF A LIQUIDITY FACILITY, AND (5) PAY ISSUANCE COSTS. THE PURPOSES OF THE SERIES 2014B BONDS WERE TO (1) CURRENTLY REFUND THE SERIES 2004A BONDS, WHICH WERE ISSUED TO (A) CONSTRUCT AND EQUIP A CRITICAL CARE PAVILION, (B) CONSTRUCT AND EQUIP OTHER HOSPITAL FACILITIES, (C) REFUND PRIOR ISSUES WITH THE FOLLOWING ISSUE DATES (I) JULY 1, 1999, (II) JULY 28, 2000, AND (III) MARCH 12, 2002, (D) FUND A DEBT SERVICE RESERVE FOR SERIES 2004A BONDS, AND (E) PAY ISSUANCE COSTS, AND (2) FUND CAPITALIZED INTEREST ON THE SERIES 2014B BONDS. THE PURPOSE OF THE DEVELOPMENT FINANCE AUTHORITY SERIES 2014 BONDS WAS TO CURRENTLY REFUND THE SERIES 2006 BONDS, WHICH WERE ISSUED TO (1) ACQUIRE A PROJECT SITE FOR AND CONSTRUCT AND EQUIP A WELLNESS INSTITUTE, AND (2) TO PAY ISSUANCE COSTS. SCHEDULE K, PART I, LINE D, COLUMN (F) AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT SERIES 2015 BONDS: THE PURPOSE OF THE SERIES 2015 BONDS WAS TO (1) ACQUIRE, CONSTRUCT, IMPROVE, EQUIP CERTAIN HOSPITAL FACILITIES, AND (2) PAY ISSUANCE COSTS. SCHEDULE K, PART II, LINE 3 TOTAL PROCEEDS OF ISSUE - COLUMN A: THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS OF THE ISSUE AND THE ISSUE PRICE PROVIDED IN PART I, LINE A, COL. (E) IS DUE TO INVESTMENT PROCEEDS OF THE ISSUE. SCHEDULE K, PART III, LINE 4 PRIVATE BUSINESS USAGE - BOND ISSUE C: THE PRIVATE BUSINESS USAGE IS PROJECTED TO BE LESS THAN 5 PERCENT OVER THE LIFE OF THE SERIES 2014 BONDS DUE TO THE EXPECTED TERMINATION OF CERTAIN LEASE ARRANGEMENTS. SCHEDULE K, PART III, LINE 6 TOTAL PRIVATE USE PERCENTAGE - COLUMN C: THIS NUMBER IS PROJECTED TO BE LESS THAN 5% OVER THE LIFE OF THE SERIES 2014 BONDS DUE TO THE EXPECTED TERMINATION OF CERTAIN LEASE ARRANGEMENTS. SCHEDULE K, PART IV, LINE 4B NAME OF HEDGE PROVIDER - COLUMN C: SERIES 2014A BONDS: GOLDMAN SACHS BANK USA. SERIES 2014B BONDS: THERE IS NO HEDGE WITH RESPECT TO THE SERIES 2014B BONDS. DEVELOPMENT FINANCE AUTHORITY SERIES 2014 BONDS: PNC BANK, NATIONAL ASSOCIATION SCHEDULE K, PART IV, LINE 4C TERM OF HEDGE - COLUMN C: THE TERM OF THE HEDGE WITH GOLDMAN SACHS BANK USA IS 20 YEARS. THE TERM OF THE HEDGE WITH PNC BANK, NATIONAL ASSOCIATION IS 30 YEARS. BRIAN BAUMAN FAMILY MEMBER OF WILLIAM BAUMAN (DIRECTOR SHS, SBH, SPI) 462630 EMPLOYMENT AND INDEPENDENT CONTRACTOR 0 M&M PROPERTIES DALE MURPHY, SPI DIRECTOR, HAS A REPORTABLE OWNERSHIP INTEREST IN M&M PROPE 54300 INDEPENDENT CONTRACTOR 0 CYNTHIA BROWNING FAMILY MEMBER OF NICHOLAS BROWNING, SUMMA HEALTH BOARD MEMBER. 51704 EMPLOYMENT 0 KAREN CUSTODIO FAMILY MEMBER OF DAVID CUSTODIO (KEY EMPLOYEE SHS) 11164 EMPLOYMENT 0 X 4 14962 APPRAISAL X 2500 REPLACEMENT COST X 9 1151615 MARKET VALUE X 1 11850 REPLACEMENT COST X EVENTS 5 45384 MARKET VALUE 0 1 0 PART I, COLUMN (B): EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS: ARTWORK: NUMBER OF CONTRIBUTIONS SECURITIES - PUBLICALLY TRADED: NUMBER OF CONTRIBUTIONS DRUGS AND MEDICAL SUPPLIES: NUMBER OF CONTRIBUTIONS OTHER: NUMBER OF CONTRIBUTIONS SUMMA BARBERTON CITIZENS HOSPITAL PATIENT ACCOUNTS RECEIVABLE,PROPERTY AND EQUIPMENT, INVENTORY, OTHER ASSETS 2015-05-31 91045889 BOOK VALUE 340714755 SUMMA HEALTH SYSTEM 1077 GORGE BLVD AKRON OH 44309 501(C)(3) 0 0 0 0 1 1 1 1 0 FORM 990, PART VI, SECTION A, LINE 1 LINES 1A AND 1B: THE DIRECTOR COUNT INFORMATION IS PRESENTED IN THE FOLLOWING FORMAT: ENTITY NAME - NUMBER OF VOTING MEMBERS - NUMBER OF INDEPENDENT VOTING MEMBERS SUMMA HEALTH SYSTEM ("SHS") - 14 - 10 SUMMA FOUNDATION ("SF") - 26 - 25 SUMMA PHYSICIANS, INC. ("SPI") - 3 - 2 TOTALS FOR GROUP RETURN - 43 - 37 ALL OF THE ORGANIZATIONS LISTED ABOVE ARE SUBORDINATES UNDER THE CONTROL OF SUMMA HEALTH ("SH"). AS OF DECEMBER 31, 2015, SH HAD 14 VOTING DIRECTORS, 10 OF WHOM WERE INDEPENDENT VOTING DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS: SUMMA HEALTH SYSTEM SUMMA BARBERTON CITIZENS HOSPITAL: THOMAS MALONE, M.D., THOMAS P. O'NEILL, ERIK, STEELE, D.O., AND MARY WARD - 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 RICHARD MARSH, LEILA VESPOLI, AND ANTHONY LOCKHART - BUSINESS RELATIONSHIP REBECCA ANGERSTEIN AND MICHAEL HUGHES, M.D. - BUSINESS RELATIONSHIP SUMMA FOUNDATION: SAMIR GIBARA AND SCOTT HONNOLD - BUSINESS RELATIONSHIP GEORGE DAVERIO, JR. AND C. GORDON EWERS - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: SUMMA HEALTH SYSTEM: THE ARTICLES OF INCORPORATION AND CODE OF REGULATIONS WAS AMENDED EFFECTIVE MARCH 1, 2015 TO CHANGE THE NAME FROM SUMMA AKRON CITY AND ST. THOMAS HOSPITALS TO SUMMA HEALTH SYSTEM. THE CODE OF REGULATIONS OF SUMMA HEALTH SYSTEM WAS FURTHER AMENDED AS FOLLOWS: THE NUMBER AND CLASSIFICATION OF THE DIRECTORS WAS CHANGED TO PROVIDE THAT THOSE DIRECTORS OF SUMMA HEALTH, THE SOLE MEMBER OF SUMMA HEALTH SYSTEM, WOULD BE THE DIRECTORS OF SUMMA HEALTH SYSTEM. AN EXECUTIVE COMMITTEE WAS AUTHORIZED FOR SUMMA HEALTH SYSTEM TO BE COMPRISED OF THOSE INDIVIDUALS WHO SERVE FROM TIME-TO-TIME AS THE EXECUTIVE COMMITTEE OF SUMMA HEALTH. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE DIRECTORS OF SUMMA HEALTH SYSTEM. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO MEET ON AN AD HOC BASIS AND IS AUTHORIZED TO EXERCISE THE POWERS OF THE BOARD AT SUCH TIME AS THE BOARD IS NOT IN SESSION, SUBJECT TO RESTRICTIONS IMPOSED BY PREVIOUS DECISIONS OF THE BOARD AND TO THE PROVISIONS OF THE SUMMA HEALTH SYSTEM CODE OF REGULATIONS. ALL INTERIM ACTIONS BY THE EXECUTIVE COMMITTEE ARE REPORTED AT THE BOARD'S NEXT MEETING SUCCEEDING SUCH ACTION. SUMMA BARBERTON CITIZENS HOSPITAL (MERGED MAY 31, 2015) SUMMA BARBERTON CITIZENS HOSPITAL MERGED WITH SUMMA HEALTH SYSTEM EFFECTIVE AS OF MAY 31, 2015. SUMMA HEALTH SYSTEM WAS THE SURVIVING ENTITY. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: SUMMA HEALTH SYSTEM:SUMMA HEALTH IS THE SOLE MEMBER OF SUMMA HEALTH SYSTEM. SUMMA FOUNDATION: SUMMA HEALTH IS THE SOLE MEMBER OF SUMMA FOUNDATION SUMMA BARBERTON CITIZENS HOSPITAL:PRIOR TO THE MERGER OF SUMMA BARBERTON CITIZENS HOSPITAL WITH SUMMA HEALTH SYSTEM EFFECTIVE MAY 31, 2015, SUMMA HEALTH WAS THE SOLE MEMBER OF SUMMA BARBERTON CITIZENS HOSPITAL. SUMMA PHYSICIANS, INC.: SUMMA PHYSICIANS, INC. HAS STOCKHOLDERS; THE STOCK IS HELD IN TRUST FOR THE BENEFIT OF SUMMA HEALTH. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY: SUMMA HEALTH SYSTEM: THE CODE OF REGULATIONS OF SUMMA HEALTH SYSTEM WAS AMENDED IN 2015 TO PROVIDE THAT THOSE DIRECTORS OF SUMMA HEALTH, THE SOLE MEMBER OF SUMMA HEALTH SYSTEM, WOULD BE THE DIRECTORS OF SUMMA HEALTH SYSTEM. SUMMA FOUNDATION: IN ADDITION TO DIRECTORS ELECTED BY THE SUMMA HEALTH BOARD AS THE SOLE MEMBER OF SUMMA FOUNDATION, THE PRESIDENT AND CEO OF SUMMA HEALTH SERVES AS A DIRECTOR OF SUMMA FOUNDATION. SUMMA PHYSICIANS, INC.: SUMMA PHYSICIANS, INC. IS AFFILIATED WITH SUMMA HEALTH SYSTEM AND ONLY PERSONS APPROVED BY SUMMA HEALTH SYSTEM OR EMPLOYED BY SUMMA HEALTH SYSTEM OR AN AFFILIATED ENTITY MAY SERVE AS A DIRECTOR OF SUMMA PHYSICIANS, INC. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS: SUMMA HEALTH SYSTEM SUMMA BARBERTON CITIZENS HOSPITAL: SUMMA HEALTH IS THE SOLE MEMBER OF EACH OF SUMMA HEALTH SYSTEM AND SUMMA BARBERTON CITIZENS HOSPITAL. AS THE SOLE MEMBER, SUMMA HEALTH HAS THE POWER AND AUTHORITY TO APPROVE OR DISAPPROVE OF EACH OF THE FOLLOWING ON BEHALF OF EACH OF SUMMA HEALTH SYSTEM AND SUMMA BARBERTON CITIZENS HOSPITAL: (I)ANY MODIFICATION OF THE ESSENTIAL NATURE, PURPOSE, MISSION OR OPERATIONS OF THE CORPORATION; (II)ADOPTION OF A CODE OF REGULATIONS, BYLAWS OR OTHER CONSTITUTIVE DOCUMENT OF THE CORPORATION AND ANY AND ALL AMENDMENTS THERETO; (III)ADOPTION OF ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OR SIMILAR CHARTER OR ORGANIZATIONAL DOCUMENT OR AGREEMENT AND/OR ANY OTHER CHANGE IN THE CORPORATE STRUCTURE OR GOVERNANCE OF THE CORPORATION; (IV)ESTABLISHMENT OF QUALIFICATIONS FOR THE SELECTION OF DIRECTORS, DIRECTORS OR MANAGERS OF THE CORPORATION; (V)APPOINTMENT OR ELECTION AND REMOVAL OF MEMBERS OF THE GOVERNING BODY OF THE CORPORATION; (VI)APPOINTMENT OR ELECTION AND REMOVAL OF THE PRESIDENT AND/OR CHIEF EXECUTIVE OFFICER OR SIMILAR OFFICER(S) OF THE CORPORATION; (VII)ADOPTION OF ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (VIII)THE BORROWING OF MONEY OR OTHER INCURRING OR CREATING OF ANY INDEBTEDNESS OF THE CORPORATION, INCLUDING BY WAY OF A GUARANTY OF THE DEBT OF ANOTHER, IN AN AMOUNT GREATER THAN $1,000,000 OR THAT WILL INCREASE THE AMOUNT OF INDEBTEDNESS INCURRED IN THE CURRENT CALENDAR YEAR, IN THE AGGREGATE, TO MORE THAN $3,500,000; (IX)ADOPTION OF THE LONG RANGE PLANS OF THE CORPORATION; (X)DETERMINATIONS AS TO THE USE AND OCCUPANCY OF ANY BUILDING OWNED OR LEASED BY THE CORPORATION; (XI)THE SALE, ENCUMBRANCE, LEASE OR DISPOSITION OF REAL PROPERTY OF THE CORPORATION OTHER THAN IN THE ORDINARY COURSE OF THE OPERATIONS OF THE CORPORATION; AND (XII)THE MERGER, REORGANIZATION, DISSOLUTION OR OTHER CORPORATE ACTION OF A SIMILAR NATURE, INCLUDING PARTICIPATION IN A JOINT VENTURE, PROPOSED BY THE CORPORATION. SUMMA FOUNDATION: SUMMA HEALTH IS THE SOLE MEMBER ("MEMBER") OF SUMMA FOUNDATION. THE FOLLOWING ARE THE MATTERS ("RESERVED POWERS") WHICH MUST BE SUBMITTED TO, AND RECEIVE THE APPROVAL OF BOTH THE BOARD OF DIRECTORS OF SUMMA FOUNDATION AND THE MEMBER: (I)ADOPTION OF THE FOUNDATION'S ANNUAL OPERATING AND CAPITAL BUDGETS; (II)EXPENDITURES FOR (A) NON BUDGETED ITEMS IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER AND (B) ITEMS WHICH ARE INCLUDED IN THE FOUNDATION'S ANNUAL BUDGETS BUT WHICH EXCEED THE BUDGETED AMOUNT BY AN AMOUNT IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER; (III)INCURRENCE, ASSUMPTION OR GUARANTEE OF ANY INDEBTEDNESS IF FOLLOWING THE INCURRENCE, ASSUMPTION, OR GUARANTEE OF SUCH INDEBTEDNESS THE AGGREGATE AMOUNT OF ALL OUTSTANDING INDEBTEDNESS INCURRED, ASSUMED OR GUARANTEED BY THE FOUNDATION WHICH HAS NOT BEEN PREVIOUSLY APPROVED BY THE MEMBER EXCEEDS CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER; (IV)SUBMISSION OF ANY CERTIFICATE OF NEED APPLICATION WITH ANY STATE OR FEDERAL REGULATORY AGENCY; (V)EXECUTION OF ANY CONTRACT THAT CALLS FOR THE FOUNDATION TO EXPEND A SUM IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER OR TO PROVIDE SERVICES WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS SET FROM TIME TO TIME BY THE MEMBER; (VI)ELECTION OF SUCH OFFICERS AS ARE REQUIRED TO BE ELECTED UNDER THIS CODE OF REGULATIONS; (VII)APPOINTMENT OF THE FOUNDATION'S AUDITORS AND/OR ACCOUNTANTS; (VIII)ADOPTION OF THE FOUNDATION'S LONG RANGE PLANS AND MANAGEMENT OBJECTIVE, INCLUDING THE EXECUTION OF ANY AGREEMENT WITH CONSORTIUMS, ALLIANCES, ETC; (IX)SALE, LEASE OR OTHER DISPOSITION OF ANY REAL OR PERSONAL PROPERTY OF THE FOUNDATION WITH A VALUE IN EXCESS OF CERTAIN DOLLAR LIMITS TO BE SET FROM TIME TO TIME BY THE MEMBER; (X)SALE, RELEASE, DISSOLUTION, TRANSFER, EXCHANGE, OR OTHER DISPOSITION OF ANY ORGANIZATION (OR OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF SUCH ORGANIZATION) CONTROLLED BY THE FOUNDATION IF AFTER SUCH SALE, RELEASE, DISSOLUTION, TRANSFER, EXCHANGE OR OTHER DISPOSITION, SUCH ORGANIZATION (OR ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF SUCH ORGANIZATION) WOULD NO LONGER BE CONTROLLED BY THE FOUNDATION; (XI)ADOPTION OR AMENDMENT OF THE FOUNDATION'S CODE OF REGULATIONS OR ARTICLES OF INCORPORATION; (XII)ANY OTHER MATTER WHICH MAY BE SPECIFIED BY THE MEMBER OR BY THE BOARD OR REQUIRED BY LAW. SUMMA PHYSICIANS, INC. N/A 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. SCHEDULE H OF THE RETURN WAS ALSO REVIEWED BY THE SUMMA HEALTH COMMUNITY BENEFITS COMMITTEE. 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 BOARDS 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 POLICY: 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 GOVERNANCE COMMITTEE (SUB-COMMITTEE OF THE SUMMA HEALTH BOARD OF DIRECTORS). THE GOVERNANCE COMMITTEE 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 SUMMA HEALTH SYSTEM: PRESIDENT SUMMA FOUNDATION: PRESIDENT SUMMA BARBERTON CITIZENS HOSPITAL: SR. VICE PRESIDENT, HOSPITAL OPERATIONS/SITE ADMINISTRATOR SUMMA PHYSICIANS, INC.: PRESIDENT 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.SUMMAHEALTH.ORG). THE FINANCIAL STATEMENTS ARE ALSO AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS (WWW.EMMA.MSRB.ORG) AND ON SUMMA'S WEBSITE (WWW.SUMMAHEALTH.ORG). FORM 990, PART VII, SECTION B, LINE 1 BEGINNING WITH THE 2014 TAX YEAR ALL INDEPENDENT CONTRACTORS WERE PAID BY SUMMA HEALTH (EIN 34-1887844) WHICH IS THE PARENT ORGANIZATION OF THE FILING ORGANIZATION. FORM 990, PART IX, LINE 11G PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 42,993,337. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,993,337. PURCHASED NON-MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 134,931,170. FUNDRAISING EXPENSES 110,804. TOTAL EXPENSES 135,041,974. PERFUSION/BLOOD: PROGRAM SERVICE EXPENSES 2,818,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,818,230. AMBULANCE SERVICES: PROGRAM SERVICE EXPENSES 282,618. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 282,618. HOSPICE SERVICES: PROGRAM SERVICE EXPENSES 2,370,354. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,370,354. PHYSICIAN PRACTICE SUPPORT: PROGRAM SERVICE EXPENSES 20,788,149. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,788,149. PHYSICIAN SERVICES - AFFILIATES: PROGRAM SERVICE EXPENSES 51,981,606. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 51,981,606. COLLECTIONS: PROGRAM SERVICE EXPENSES 4,848,423. MANAGEMENT AND GENERAL EXPENSES 930,389. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,778,812. REPAIR/MAINTENANCE: PROGRAM SERVICE EXPENSES 12,746,190. MANAGEMENT AND GENERAL EXPENSES 2,445,931. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,192,121. FORM 990, PART XI, LINE 9: PENSION LIABILITY ADJUSTMENT -281,000. POST RETIREMENT BENEFIT ADJUSTMENT 36,000. NET ASSETS RELEASED FROM RESTRICTION 3,752,000. NET ASSET CONTRIBUTION TO(FROM) AFFILIATED ORGANIZATION -61,644,000. OTHER CHANGES IN NET ASSETS 42,000. CHANGE IN TRUST VALUE -558,662. RESTRICTED ACTIVITY - SUMMA FOUNDATION 388,193. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -3,893,994. CHANGE IN PERMANENTLY RESTRICTED NET ASSETS -270,572. OTHER CHANGES IN NET ASSETS - ADJUSTMENTS -6,170. SUMMA ENTERPRISE GROUP LLC 525 EAST MARKET STREET AKRON OH 44304 030507853 INVESTMENTS/REAL ESTATE, DISSOLVED DECEMBER 2015 OH 2847000 0 SUMMA HEALTH SYSTEM SEG PROPERTIES LLC 525 EAST MARKET STREET AKRON OH 44304 550837372 REAL ESTATE OH 0 0 SUMMA HEALTH SYSTEM AKRON ENDOSCOPY ASC LLC 525 EAST MARKET STREET AKRON OH 44304 621865245 PROFESSIONAL MEDICAL SERVICES OH 0 0 SUMMA HEALTH SYSTEM ST THOMAS MEDICAL CENTER WOMEN'S BOARD 444 NORTH MAIN STREET AKRON OH 44310 346576575 SUPPORT ORGANIZATION OH 501(C)(3) LINE 11A, I SUMMA HEALTH SYSTEM 0 SUMMA HEALTH SYSTEM COMMUNITY 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 463018310 SUPPORT ORGANIZATION OH 501(C)(3) LINE 11B, II SUMMA HEALTH 1 SUMMA ROBINSON HEALTH VENTURES 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 208650711 SUPPORT ORGANIZATION OH 501(C)(3) LINE 11A, I SUMMA HEALTH 1 OHIO SLEEP DISORDERS CENTER 130 WEST EXCHANGE STREET AKRON OH 44309 341872278 NEUROLOGY OH SUMMA HEALTH SYSTEM RELATED 0 0 0.67000 SUMMA REHAB HOSPITAL LLC 29 NORTH ADAMS STREET AKRON OH 44304 271952573 REHAB HOSPITAL OH SUMMA HEALTH SYSTEM RELATED 14843156 4425032 0 1 0.52000 OHIO HEALTH CHOICE INC 1077 GORGE BLVD AKRON OH 443092090 341895396 PPO OH SHS CORP C 2790000 5346000 0.80000 1 SUMMA INSURANCE COMPANY INC 10 NORTH MAIN STREET AKRON OH 44308 341809108 PROP/CAS INS OH SHS CORP C 214854062 59694266 1.00000 1 SUMMA HEALTH SYSTEM CORP 1077 GORGE BLVD AKRON OH 443092090 341515252 MGMT SVCS OH SUMMA HEALTH C 1997833 4213744 1.00000 1 WADSWORTH RITTMAN HOS PROF SVC CORP 195 WADSWORTH RD WADSWORTH OH 44281 010842997 PROF MED SVCS OH SHS CORP C 1.00000 1 MIDDLEBURY ASSURANCE COMPANY PO BOX 1051 KY1-1102 GRAND CAYMAN CJ 980405096 SELF INSURANCE CJ SUMMA HEALTH C 10818647 62744101 1.00000 1 SUMMACARE INC 10 NORTH MAIN STREET AKRON OH 44308 341726655 PROP/CAS INS OH SIC C 271448549 90584577 1.00000 1 ARIS TELERADIOLOGY HOLDINGS INC 5655 HUDSON DRIVE SUITE 210 HUDSON OH 44236 453697866 RADIOLOGY SVC OH SUMMA HEALTH SYSTEM C 24468674 13179234 0.58800 1 SUMMA ACCOUNTABLE CARE ORGANIZATION 1077 GORGE BLVD AKRON OH 443092090 273857055 CONTRACTING OH SUMMA HEALTH C 11972000 5256000 1.00000 1 HEALTH CARE CENTERS PHYSICIANS INC 1900 23RD STREET CUYAHOGA FALLS OH 44223 341692767 INACTIVE OH SHS CORP C 1.00000 1 SUMMA MANAGEMENT SERVICES ORGANIZATION 10 NORTH MAIN STREET AKRON OH 44308 461145832 MGMT SVCS OH SHS CORP C 32869000 8170000 1.00000 1 SUMMA INTEGRATED SERVICES ORGANIZATION 10 NORTH MAIN STREET AKRON OH 44308 461159251 MGMT SVCS OH SHS CORP C 21962000 12863000 1.00000 1 1 1 1 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 SUMMA REHAB HOSPITAL LLC A 2362572 FMV SUMMA INSURANCE COMPANY INC L 101475697 FMV SUMMA REHAB HOSPITAL LLC L 586140 FMV MIDDLEBURY ASSURANCE COMPANY M 8550429 FMV MIDDLEBURY ASSURANCE COMPANY M 2058756 FMV SUMMA INTEGRATED SERVICES ORGANIZATION M 947048 FMV SUMMA HEALTH