2019-11-15T09:11:07-06:00 2018-12-31 346565596 ERNST & YOUNG 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2018-01-01 900640432 SUMMA HEALTH GROUP RETURN SUMM 2343125867 1077 GORGE BLVD AKRON OH 44310 T CLIFFORD DEVENY MD SR VP, CFO, TREAS 2343125867 2019-11-15 1 JENNIFER D RHODERICK P00395735 3176817000 199.52.13.132 2019-11-15 09:10:59 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7C60462F21CDFFB40771A052A0B004FBCDB53576 2018 2020-04-17 16:48:07Z T CLIFFORD DEVENY MD 1077 GORGE BLVD AKRON OH 44310 1069627893 1 1 5864 X www.summahealth.org X THE MISSION OF SUMMA HEALTH IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO OUR PATIENTS AND TO CONTRIBUTE TO A HEALTHIER COMMUNITY. 39 33 7503 2020 6625701 242085 1017693 1059909 980455645 1008429386 8423490 16248192 11330107 16219303 1001226935 1041956790 151500 250271 0 0 472335028 459853972 0 0 1853875 554008926 532152144 1026495454 992256387 -25268519 49700403 1304834315 1378833024 949419049 977480290 355415266 401352734 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 445939226 555889963 OUTPATIENT SERVICES FOR 2018: SUMMA HEALTH SYSTEM, AND SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP, PROVIDED MORE THAN 1.7 MILLION OCCASIONS OF SERVICE, INCLUDING 155,175 EMERGENCY DEPARTMENT VISITS, 13,499 OBSERVATION PATIENTS, 15,290 SURGICAL OPERATIONS, AND NEARLY 1.5 MILLION OTHER OUTPATIENT VISITS. 308322391 384342333 INPATIENT SERVICES FOR 2018: SUMMA HEALTH SYSTEM HAD APPROXIMATELY 649 BEDS IN SERVICE, ADMITTED 31,724 ADULT PATIENTS, AND DELIVERED 4,134 NEWBORNS. THE ADULT PATIENTS RECEIVED 143,367 DAYS OF CARE, INPATIENT SURGERIES TOTALED 6,371, EMERGENCY ADMISSIONS TOTALED 21,782 AND THE AVERAGE LENGTH OF STAY WAS 4.52 DAYS. 45138008 11440836 RESEARCH/EDUCATION FOR 2018: 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 241 MEDICAL SCHOOL GRADUATES TRAIN IN 19 ACCREDITED RESIDENCY PROGRAMS. SUMMA HEALTH PROVIDES CLINICAL LEARNING EXPERIENCES TO MORE THAN 2,599 NURSING, MEDICAL, PHARMACY, EMERGENCY MEDICAL TECHNICIAN, PARAMEDIC, AND ALLIED HEALTH STUDENTS. 45530305 250271 56756254 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 HUNDREDS OF THOUSANDS OF PATIENTS EACH YEAR IN COMPREHENSIVE EMERGENCY, ACUTE, CRITICAL, OUTPATIENT AND LONG-TERM/HOMECARE SETTINGS AND REPRESENTS 1,045 REGISTERED, INPATIENT BEDS ON THE CAMPUSES OF SUMMA HEALTH SYSTEM AND SUMMA REHAB HOSPITAL. IN ADDITION, OUTPATIENT CARE IS PROVIDED IN NEARLY 20 COMMUNITY HEALTH CENTERS, URGENT CARE FACILITIES AND EMERGENCY DEPARTMENTS (EDS), SOME INTEGRATED IN THE HEALTHCARE FACILITIES, AND OTHERS ARE FREESTANDING. SUMMA REHAB HOSPITAL IS A JOINT VENTURE IN WHICH SUMMA HEALTH SYSTEM HAS AN INTEREST, AND IS REFERENCED IN THIS DOCUMENT FOR THE PURPOSE OF IDENTIFYING ALL ENTITIES AFFILIATED WITH SUMMA HEALTH. SUMMA'S PROPORTIONATE INTEREST OF THIS JOINT VENTURE'S CHARITY CARE AND OTHER COMMUNITY BENEFITS IS 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: WEIGHT MANAGEMENT, CARDIOVASCULAR, EMERGENCY, ONCOLOGY, ORTHOPAEDIC, SURGERY, PRIMARY CARE, SPORTS MEDICINE, STROKE, UROLOGY, WOMEN'S SERVICES 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 SERVICESOHIO PATIENT SAFETY INSTITUTEUS NEWS AND WORLD REPORTAMERICAN COLLEGE OF RADIATIONNURSES IMPROVING CARE FOR HEALTH SYSTEM ELDERSAMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERYMETABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM- COMPREHENSIVE CENTERTHE 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 7,000 INDIVIDUALS WITH SUMMA HEALTH SYSTEM ACCOUNTING FOR THE VAST MAJORITY OF THESE EMPLOYEES. SUMMA HEALTH SYSTEM HAS A MEDICAL STAFF OF MORE THAN 1,000 PROFESSIONALS WORKING ON ITS CAMPUSES. SUMMA HEALTH SYSTEM HAS 1,045 REGISTERED BEDS. THE BUILDINGS AND FACILITIES ON ALL CAMPUSES TOTAL MORE THAN 3 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- 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 86 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 251 LICENSED BEDS. 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 2018, SUMMA HEALTH PROVIDED CHARITY CARE AT AN ESTIMATED NET COST OF OVER $5.4 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 2018, THE CHARITY CARE PROGRAM (INCLUDING HOSPITAL CARE ASSURANCE PROGRAM) BENEFITED OVER 17,800 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 $30 MILLION.BAD DEBTSUMMA HEALTH IS COMMITTED 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 2018, THE COST FOR PROVIDING CARE WRITTEN OFF AS A BAD DEBT EXPENSE WAS APPROXIMATELY $15.3 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 2018, SUMMA HEALTH PROVIDED MORE THAN $9.5 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 - CLINICAL SERVICES THAT MEET AN IDENTIFIED COMMUNITY NEED AND ARE PROVIDED DESPITE FINANCIAL LOSS. VITAL SERVICES SUCH AS THE SUMMA HEALTH SENIOR HEALTH CENTER, SUMMA HEALTH TRAUMATIC STRESS CENTER, THE SUMMA HEALTH DENTAL CLINIC AND DIABETES EDUCATION ARE OFFERED, EVEN THOUGH THEY ARE NOT PROFITABLE. INCOME FROM OTHER SERVICES IS USED TO COVER THESE COSTS. IN 2018, THE COST FOR SUBSIDIZED SERVICES WAS APPROXIMATELY $29.7 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 NEIGHBORHOOD HEALTH FACILITIES SUCH AS OPEN M AND FAITHFUL SERVANTS CARE CENTER, TO MEDICAL SERVICES AT ATHLETIC EVENTS THROUGHOUT THE COMMUNITY, SUMMA HEALTH PARTICIPATES IN NUMEROUS COMMUNITY PROGRAMS AND HELPS OTHER NONPROFITS FULFILL THEIR MISSIONS. IN 2018, THESE CONTRIBUTIONS WERE MORE THAN $1.8 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 SPECIALTIES 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 $6.4 MILLION IN RESEARCH IN 2018.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 2018, APPROXIMATELY 241 RESIDENTS AND FELLOWS TRAINED AT SUMMA HEALTH'S THREE MAIN HOSPITALS. ON AVERAGE, APPROXIMATELY 38% OF THESE RESIDENTS REMAIN IN OUR LOCAL AND SURROUNDING COMMUNITIES. SUMMA HEALTH'S 2018 INVESTMENT IN HEALTH PROFESSIONAL EDUCATION TOTALED APPROXIMATELY $23.6 MILLION. SUMMA HEALTH SERVICES:FOLLOWING IS A DESCRIPTION OF SUMMA HEALTH'S NOTABLE ACCOMPLISHMENTS BY PRIMARY SERVICE LINES IN 2018: WEIGHT MANAGEMENT- SUMMA'S BARIATRIC CARE CENTER IS DESIGNATED BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY (ASMBS) AS A MBSAQIP ACCREDITED - COMPREHENSIVE CENTER. THE MBSAQIP ACCREDITED - COMPREHENSIVE CENTER DESIGNATION IS ONLY AWARDED TO SURGICAL PROGRAMS THAT: SUCCESSFULLY UNDERGO A RIGOROUS SITE SURVEY TO VERIFY COMPLIANCE WITH A SET OF NATIONALLY RECOGNIZED STANDARDS AND REQUIREMENTS. DEMONSTRATE A COMPREHENSIVE COMMITMENT TO A HIGH LEVEL OF CARE. SUBMIT INFORMATION FOR INCLUSION IN THE LARGEST REPOSITORY OF DEDICATED WEIGHT LOSS SURGERY PATIENT STATISTICAL DATA IN THE WORLD. MEASURE AND REPORT SURGICAL OUTCOMES THAT ARE DEEMED FAVORABLE BY THE ASMBS, AN ORGANIZATION DEDICATED TO EXCELLENCE IN SURGICAL OUTCOMES. CARDIOVASCULAR: THE AMERICAN COLLEGE OF CARDIOLOGY (ACC) DESIGNATED THE AKRON CAMPUS OF THE SUMMA HEALTH HEART AND VASCULAR INSTITUTE (SHHVI) A 2018 HEARTCARE CENTER. THIS NATIONAL DISTINCTION OF EXCELLENCE RECOGNIZES SUMMA AMONG AN ELITE GROUP OF FORWARD-THINKING HOSPITALS AND INSTITUTIONS THAT GO ABOVE AND BEYOND TO ENSURE THAT PATIENTS HAVE ACCESS TO THE HIGHEST LEVELS OF CONSISTENT CARDIOVASCULAR CARE. TO BE ELIGIBLE FOR CONSIDERATION, ORGANIZATIONS MUST MEET A SET OF CRITERIA THAT CAN BE REALIZED THROUGH PARTICIPATION IN THE ACC'S EXISTING SUITE OF QUALITY IMPROVEMENT PROGRAMS.NEUROSCIENCE - SUMMA HEALTH SYSTEM- AKRON CAMPUS HAS BEEN CERTIFIED AS AN ADVANCED PRIMARY STROKE CENTER BY THE JOINT COMMISSION SINCE 2007. OUR STROKE CENTER IS NATIONALLY RECOGNIZED AS HAVING RECEIVED THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD FOR THE PRIOR 8 YEARS. IN 2018 SUMMA AKRON CAMPUS ER SAW 83 MORE STROKE TEAMS DUE TO THE EXPANSION OF STROKE GUIDELINES, LEADING TO 23 MORE PATIENTS RECEIVING CLOT BUSTER DRUG TREATMENT. IN 2018, OUR AKRON CAMPUS'S DOOR-TO-DRUG TIME WAS 13 MINUTES FASTER THAN THE NATIONAL GOAL OF 60 MINUTES. ADDITIONALLY, WE GAVE OUR CLOT BUSTER DRUG IN 45 MINUTES OR LESS 69% OF THE TIME, COMPARED TO ONLY 49% OF OTHER OHIO HOSPITALS. SUMMA HIRED A NEUROINTERVENTIONAL SURGEON IN JULY 2018, LEADING TO 12 MORE CLOT RETRIEVAL PROCEDURES THAN IN PRIOR YEAR AND 11 MINIMALLY INVASIVE ANEURYSM COILINGS. NURSING:SUMMA HEALTH SYSTEM- AKRON AND ST. THOMAS CAMPUSES HAVE MAGNET RECOGNITION FOR EXCELLENCE IN NURSING FROM THE AMERICAN NURSES CREDENTIALING CENTER (ANCC). SUMMA SHARES MAGNET STATUS WITH JUST SEVEN PERCENT OF HOSPITALS IN THE COUNTRY. ONCOLOGY:SUMMA HEALTH IS A LEADER IN CANCER TREATMENT WITH NATIONALLY RECOGNIZED CANCER CENTERS THROUGHOUT NORTHEAST OHIO. SUMMA TREATS MORE THAN 100 CANCER TYPES, SPECIALIZING IN LUNG, BREAST, COLORECTAL, GYNECOLOGICAL AND ORTHOPEDIC. SUMMA HEALTH'S CANCER CENTERS ARE FULLY ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER (COC). SUMMA HEALTH EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR HOSPITAL ACCREDITATION BY DEMONSTRATING CONTINUOUS COMPLIANCE WITH ITS PERFORMANCE STANDARDS. THE GOLD SEAL OF APPROVAL IS A SYMBOL OF QUALITY THAT REFLECTS AN ORGANIZATION'S COMMITMENT TO PROVIDING SAFE AND EFFECTIVE PATIENT CARE. IN 2018, SUMMA HEALTH ALSO RECEIVED THE 2017 OUTSTANDING ACHIEVEMENT AWARD FROM THE COC. COC IS A PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS AND RECOGNIZES CANCER CARE PROGRAMS FOR THEIR COMMITMENT TO PROVIDING COMPREHENSIVE, HIGH-QUALITY AND MULTIDISCIPLINARY PATIENT-CENTERED CARE. SUMMA HEALTH IS ONE OF JUST 16 COC-ACCREDITED PROGRAMS TO ACHIEVE THIS RECOGNITION DURING THE SECOND-HALF 2017 SURVEY PERIOD. IT IS THE FIRST TIME SUMMA HAS ACHIEVED SUCH A HIGH HONOR. IN ADDITION, SUMMA IS ONE OF ONLY TWO MAJOR HEALTH SYSTEMS IN NORTHEAST OHIO TO EARN THE PRESTIGIOUS AMERICAN COLLEGE OF RADIATION (ACR) ACCREDITATION IN RADIATION ONCOLOGY. SUMMA HEALTH LUNG IMAGING CENTER WAS NAMED A SCREENING CENTER OF EXCELLENCE BY THE LUNG CANCER ALLIANCE FOR THE ONGOING COMMITMENT TO RESPONSIBLE LUNG CANCER SCREENING.WOMEN'S SERVICES:SUMMA HEALTH EXPANDED ITS CENTERING GROUP CARE (CGC) PROGRAM BY ADDING A MOMMY CARE CENTERING CLASS. CENTERING IS 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).BARBERTON CAMPUS IS PARTICIPATING IN THE OHIO HOSPITAL ASSOCIATION AND THE OHIO DEPARTMENT OF HEALTH'S OHIO FIRST STEPS FOR HEALTHY BABIES BREASTFEEDING RECOGNITION PROGRAM. THE PURPOSE OF THIS PROGRAM IS TO RECOGNIZE MATERNITY CENTERS IN OHIO THAT HAVE TAKEN STEPS TO PROMOTE, PROTECT AND SUPPORT BREASTFEEDING IN THEIR ORGANIZATIONS. THIS PROGRAM OFFERS A NUMBER OF OPPORTUNITIES FOR LEARNING AND NETWORKING IN SUPPORT OF THE TEN STEPS TO SUCCESSFUL BREASTFEEDING. SYSTEM: FOR THE 14TH 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 COUNCILIN NOVEMBER 2018, THE LEAPFROG HOSPITAL SAFETY GROUP, THE LEADING SCORECARD ON HOSPITAL SAFETY ACROSS THE COUNTRY, ANNOUNCED THAT IT HAS AWARDED ITS TOP "A" GRADE TO BOTH THE SUMMA HEALTH AKRON AND BARBERTON CAMPUSES. 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 2018, SUMMA HEALTH PROVIDED CHARITY CARE TO THE INDIGENT (INCLUDING UNREIMBURSED MEDICAID) AT THE COST OF MORE THAN $36 MILLION. THIS AMOUNT DOES NOT INCLUDE SERVICES PROVIDED WRITTEN OFF AS BAD DEBT.IN ADDITION 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 CONSISTS OF PERSONS WHO ARE BROADLY REPRESENTATIVE OF THE COMMUNITY AND MEDICAL STAFF.SUMMA HEALTH MEDICAL GROUP- PROGRAM SERVICE ACCOMPLISHMENTS:SUMMA HEALTH MEDICAL GROUP, A SUMMA HEALTH ENTITY, IS A MULTI-SPECIALTY GROUP OF PHYSICIANS AND PHYSICIAN PRACTICES. IN TOTAL, SUMMA HEALTH MEDICAL GROUP EMPLOYS NEARLY 300 PHYSICIANS, 150 APPS AND 700 SUPPORT STAFF IN MORE THAN 30 SPECIALTIES AND SUB-SPECIALTIES. SUMMA HEALTH MEDICAL GROUP PROMOTES STRONG AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIAN SERVICES ARE MET. IN 2018, SUMMA HEALTH MEDICAL GROUP CONTINUED ITS DEVELOPMENT 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 FOUNDATION - PROGRAM SERVICE ACCOMPLISHMENTS:THROUGH PHILANTHROPY, SUMMA FOUNDATION SUPPORTS PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. SUMMA 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 2018 TOTALED $8.0 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 DEPARTMENTS TO BEST POSITION SUMMA EDUCATION, RESEARCH AND CLINICAL INNOVATION PRIORITIES WITH PUBLIC SECTOR FUNDING OPPORTUNITIES. 45530305 250271 56756254 844929930 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 7503 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 39 33 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH FL X X Keith Coleman 2343125867 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 X NICHOLAS BROWNING DIR. SHS & DIR. SHMG 2.00 2.00 X 0 0 0 Stephen Comunale DIRECTOR SHS 2.00 2.00 X 0 0 0 Anton Decker DIRECTOR SHS (End 11/2018) 2.00 2.00 X 0 0 0 T Clifford Deveny MD CEO SHS, Director SHS & SF 4.00 46.00 X X 0 1502579 32943 Barbara Faciana DIRECTOR SHS 2.00 2.00 X 0 0 0 Philip Kaufmann DIRECTOR SHS 2.00 2.00 X 0 0 0 ANTHONY LOCKHART DIRECTOR & CHAIRMAN SHS 2.00 2.00 X X 0 0 0 JAMES MCILVAINE DIR. SHS & CHAIR/DIR. SHMG 4.00 2.00 X X 0 0 0 George Strickler DIRECTOR SHS (Start 5/18) Dir/Treas SF (end 7/18 4.00 2.00 X X 0 0 0 LEILA VESPOLI DIRECTOR SHS (End 3/2018) 2.00 2.00 X 0 0 0 Peter Bittenbender MD DIR. SHS & DIR. SHMG 52.00 2.00 X 710999 0 16762 Lynn Hamrich MD DIRECTOR SHS 52.00 2.00 X 262831 0 24336 Costas Kefalas MD DIRECTOR SHS 2.00 2.00 X 0 0 0 DARYL CAMERON DIRECTOR SHS 2.00 2.00 X 0 0 0 Jeffrey Copeland DIRECTOR SHS 2.00 2.00 X 0 0 0 JAMES KRAVEC MD DIRECTOR SHS 2.00 2.00 X 0 0 0 Jason Seigert DIRECTOR SHS (Start 11/2018) 2.00 2.00 X 0 0 0 ROBERT SHRODER DIRECTOR SHS 2.00 2.00 X 0 0 0 MARK ALLIO DIRECTOR SF (Started 1/2018) 2.00 0.00 X 0 0 0 KEN BABBY DIRECTOR SF 2.00 0.00 X 0 0 0 JULIA BIANCHI DIRECTOR SF 2.00 0.00 X 0 0 0 Karen Budd PhD RN DIRECTOR SF 2.00 0.00 X 0 0 0 JASON BUTTERWORTH DIRECTOR SF 2.00 0.00 X 0 0 0 Betsy Clark DIRECTOR SF (Start 12/2018) 2.00 0.00 X 0 0 0 THOMAS CLARK DIRECTOR/CHAIR SF 4.00 0.00 X X 0 0 0 GEORGE DAVERIO JR DIRECTOR SF 2.00 0.00 X 0 0 0 C GORDON EWERS DIRECTOR SF 2.00 0.00 X 0 0 0 PHYLIS FERRARA PRESIDENT & CDO, SF 50.00 0.00 X X 400917 0 21191 SAMIR GIBARA DIRECTOR SF (End 3/2018) 2.00 0.00 X 0 0 0 William Ginter DIRECTOR SF 2.00 0.00 X 0 0 0 IRIS HARVEY DIRECTOR SF 2.00 0.00 X 0 0 0 MARY ANN JACKSON DIRECTOR SF 2.00 0.00 X 0 0 0 Lyn Jones DIRECTOR SF (start 12/2018) 2.00 0.00 X 0 0 0 Patrick O'Neill DIRECTOR & Secretary SF 2.00 0.00 X X 0 0 0 JONATHON PAVLOFF DIRECTOR & Treas. SF 2.00 0.00 X X 0 0 0 Julie L Pulk DIRECTOR SF 2.00 0.00 X 0 0 0 PAUL TESTA DIRECTOR & Vice Chair SF 4.00 0.00 X X 0 0 0 R Mark Wernig DIRECTOR SF 2.00 0.00 X 0 0 0 Lydia Cook MD President Summa Health Medical Group 50.00 0.00 X 509434 0 18432 BRIAN DERRICK SVP CFO, TR. SHS & SHMG, Asst. TR SF (End 1/2018) 4.00 46.00 X 0 1413771 22256 KEITH T COLEMAN SVP CFO, TR. SHS & SHMG, Asst. TR SF (Start 10/201 4.00 46.00 X 0 262725 9126 ROBERT A GERBERRY SHS SEC./SR. VP G.Counsel, SF Secretary 4.00 46.00 X 0 435557 30972 THOMAS P O'NEILL VP, CFO SHS, Assistant Tresurer 46.00 4.00 X 0 460639 24386 David Custodio MD President, SHS 50.00 0.00 X 501189 0 32678 Michael Hughes MD President Summa Barberton 50.00 0.00 X 441237 0 25869 Lori Rhine RN VP, CNO Akron & St. Thomas 50.00 0.00 X 244144 0 30612 Tammy Scarborough President Ambulatory Care & Clinical Care Services 46.00 4.00 X 0 400402 17179 MARK POZSGAY DO ClINICAL PHYSICIAN - SHMG 50.00 0.00 X 1227736 0 36884 JOHN G ZOGRAFAKIS MD clinICAL PHYSICIAN - SHMG 50.00 0.00 X 1083534 0 35105 ERIC A ESPINAL MD CliniCAL PHYSICIAN - SHMG 50.00 0.00 X 1001994 0 34887 Derek Klaus MD CLINICAL PHYSICIAN - SHMG 50.00 0.00 X 1040086 0 33939 Anand Desai MD CLINICAL PHYSICIAN - SHMG 50.00 0.00 X 965396 0 9983 MARY WARD Former SR VP CNO SHS 46.00 4.00 X 0 406334 0 8389497 4882007 457540 476 1 1 0 0 1059909 1059909 NET PATIENT REVENUE le 621110 943060698 942974113 86585 SHMG Practice support 621110 34383525 34383525 Program related invest 900099 5040104 4433990 606114 Reference Lab 621500 4725112 4725112 Rental Income From Aff 900099 2524310 2524310 18695637 18695637 1008429386 217019 217019 2182791 2182791 5489198 6860222 -1371024 -1371024 -1371024 34659263 20810881 13848382 13848382 13848382 CAFETERIA SALES 722210 5286353 474819 4811534 REBATES 900099 2886418 2886418 Wellness Institute 621990 2592396 334130 2258266 6825160 398941 6426219 17590327 1041956790 1003011575 6625701 31259605 250271 250271 2834297 2380809 453488 379154856 317259916 60430460 1464480 7222414 6066828 1155586 46205393 38767068 7384203 54122 24437012 20527090 3909922 2536458 2130625 405833 137502 137502 5832 5832 84259825 58419816 25801840 38169 79254 66573 12681 9713990 8085462 1540088 88440 1134662 902564 171917 60181 11578492 9725933 1852559 401854 329744 62808 9302 1272616 1068108 203449 1059 22600138 18984116 3616022 42480824 35683892 6796932 1544053 1297005 247048 Medical Supplies 158740941 158740941 Management fees 129194400 108523296 20671104 SHMG PRACTICE SUPPORT 34383525 28882161 5501364 Taxes and Franchise fee 13273378 11149638 2123740 18814400 15688074 2988204 138122 992256387 844929930 145472582 1853875 X 97327 100200 6390943 5092750 133829574 126197284 1618384 3343435 13364973 14570264 6545644 3213183 1394238317 854986557 420299931 539251760 177910668 78373119 10856164 0 26491165 9001289 2228740 2228740 505200802 597461000 1304834315 1378833024 82100375 84737027 2030250 806200 605198987 597152806 260089437 294784257 949419049 977480290 X 355012743 400989497 8389 8389 394134 354848 355415266 401352734 1304834315 1378833024 X 49700403 760551 -4523486 X X 0 1 X 1 1 1 X 1 Summa Health System 340714755 3 1 0 0 1 0 0 Schedule A, Part I, Line 3, 7, 12: SUMMA HEALTH SYSTEM, EIN 34-0714755, IS A SUBORDINATE MEMBER OF THE SUMMA HEALTH GROUP RULING. THE ORGANIZATION'S PUBLIC CHARITY STATUS IS AS A HOSPITAL ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III). SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP (SHMG), EIN 34-1790929, IS A SUBORDINATE MEMBER OF THE SUMMA HEALTH GROUP RULING. THE ORGANIZATION'S PUBLIC CHARITY STATUS IS SECTION 509(A)(3) TYPE III FUNCTIONALLY INTEGRATED AND MUST COMPLETE SCHEDULE A, PART IV, SECTIONS A, D, AND E. THE NUMBER OF SUPPORTING ORGANIZATIONS FOR LINE 12F IS 1. THE SUPPORTED ORGANIZATION FOR LINE 12G IS SUMMA HEATLH SYSTEM, EIN 34-0714755, WHOSE ORGANIZATION TYPE DESCRIBED ON LINES 1-10 IS 3, AND WHICH IS LISTED IN THE SHMG ORGANIZING DOCUMENTS. LISTING ZERO IN SUPPORT FOR LINE 12G COLUMN (V) AND (VI). SUMMA FOUNDATION, EIN 34-1219001, IS A SUBORDINATE MEMBER OF THE SUMMA HEALTH GROUP RULING. THE ORGANIZATION'S PUBLIC CHARITY STATUS AN ORGANIZATION THAT NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(a)(VI) AND MUST COMPLETE SCHEDULE A PART II. PURSUANT TO THE INSTRUCTIONS FOR GROUP FILINGS, THE ABOVE LISTED ORGANIZATIONS HAVE SEPARATELY DOCUMENTED THEIR COMPLIANCE REQUIREMENTS ON SCHEDULE A, PART VI, SUPPLEMENTAL INFORMATION. SCHEDULE A, PART II, SECTION A, PUBLIC SUPPORT: SCHEDULE A PUBLIC SUPPORT SCHEDULE IS BEING PREPARED FOR SUMMA FOUNDATION, EIN 34-1219001. SUMMA FOUNDATION IS A SUBORDINATE MEMBER OF THE SUMMA HEALTH GROUP RULING. THE ORGANIZATION'S PUBLIC CHARITY STATUS AN ORGANIZATION THAT NORMALLY RECEIVES A SUBSTANTIAL PART OF ITS SUPPORT FROM A GOVERNMENTAL UNIT OR FROM THE GENERAL PUBLIC DESCRIBED IN SECTION 170(B)(1)(a)(VI) AND MUST COMPLETE SCHEDULE A PART II. THE SOFTWARE USED TO PREPARE THE SUMMA HEALTH GROUP RETURN DOES NOT ALLOW FOR MULTIPLE PUBLIC CHARITY STATUS. ACCORDINGLY, THE ABOVE LISTED ORGANIZATION IS SEPARATELY DOCUMENTING ITS PUBLIC SUPPORT PERCENTAGES AGGREGATED AS FOLLOWS: Part II, Section A. Public Support: Line 1 - column (a) 8,525,120, (b) 5,313,648, (c) 1,438,055, (d) 0, (e) 0, (f) 15,276,823; Line 4 - column (a) 8,525,120, (b) 5,313,648, (c) 1,438,055, (d) 0, (e) 0, (f) 15,276,823; Line 5 - column (f) 2,381,500; Line 6 - Public Support (f) 12,895,323 Part II, Section B. Total Support: Line 7 - column (a) 8,525,120, (b) 5,313,648, (c) 1,438,055, (d) 0, (e) 0, (f) 15,276,823; Line 8 - column (a) 236,286, (b) 212,488, (c) 98,245, (d) 0, (e) 0, (f) 547,019 Line 11 - Total support (f) 15,823,842 Line 12 Gross receipts from related activities (f) 2,841,906 Part II, Section C. Computation of Public Support Percentage: Line 14 - PUBLIC SUPPORT PERCENTAGE FOR 2018, SCHEDULE A, PART II, LINE 14 IS 81.49% Line 15 - PUBLIC SUPPORT PERCENTAGE FOR 2017, SCHEDULE A, PART II, LINE 15 IS 81.22% Line 16a Box = X Schedule A, Part IV, Sections A, D, and E: SHMG, EIN 34-1790929, IS A SUBORDINATE MEMBER OF THE SUMMA HEALTH GROUP RULING. THE ORGANIZATION'S PUBLIC CHARITY STATUS IS SECTION 509(A)(3) TYPE III FUNCTIONALLY INTEGRATED AND MUST COMPLETE SCHEDULE A, PART IV, SECTIONS A, D, AND E. THE SOFTWARE USED TO PREPARE THE SUMMA HEALTH GROUP RETURN DOES NOT ALLOW FOR MULTIPLE PUBLIC CHARITY STATUS. ACCORDINGLY, THE ANSWERS PROVIDED ON SCHEDULE A, PART VI, FOR SCHEDULE A PART IV, SECTIONS A, D AND E ARE PROVIDED FOR SHMG. Schedule A, Part IV, Section A, Line 1: THE ANSWER TO FOR SCHEDULE A, PART IV, SECTION A, LINE 1 IS YES. SUPPORTED ORGANIZATIONS LISTED BY NAME: SHMG, EIN 34-1790929, WAS THE SUPPORTING ORGANIZATION TO THE FOLLOWING SUPPORTED ORGANIZATION - SUMMA HEALTH SYSTEM, INC. EIN 34-0714755. SUMMA HEALTH SYSTEM IS DESIGNATED AS A SUPPORTED ORGANIZATION BY NAME IN THE ARTICLES OF INCORPORATION OF SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP. AN HISTORIC AND CONTINUING RELATIONSHIP OF SUPPORT EXISTS BETWEEN SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP, AND SUMMA HEALTH SYSTEM, THE SUPPORTED HOSPITAL LISTED ON PART I LINE 12G. Schedule A, Part IV, Section A, Lines 2 - 4a: THE ANSWERS FOR SCHEDULE A, PART IV, SECTION A, LINES 2-4A ARE AS FOLLOWS: 2, NO 3A, NO 4A, NO Schedule A, Part IV, Section A, Line 5a: THE ANSWER FOR SCHEDULE A, PART IV, SECTION A, LINE 5A IS NO. Schedule A, Part IV, Section A, Lines 6-11c : THE ANSWERS FOR SCHEDULE A, PART IV, SECTION A, LINES 6 - 11C ARE AS FOLLOWS: 6, NO 7, NO 8, NO 9A-9C, NO 10A, NO 11A-11C, NO Schedule A, Part IV, SECTION D, LINES 1-3: THE ANSWERS FOR SCHEDULE A, PART IV, SECTION D, LINES 1 - 3 ARE AS FOLLOWS: 1, YES 2, YES 3, YES. Summa Health System has a significant voice in SHMG's investment policies and in directing the use of SHMG's income or assets at all time during the tax year through common board membership and through common control provided by Summa Health, the parent organization of Summa Health System, the supported organization. Schedule A, Part IV, Section E, Line 1A: SCHEDULE A, PART IV, SECTION E, LINE 1A IS "X" Schedule A, Part IV, Section E, Line 2A: THE ANSWER FOR SCHEDULE A, PART IV, SECTION E, LINE 2A IS YES: ORGANIZATION ACTIVITIES DIRECTLY FURTHER THE EXEMPT PURPOSES: SHMG PROMOTES THE STRONGER AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE THE SUPPORTED HOSPITALS LISTED IN PART I LINE 12G MEET COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIAN SERVICES, AND ALSO DEVELOPS PHYSICIAN COVERAGE IN NEW MARKETS. SHMG DIRECTORS AND OFFICERS SERVE AS DIRECTORS AND OFFICERS ON THE BOARDS OF THE SUPPORTED ORGANIZATIONS, ENSURING RESPONSIVENESS. SHMG'S PROGRAM SERVICE ACCOMPLISHMENTS INCLUDE HOSPITAL-BASED PRACTICES, MISSION-BASED PRACTICES, AND STRATEGIC-BASED PRACTICES, ALL BASED EXCLUSIVELY IN THE IDENTIFIED SUPPORTED HOSPITAL AND CONSTITUTING SUBSTANTIALLY ALL OF SHMG'S ACTIVITIES. Schedule A, Part IV, Section E, Line 2B: THE ANSWER FOR SCHEDULE A, PART IV, SECTION E, LINE 2B IS YES. ACTIVITIES THAT ONE OR MORE SUPPORTED ORGANIZATIONS ENGAGED IN: BUT FOR SHMG'S WORK TO ENSURE A STRONG AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE THE SUPPORTED HOSPITAL LISTED IN PART I LINE 12G MEETS COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIAN SERVICES, THE IMPORTANT RELATIONSHIPS BETWEEN THE SUPPORTED HOSPITAL AND ITS PHYSICIANS WOULD HAVE TO BE MANAGED BY THE HOSPITAL. 0 0 0 0 0 1 5832 0 0 0 5832 0 Part II-B, Line 1: The amount on Line 1(f) represents the portion of annual dues to the Ohio Hospital Association allocable to lobbying activities. 22691956 -86257 -682201 21923498 20437936 426808 1827212 22691956 19720810 66105 651021 20437936 19966435 313575 -559200 19720810 17564267 1927170 474998 19966435 1.00000 0 1 1 69251739 69251739 660655897 453449566 207206331 5349868 2775002 2574866 461879330 377759308 84120022 197101483 21002681 176098802 539251760 Non-Perf Asset Air Rights 491870 Taxes receivable 385205 Other Accounts Receivable 68571 Beneficial Interest in Property 3128586 Due from Related Organizations 593386768 597461000 Lease Escalation Liability 225639 Capital Lease Obligations 23970497 Asset Retirement Obligation 2796880 Interest Rate Swap 8423309 Post Retirement Benefits 765940 Contingent Liabilities 490083 Malpractice Liability 12869883 Unsecured Payables 240627414 Purchase Option Liability 4614612 294784257 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 Corp. ("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 9697251 1 0 0 0 1 0 9697251 0 9697251 0 0 0 0 0 0 Part I, line 3: Central American and the Caribbean: Accrual SCHEDULE F, PART I, LINE 3(F) EXPENDITURES: INSURANCE PREMIUMS PAID $9,697,251 1 1 X 1 X 1 X 1 1 1 0 1 1 38850346 29923068 8927278 0.00890 160841014 130204334 30636680 0.03050 199691360 160127402 39563958 0.03940 9624148 116975 9507173 0.00950 35083103 11445680 23637423 0.02360 29744770 0 29744770 0.02960 7277400 788875 6488525 0.00650 1763539 0 1763539 0.00180 83492960 12351530 71141430 0.07100 283184320 172478932 110705388 0.11040 1 16666 0 16666 0.00000 2 6000 0 6000 0.00000 1 2525 2525 0.00000 2 8205 8205 0.00000 6 33396 33396 0.00000 1 15258000 153872898 157115162 -3242264 X 1 1 2 Digestive Health Center LLC Digestive Disease 0.05000 0.00000 0.44000 3 Medina-Summit ASC LLC Ambulatory Surgery Center 0.20000 0.00000 0.70000 2 1 Summa Health System 525 East Market Street Akron OH 44304 www.summahealth.org 1275 X X X X X 2 Summa Rehab Hospital LLC 29 North Adams Street Akron OH 44304 www.summarehabhospital.com 1503 X X Rehabilitation Summa Health System 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X SEE PART V, PAGE 8 X 1 17 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 Summa Rehab Hospital LLC 2 0 0 1 X X X X X X X X X 16 1 1 1 1 X SEE PART V, PAGE 8 X 1 17 1 SEE PART V, PAGE 8 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X 0 X X 0 0 Summa Health System Part V, Section B, Line 5: Input from persons who represent broad interests of community served:Summa Health System:INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS IN MARCH-JUNE 2016 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 WHAT HOSPITALS CAN DO TO ADDRESS THE PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE COMMUNITY LEADERS PROVIDE A PERSPECTIVE ON THE BROAD INTERESTS OF THE GROUPS 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: AKRON PUBLIC SCHOOLSBARBERTON COMMUNITY FOUNDATIONCITY OF AKRON ASSISTANT TO THE MAYOR FOR HEALTH, EDUCATION AND FAMILIESCITY OF HUDSON MAYORCITY OF NEW FRANKLIN MAYORCITY OF STOW MAYOREMERGE MINISTRIESGREATER AKRON CHAMBER OF COMMERCE PRESIDENT AND CEOHAVEN OF REST MINISTRIESHUDSON CITY SCHOOL DISTRICTINTERNATIONAL INSTITUTE OF AKRON DIRECTOR OF REFUGEE RESETTLEMENTLOVE AKRONOPEN M MINISTRIESSENATOR SHERROD BROWNSENATOR ROB PORTMANSUMMIT COUNTY ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH BOARD DIRECTORSUMMIT COUNTY EXECUTIVESUMMIT COUNTY PUBLIC HEALTH COMMISSIONERIN ADDITION TO THE INPUT FROM COMMUNITY LEADERS, FIVE COMMUNITY RESIDENT FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS FROM APRIL-SEPTEMBER 2016 TO GET THEIR INPUT ON WHAT THEY THOUGHT WERE THE SIGNIFICANT HEALTH NEEDS 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 SUBSTANCE ABUSE ISSUES AND MENTAL HEALTH ISSUES, SEVERAL QUESTIONS WERE ASKED TO PROBE MORE DEEPLY INTO 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 FIFTY-FOUR SUMMIT COUNTY RESIDENTS PARTICIPATED IN THE COMMUNITY RESIDENT FOCUS GROUPS. ADDITIONAL DETAIL CAN BE FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2016. Summa Rehab Hospital, LLC Part V, Section B, Line 5: Input from persons who represent broad interests of community served:Summa Rehabilitation Hospital:INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS IN MARCH-JUNE 2016 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 WHAT HOSPITALS CAN DO TO ADDRESS THE PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THESE COMMUNITY LEADERS PROVIDE A PERSPECTIVE ON THE BROAD INTERESTS OF THE GROUPS 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: AKRON PUBLIC SCHOOLSBARBERTON COMMUNITY FOUNDATIONCITY OF AKRON ASSISTANT TO THE MAYOR FOR HEALTH, EDUCATION AND FAMILIESCITY OF HUDSON MAYORCITY OF NEW FRANKLIN MAYORCITY OF STOW MAYOREMERGE MINISTRIESGREATER AKRON CHAMBER OF COMMERCE PRESIDENT AND CEOHAVEN OF REST MINISTRIESHUDSON CITY SCHOOL DISTRICTINTERNATIONAL INSTITUTE OF AKRON DIRECTOR OF REFUGEE RESETTLEMENTLOVE AKRONOPEN M MINISTRIESSENATOR SHERROD BROWNSENATOR ROB PORTMANSUMMIT COUNTY ALCOHOL, DRUG ADDICTION, AND MENTAL HEALTH BOARD DIRECTORSUMMIT COUNTY EXECUTIVESUMMIT COUNTY PUBLIC HEALTH COMMISSIONERIN ADDITION TO THE INPUT FROM COMMUNITY LEADERS, FIVE COMMUNITY RESIDENT FOCUS GROUPS WERE CONDUCTED WITH COMMUNITY RESIDENTS FROM APRIL-SEPTEMBER 2016 TO GET THEIR INPUT ON WHAT THEY THOUGHT WERE THE SIGNIFICANT HEALTH NEEDS 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 SUBSTANCE ABUSE ISSUES AND MENTAL HEALTH ISSUES, SEVERAL QUESTIONS WERE ASKED TO PROBE MORE DEEPLY INTO 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 FIFTY-FOUR SUMMIT COUNTY RESIDENTS PARTICIPATED IN THE COMMUNITY RESIDENT FOCUS GROUPS. ADDITIONAL DETAIL CAN BE FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2016. Summa Health System Part V, Section B, Line 6a: CHNA conducted with one or more other hospital facilities:Summa Health System: SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF EACH OF ITS HOSPITAL FACILITIES LISTED IN PART V, SECTION A. IN ADDITION SUMMA HEALTH COLLABORATED WITH CLEVELAND CLINIC AKRON GENERAL AND AKRON CHILDREN'S HOSPITAL IN CONDUCTING THE CHNA. Summa Rehab Hospital, LLC Part V, Section B, Line 6a: CHNA conducted with one or more other hospital facilities:Summa Rehabilitation Hospital:SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF EACH OF ITS HOSPITAL FACILITIES LISTED IN PART V, SECTION A. IN ADDITION SUMMA HEALTH COLLABORATED WITH CLEVELAND CLINIC AKRON GENERAL, AND AKRON CHILDREN'S HOSPITAL IN CONDUCTING THE CHNA. Summa Health System Part V, Section B, Line 6b: CHNA conducted with one or more organizations other than hospital facilities:Summa Health System:KENT STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH Summa Rehab Hospital, LLC Part V, Section B, Line 6b: CHNA conducted with one or more organizations other than hospital facilities:Summa Rehabilitation Hospital:KENT STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH Summa Health System Part V, Section B, Line 11: How the hospital facility is addressing needs identified in its CHNA:Summa Health System:AFTER CAREFUL ANALYSIS OF BOTH THE EPIDEMIOLOGICAL AND QUALITATIVE DATA, SUMMA HEALTH WILL ADDRESS THE ADULT HEALTH NEEDS IN FIVE PRIMARY CATEGORIES: CHRONIC DISEASE MANAGEMENT, ACCESS AND BARRIERS TO HEALTH CARE, HEALTH DISPARITIES, PREVENTION AND WELLNESS. THE PRIORITIES ARE IN ALIGNMENT WITH CURRENT COMMUNITY HEALTH NEEDS IDENTIFIED BY THE SUMMIT COUNTY PUBLIC HEALTH 2016 COMMUNITY HEALTH ASSESSMENT AND THE OHIO DEPARTMENT OF HEALTH'S 2017-2019 STATE HEALTH IMPROVEMENT PLAN.PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2016 SUMMA CHNA:PRIORITY HEALTH ISSUE, PLAN TO ADDRESSACCESS TO HEALTH CARE, YESCHRONIC DISEASE, YESENVIRONMENTAL FACTORS, NOHEALTH DISPARITIES, YESINFECTIOUS DISEASE, NOINJURY AND ACCIDENTS, NOQUALITY OF HEALTH CARE, YESMATERNAL AND CHILD HEALTH, YESMENTAL HEALTH, YESPREVENTION AND WELLNESS, YESSUBSTANCE ABUSE, YESSIGNIFICANT HEALTH NEEDS ADDRESSED:PRIORITY HEALTH OUTCOME: IMPROVING PREVENTION AND WELLNESSAT SUMMA HEALTH, OUR POPULATION HEALTH STRATEGY IS EVOLVING THE WAY WE DELIVER CARE. OUR VISION FOR CARE PUTS THE PATIENT AT THE CENTER OF THIS MODEL BY CREATING A COLLABORATION BETWEEN THE PATIENT AND THEIR CAREGIVERS THAT IS FOCUSED ON PREVENTION AND WELLNESS (P&W). P&W FOCUSES ON IMPROVING THE WHOLE PERSON, BODY AND MIND AND REDUCING LIFESTYLE RISK FACTORS AND "EVERYDAY" BEHAVIORS THAT CAN NEGATIVELY IMPACT HEALTH. P&W STRATEGIES CROSS ALL THE PRIORITY HEALTH OUTCOMES, ARE EMBEDDED IN EACH OBJECTIVE AND WILL BE IDENTIFIED AS P&W.PRIORITY HEALTH OUTCOME: IMPROVING ACCESS TO HEALTH CARETHE HEALTH NEEDS PERTAINING TO ACCESS ARE BEING ADDRESSED BY INCORPORATING COMMUNITY HEALTH WORKERS IN COMMUNITY BASED SETTINGS (P&W), AND INCREASING THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES AND COMPREHENSIVE PRIMARY CARE PLUS PRACTICES THEREBY INCREASING THE OPPORTUNITIES FOR PREVENTATIVE AND EARLY INTERVENTIONS FOR INDIVIDUALS REQUIRING PRIMARY CARE, DENTAL, AND BEHAVIORAL HEALTH PROVIDERS (P&W). PRIORITY HEALTH OUTCOME: PROVIDING CHRONIC DISEASE MANAGEMENTTHE HEALTH NEEDS PERTAINING TO CHRONIC DISEASE ARE BEING ADDRESSED THROUGH INCREASING CONSUMER KNOWLEDGE BASE OF RISK FACTORS, RISK BEHAVIORS, AND GENETIC CONSIDERATIONS WHICH LEAD TO CANCER, CARDIOVASCULAR DISEASE AND DIABETES(P&W). THE HEALTH NEEDS PERTAINING TO SUBSTANCE ABUSE ARE BEING ADDRESSED BY DECREASING ALCOHOL AND OPIATE RELATED OVERDOSES AND DEATHS(P&W). THE HEALTH NEEDS PERTAINING TO LIFESTYLE FACTORS ARE BEING ADDRESSED BY DECREASING SMOKING AND TOBACCO USE IN ADULTS(P&W). PRIORITY HEALTH OUTCOME: REDUCING HEALTH DISPARITIESTHE HEALTH NEEDS PERTAINING TO HEALTH DISPARITIES ARE BEING ADDRESSED THROUGH REDUCING INFANT MORTALITY BY PROVIDING PROGRAMS AND SERVICES THAT PROVIDE OUTREACH, EDUCATION, COORDINATION AND FOCUS ON REDUCING THE IMPACTS OF THE SOCIAL DETERMINANTS OF HEALTH FOR LOW INCOME MOTHERS(P&W). PRIORITY HEALTH OUTCOME: IMPROVING QUALITY OF HEALTH CARETHE HEALTH NEEDS PERTAINING TO QUALITY OF CARE FACTORS ARE BEING ADDRESSED BY DECREASING HOSPITAL READMISSIONS AND INCREASING CONSUMER KNOWLEDGE OF PREOPERATIVE CARE. SIGNIFICANT HEALTH NEEDS NOT ADDRESSEDTHE LIST ABOVE INDICATES SEVERAL PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE 2016 CHNA THAT SUMMA WILL NOT ADDRESS IN THE PLAN. POOR HEALTH STATUS CAN RESULT THROUGH A COMPLEX INTERACTION OF CHALLENGING SOCIAL, ECONOMIC, ENVIRONMENTAL AND BEHAVIORAL FACTORS, COMBINED WITH LACK OF ACCESS TO CARE. ADDRESSING THE MORE COMMON "ROOT" CAUSES OF POOR COMMUNITY HEALTH CAN SERVE TO IMPROVE A COMMUNITY'S QUALITY OF LIFE AND TO REDUCE MORTALITY AND MORBIDITY. HOWEVER, SUMMA RECOGNIZES THAT NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE ROOT CAUSES AND HEALTH NEEDS PRESENT IN ITS COMMUNITY. THEREFORE, IT WAS DETERMINED THAT THE HEALTH SYSTEM WILL COLLABORATE WITH OTHER ORGANIZATIONS AS NEEDED TO ADDRESS THE HEALTH NEEDS NOT SELECTED. INJURIES, ACCIDENTS AND ENVIRONMENTAL FACTORS INCLUDING VIOLENCE, CRIME, AND POVERTY WILL NOT BE ADDRESSED DIRECTLY THROUGH OUR PLAN. RESOURCES, AS WELL AS AVAILABLE EXPERTISE, LIMIT OUR SELECTION OF PRIORITIES. SUMMA HEALTH WILL, HOWEVER, LOOK FOR OPPORTUNITIES TO COLLABORATE WITH SAFE COMMUNITIES OF SUMMIT COUNTY, SUMMIT COUNTY SAFE KIDS COALITION, COMMUNITY DEVELOPMENT CORPORATIONS, LOCAL SERVICES AGENCIES AND OTHER ORGANIZATIONS TO ADDRESS THESE IMPORTANT HEALTH ISSUES WHENEVER POSSIBLE. THE PLAN IS ALSO IN ALIGNMENT WITH CURRENT COMMUNITY HEALTH NEEDS AND PRIORITIES IDENTIFIED BY THE SUMMIT COUNTY PUBLIC HEALTH 2016 COMMUNITY HEALTH ASSESSMENT AND THE OHIO DEPARTMENT OF HEALTH'S 2017-2019 STATE HEALTH IMPROVEMENT PLAN.A DETAILED DESCRIPTION OF THE ACTIONS BEING TAKEN TO ADDRESS THE HEALTH NEEDS IDENTIFIED ABOVE CAN BE FOUND ON THE 2017-2019 SUMMA HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2016. Summa Rehab Hospital, LLC Part V, Section B, Line 11: How the hospital facility is addressing needs identified in its CHNA:Summa Rehabilitation Hospital:Due to the nature of the adult rehabilitation specialty services provided by Summa Rehab Hospital, LLC,(" Hospital") the identified health need in which they have the opportunity to address in this implementation plan for the greatest impact is access to health care. The community resources provided by a variety of institutions and agencies, including Summa Health System, Akron and St. Thomas campuses, and Akron Children's Hospital led to the determination by Summa Rehab Hospital, LLC to not address any other identified health needs as described in the CHNA. A DETAILED DESCRIPTION OF THE ACTIONS BEING TAKEN TO ADDRESS THE HEALTH NEEDS IDENTIFIED ABOVE CAN BE FOUND ON THE 2017-2019 SUMMA HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2016. PART V SECTION C LINE 3e Facility Reporting Summa Health & Summa Rehab The significant health needs are a prioritized description of the significant health needs of the community and identified through the CHNA. Part V, Section B, line 7a Facility Reporting Summa Health & Summa Rehab Summa Health System: https://www.summahealth.org/about-us/about-summa/community-benefit-and-diversity/communityneedsassessments/communityneedsassessment2016Summa Rehab Hospital:http://www.summarehabhospital.com/about-us/community-health-needs-assessments/ Part V, Section B, line 10a Facility Reporting Summa Health and Summa Rehab Summa Health System:https://www.summahealth.org/about-us/about-summa/community-benefit-and-diversity/communityneedsassessments/communityneedsassessment2016Summa Rehab Hospital:https://www.summahealth.org/about-us/about-summa/community-benefit-and-diversity/communityneedsassessments/communityneedsassessment2016 PART V SECTION B LINE 16a: Facility Reporting Summa Health & Summa Rehab Summa Health System: https://www.summahealth.org/patientvisitor/insuranceandbilling/financialassistanceSumma Rehab Hospital: http://www.summarehabhospital.com/patient-resources/financial-assistance-policy/ PART V SECTION B LINE 16B Facility Reporting Summa Health & Summa Rehab Summa Health System: https://www.summahealth.org/patientvisitor/insuranceandbilling/financialassistanceSumma Rehab Hospital: http://www.summarehabhospital.com/patient-resources/financial-assistance-policy/ PART V SECTION B LINE 16C Facility Reporting Summa Health & Summa Rehab Summa Health System: https://www.summahealth.org/patientvisitor/insuranceandbilling/financialassistanceSumma Rehab Hospital: http://www.summarehabhospital.com/patient-resources/financial-assistance-policy/ PART V SECTION B LINE 20a: Extraordinary Collection Action Summa Rehab Hospital:Summa Rehab Hospital does not take ECAs and therefore written notices are not necessary 125 1 - SUMMA HEALTH EQUITY CENTER 1493 S HAWKINS AVENUE AKRON OH 44320 CHRONIC DISEASE MANAGEMENT, HEALTH, NUTRITION, EXERCISE & EDUCATION SERVICES 2 - PARKVIEW CENTER 155 FIFTH STREET NE BARBERTON OH 44203 CANCER CENTER & CANCER CARE 3 - SUMMA HEALTH JEAN & MILTON COOPER PAVILION 161 NORTH FORGE STREET AKRON OH 44304 CANCER CENTER & CANCER CARE 4 - SUMMA HEALTH CENTER AT GREEN - SLEEP LAB 1700 BOETTLER ROAD STE 215 UNIONTOWN OH 44685 SLEEP AND NEUROLOGY SERVICES, OBSTETRICS & GYNECOLOGY 5 - SUMMA HEALTH GREEN MEDICAL CENTER 1835 FRANKS PARKWAY UNIONTOWN OH 44685 LAB, IMAGING, AND OTHER SPECIALTY HEALTH PROGRAMS. 6 - SUMMA HEALTH WADSWORTH-RITTMAN MEDICAL C 195 WADSWORTH ROAD WADSWORTH OH 44281 OUTPATIENT SERVICES, EMERGENCY DEPARTMENT 7 - SUMMA HEALTH THERAPY AT ANNA DEAN PROFES 28 CONSERVATORY DR STE A BARBERTON OH 44203 OUTPATIENT REHAB AND THERAPY 8 - SUMMA HEALTH IGNATIA HALL SOUTH 3730 WHIPPLE AVE NW STE 5 CANTON OH 44718 OUTPATIENT ADDICTION MEDICINES 9 - SUMMA HEALTH THERAPY AT TALLMADGE RECREA 46 NORTH MUNROE ROAD TALLMADGE OH 44278 PHYSICAL THERAPY AND SPORTS HEALTH 10 - SUMMA HEALTH THERAPY AT KOHL FAMILY YMCA 477 EAST MARKET ST STE 100 AKRON OH 44304 THERAPY, REHABILITATION, AND SPORTS MEDICINE 11 - Professional Center South 55 Arch AKRON OH 44304 Family medicine, internal medicine 12 - SUMMA HEALTH WELLNESS CENTER 5625 HUDSON DRIVE HUDSON OH 44236 MEDICAL-BASED FITNESS PROGRAMS REHABILITATION & THERAPY 13 - SUMMA HEALTH HUDSON MEDICAL CENTER 5655 HUDSON DRIVE STE 200 HUDSON OH 44236 LAB, IMAGING, REHABILITATION, WOUND CARE & SPORTS MEDICINE 14 - SUMMA HEALTH AT WADSWORTH COMMUNITY CENT 621 SCHOOL DRIVE WADSWORTH OH 44281 IMAGING, REHABILITATION, AND ORTHOPAEDIC SPORTS MEDICINE 15 - SUMMA HEALTH NEUROSCIENCE CENTER 701 WHITE POND DR STE 210 AKRON OH 44320 NEUROLOGY SERVICES 16 - SUMMA HEALTH THERAPY AT SHAW JEWISH COMM 750 WHITE POND DR STE 500 AKRON OH 44320 OCCUPATIONAL & REHAB SERVICES 17 - Summa Health Group 1 Park West Blvd Suite 350 Akron OH 44320 Physician office 18 - Summa Health Group 1 Park West Blvd Suite 200 Akron OH 44320 Physician office 19 - Summa Health Group 1 Park West Suite 330 Akron OH 44320 Physician office 20 - Summa Health Group 1 Park West Suite 330 Akron OH 44320 Physician office 21 - Summa Health Group & Labcare Plus 1260 Independence Ave Akron OH 44310 Physician office and lab 22 - Summa Health Group 1305 Corporate Dr Suite A Hudson OH 44236 Physician office 23 - Summa Health Group 1320 Mercy Drive NW Canton OH 44708 Physician office 24 - Summa Health Group 1463 Canton Rd Akron OH 44312 Physician office 25 - Summa Health Group & Labcare Plus 1493 South Hawkins Ave Akron OH 44320 Physician office and lab 26 - Summa Health Group 155 Fifth Street NE Barberton OH 44203 Physician office 27 - Summa Health Group 156 Fifth St Parkview Bldg Barberton OH 44204 Physician office 28 - Summa Health Group 161 N Forge St Suite G90 Akron OH 44304 Physician office 29 - Summa Health Group 161 N Forge St Suite 190 Akron OH 44304 Physician office 30 - Summa Health Group 161 North Forge St Suite 298 Akron OH 44304 Physician office 31 - Summa Health Group 161 North Forge StSuite 198 Akron OH 44304 Physician office 32 - Summa Health Group 161 North Forge Street Suite G90 Akron OH 44304 Physician office 33 - Summa Health Group 1700 Boettler Rd Suite 225 Uniontown OH 44685 Physician office 34 - Summa Health Group 1700 Boettler Rd Suite 150 Uniontown OH 44685 Physician office 35 - Summa Health Group 1835 Franks Parkway Uniontown OH 44685 Physician office 36 - Summa Psychiatry Associates 1835 Franks Parkway Uniontown OH 44685 Physician office 37 - Summa Health Group 1860 State Rd Suite D Cuyahoga Falls OH 44223 Physician office 38 - Summa Health Group 1860 State RdSuite A Cuyahoga Falls OH 44223 Physician office 39 - Summa Health Group 1900 23rd St Suite 1000 Cuyahoga Falls OH 44223 Physician office 40 - Summa Health Group 195 Wadsworth Rd Wadsworth OH 44281 Physician office 41 - Summa Health Group 195 Wadsworth Rd Suite 301 Wadsworth OH 44256 Physician office 42 - Summa Health Group 195 Wadsworth Rd Suite 305 Wadsworth OH 44281 Physician office 43 - Summa Health Group 201 5th St NESuite 16 Barberton OH 44203 Physician office 44 - Summa Health Group 201 5th St Suite 2 Barberton OH 44203 Physician office 45 - Summa Health Group 201 5th St Suite 6 Barberton OH 44203 Physician office 46 - Summa Health Group 201 5th Street NE Suite 3 Barberton OH 44203 Physician office 47 - Summa Health Group 201 Fifth St NE Suite 10 Barberton OH 44203 Physician office 48 - Summa Health Group 201 Fifth Street NE Suite 8 Barberton OH 44203 Physician office 49 - Summa Health Group 223 N Main St Rittman OH 44270 Physician office 50 - Summa Health Group 242 Portage Trail Ext W Cuyahoga Falls OH 442233613 Physician office 51 - Summa Health Group 25 S Main Street Suite B Rittman OH 44270 Physician office 52 - Summa Health Group 275 Graham Road Suite 11 Cuyahoga Falls OH 44223 Physician office 53 - Summa Health Group 28 Conservatory Dr Suite C Akron OH 44314 Physician office 54 - Summa Health Group & Labcare Plus 2875 West Market St Suite A Fairlawn OH 44333 Physician office and lab 55 - Summa Health Group 2875 West Market St Suite B Fairlawn OH 44333 Physician office 56 - Summa Health Group 328 Hines Hill Road Boston Heights OH 44236 Physician office 57 - Summa Health Group 3378 W Market St Fairlawn OH 44333 Physician office 58 - Summa Health Group 3593 S Arlington Road Suite D Akron OH 44312 Physician office 59 - Summa Health Group 3780 Medina Rd Suite 250 Medina OH 44256 Physician office 60 - Summa Health Group 3780 Medina Rd Suite 220 Medina OH 44256 Physician office 61 - Summa Health Group 3780 Medina Rd Suite 210 Medina OH 44256 Physician office 62 - Summa Health Group 3780 Medina Road Suite 150 Medina OH 44256 Physician office 63 - Summa Health Group 3780 Medina Road Suite 200 Medina OH 44256 Physician office 64 - Summa Health Group 3780 Medina Road Suite 310 Medina OH 44256 Physician office 65 - Summa Health Group 3838 Massillon Rd Suite 350 Uniontown OH 44685 Physician office 66 - Summa Health Group 4055 Embassy Parkway Suite 110 Fairlawn OH 44333 Physician office 67 - Summa Health Group 4211 St Rt 44 Rootstown OH 44272 Physician office 68 - Summa Health Group 444 N Main St Suite 201 Akron OH 443092090 Physician office 69 - Summa Psychiatry Associates 444 North Main St 6th Floor Akron OH 44310 Physician office 70 - Summa Psychiatry Associates 444 North Main St 4th Floor Akron OH 44310 Physician office 71 - Summa Psychiatry Associates 444 North Main StSuite 420 Akron OH 44310 Physician office 72 - Summa Health Group 500 Portage Lakes Drive Suite B Akron OH 44319 Physician office 73 - Summa Health Group 51 Park West Blvd Suite 200 Akron OH 44320 Physician office 74 - Summa Health Group 525 E Market St Suite 400 Akron OH 44304 Physician office 75 - Summa Health Group 525 E Market St Suite 3E Akron OH 44304 Physician office 76 - Summa Health Group 525 East Market StSuite 1-N Akron OH 44304 Physician office 77 - Summa Health Group 55 Arch St Suite 2A Akron OH 44304 Physician office 78 - Summa Health Group 55 Arch St Suite 3A Akron OH 44304 Physician office 79 - Summa Health Group 55 Arch St Suite 1A Akron OH 44304 Physician office 80 - Summa Health Group 55 Arch St Suite 1B Akron OH 44304 Physician office 81 - Summa Health Group 55 Arch Street Suite 2A Akron OH 44304 Physician office 82 - Summa Psychiatry Associates 5655 Hudson Drive Suite 305 Hudson OH 44236 Physician office 83 - Summa Health Group 5655 Hudson Dr Suite 315 Hudson OH 44236 Physician office 84 - Summa Health Group 60 North Ave Tallmadge OH 44278 Physician office 85 - Summa Health Group 621 School Dr Wadsworth OH 44281 Physician office 86 - Summa Health Group 75 Arch St Suite 103 Akron OH 44304 Physician office 87 - Summa Health Group 75 Arch St Suite 104 Akron OH 44304 Physician office 88 - Summa Health Group 75 Arch St Suite 201 Akron OH 44304 Physician office 89 - Summa Health Group 75 Arch St Suite 202 Akron OH 44304 Physician office 90 - Summa Health Group 75 Arch St Suite 301 Akron OH 44304 Physician office 91 - Summa Health Group 75 Arch St Suite 302 Akron OH 44304 Physician office 92 - Summa Health Group 75 Arch St Suite 302 Akron OH 44304 Physician office 93 - Summa Health Group 75 Arch St Suite 402 Akron OH 44304 Physician office 94 - Summa Health Group 75 Arch St Suite 406 Akron OH 44304 Physician office 95 - Summa Psychiatry Associates 75 Arch St Suite 410 Akron OH 44304 Physician office 96 - Summa Health Group 75 Arch St Suite 501 Akron OH 44304 Physician office 97 - Summa Health Group 75 Arch St Suite 506 Akron OH 44304 Physician office 98 - Summa Health Group 75 Arch St Suite 514 Akron OH 44304 Physician office 99 - Summa Health Group 75 Arch St Suite B1 Akron OH 44304 Physician office 100 - Summa Health Group 75 Arch St Suite B1 Akron OH 44304 Physician office 101 - Summa Health Group 75 Arch St Suite G2 Akron OH 44304 Physician office 102 - Summa Dental Center 75 Arch St Suite 303 Akron OH 44304 Full-service outpatient dental facility 103 - Summa Health Group 75 Arch StSuite 206 Akron OH 44304 Physician office 104 - Summa Health Group 75 Arch StSuite 407 Akron OH 44304 Physician office 105 - Summa Health Group 75 Arch Suite 201 Akron OH 44304 Physician office 106 - Summa Health Group 91 5th Street Barberton OH 44203 Physician office 107 - Summa Health Group 95 Arch St Suite 150 Akron OH 44304 Physician office 108 - Summa Health Group 95 Arch St Suite 165 Akron OH 44304 Physician office 109 - Summa Health Group 95 Arch St Suite 175 Akron OH 44304 Physician office 110 - Summa Health Group 95 Arch St Suite 215 Akron OH 44304 Physician office 111 - Summa Health Group 95 Arch StSuite 220 Akron OH 44304 Physician office 112 - Summa Health Group 95 Arch St Suite 240 Akron OH 44304 Physician office 113 - Summa Health Group 95 Arch St Suite 270 Akron OH 44304 Physician office 114 - Summa Health Group 95 Arch St Suite 280 Akron OH 44304 Physician office 115 - Summa Health Group 95 Arch StSuite 260 Akron OH 44304 Physician office 116 - Summa Psychiatry Associates 95 Arch StSuite 260 Akron OH 44304 Physician office 117 - Summa Health Group 95 Arch StSuite 300 Akron OH 44304 Physician office 118 - Summa Health Group 95 Arch StSuite 350 Akron OH 44304 Physician office 119 - Summa Health Group AES Building 388 South Main Suite 201 Akron OH 44311 Physician office 120 - LABCARE PLUS 165 FIFTH STREET SE STE A BARBERTON OH 44203 LAB 121 - LABCARE PLUS 201 FIFTH STREET NE SUITE 4 BARBERTON OH 44203 LAB 122 - LABCARE PLUS 3869 DARROW RD STE 208 STOW OH 44224 LAB 123 - LABCARE PLUS 600 PORTAGE TRAIL CUYAHOGA FALLS OH 44221 LAB 124 - LABCARE PLUS 754 S CLEVELAND AVE STE 100 MAGADORE OH 44260 LAB 125 - LABCARE PLUS 908 E WATERLOO RD AKRON OH 44603 LAB 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. dba Summa Health Medical Group is $23,192,389. 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 in the communities served. 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: AN ESTIMATED PROVISION FOR DOUBTFUL ACCOUNTS IS RECORDED THAT RESULTS IN NET PATIENT SERVICE REVENUE BEING REPORTED AT THE NET AMOUNT EXPECTED TO BE RECEIVED. SUMMA HAS DETERMINED, BASED ON AN ASSESSMENT AT THE CONSOLIDATED LEVEL, THAT PATIENT SERVICE REVENUE IS PRIMARILY RECORDED PRIOR TO ASSESSING THE PATIENT'S ABILITY TO PAY AND AS SUCH, THE ENTIRE PROVISION FOR DOUBTFUL ACCOUNTS RELATED TO PATIENT REVENUE IS RECORDED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. AT THE POINT IN TIME THAT A CHARGE IS BELIEVED TO BE UNCOLLECTIBLE, THE RELATED RECEIVABLE IS WRITTEN OFF AS A DOUBTFUL ACCOUNT.SUMMA MAINTAINS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EXPECTED COLLECTABILITY 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. PERIODICALLY THROUGH THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR THE UNCOLLECTIBLE RECEIVABLES. Part III, Line 4: Footnote in organization's financial statements describing bad debt expense:Summa Health's audited financial statements Notes to consolidated financial statements, 14. Patient Service Revenue, page 37. Part III, Line 8: Describe extent any shortfall from Line 7 is treated as community benefit and Costing methodology or source used to determine amount on line 6:Any Medicare shortfall incurred by Summa Health is not reported as a community benefit.Costing method used was total allowable cost less all costs deemed non-allowable by Medicare regulations. Medicare allowable cost are based on information provided on worksheet B, Part I, Column 26, Line 118 from the various hospitals' Medicare cost reports. 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'S HOSPITALS HAVE NOTICES POSTED IN THE EMERGENCY ROOMS, 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. EVERY PATIENT BILLING STATEMENT CONTAINS CONTACT INFORMATION AND INSTRUCTIONS TO LEARN ABOUT AND APPLY FOR FINANCIAL ASSISTANCE, AND INCLUDES AN APPLICATION FOR FINANCIAL ASSISTANCE. Part VI, Line 4: Community information:BASED ON 2018 PATIENT ADMISSION DATA, SUMMA HEALTH CARE DELIVERY IS PRIMARILY IN SUMMIT COUNTY. SUMMIT COUNTY REPRESENTS 75% OF THE 2018 ADMISSIONS FROM SUMMA HEALTH. WHILE SUMMA ALSO TREATS PATIENTS FROM MEDINA, NORTHERN STARK, AND WAYNE COUNTIES, MOST PATIENTS COME FROM SUMMIT COUNTY. THERE ARE 541,372 PEOPLE LIVING IN SUMMIT COUNTY. 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 20.4% PERCENT OF THE POPULATION IS NON WHITE, COMPARED TO 18.1% IN THE STATE. EDUCATIONAL ATTAINMENT IS SLIGHTLY HIGHER IN SUMMIT COUNTY THAN THE STATE OF OHIO, WITH 91% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 30.7% 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 14.3%. OF THE HOUSEHOLDS IN SUMMIT COUNTY 48.4% MAKE LESS THAN $50,000 ANNUALLY AND 13.1% OF HOUSEHOLDS MAKE LESS THAN $15,000 ANNUALLY RESPECTIVELY. FOR THE CALENDAR YEAR 2018, THE AVERAGE MONTHLY UNEMPLOYMENT RATE FOR SUMMIT COUNTY WAS 4.7% 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, EIN 34-1887844, IS THE PARENT ORGANIZATION OF SUMMA HEALTH SYSTEM. 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 2018, SUMMA HEALTH PROVIDED INPATIENT CARE THROUGH FACILITIES LOCATED ON THREE MAIN 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 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. THE BARBERTON CAMPUS IS A 251-BED HOSPITAL FACILITY THAT OFFERS INPATIENT SERVICES, OUTPATIENT SERVICES AND COMMUNITY OUTREACH PROGRAMS. THE BARBERTON CAMPUS IS LOCATED IN THE City OF BARBERTON IN SOUTHERN SUMMIT COUNTY. 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 71,000 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 1,500 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, 14,000 PRIMARY CARE PROVIDERS, 25,000 SPECIALISTS, COVERING MEMBERS ACROSS ALL 88 COUNTIES IN OHIO. SUMMA PHYSICIANS, INC. (D/B/A SUMMA HEALTH MEDICAL GROUP ("SHMG")) IS A MULTI-SPECIALTY PHYSICIAN PRACTICE EMPLOYING NEARLY 300 PHYSICIANS IN MULTIPLE SPECIALTIES. SHMG PROMOTES STRONGER AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIANS SERVICES ARE MET. Schedule H, Part VI, line 7 Facility Reporting Summa Health & Summa Rehab State filing of community benefit report:The State of Ohio does not require the filing of the community benefit report for 2018. However, Ohio requires all tax-exempt hospitals to submit to the Ohio Department of Health (ODH)existing community health needs assessments and plans. Additionally, hospitals are required to submit to ODH a copy of the hospital's schedule H (form 990), corresponding attachments and reporting on financial assistance and means-tested government programs and community building activities in parts I and II of Schedule H. 1 AMERICAN HEART ASSOCIATION 3505 EMBASSY PARKWAY STE 100 AKRON OH 44333 135613797 501(C)(3) 27500 Prevention, Wellness, Access to Care and Health Disparities, RESEARCH AND EDUCATION CITY OF AKRON 166 SOUTH HIGH STREET AKRON OH 44308 346000020 Governmental 10000 HEALTH EQUITY THE UNIVERSITY OF AKRON 302 BUCHTEL COMMON AKRON OH 44301 346002924 Governmental 6000 EDUCATIONAL SUSAN G KOMEN FOR THE CURE 26210 EMERY ROAD CLEVELAND OH 44128 751835298 501(C)(3) 20000 Prevention, Wellness, Access to Care and Health Disparities, CANCER WELLNESS SUPPORT AKRON COMMUNITY FOUNDATION 345 WEST CEDAR STREET AKRON OH 44307 341087615 501(C)(3) 8000 Prevention, Wellness and Health Disparities STEWARTS CARING PLACE 2955 WEST MARKET STREET AKRON OH 44333 200181338 501(C)(3) 10000 Prevention, Wellness, Access to Care and Health Disparities AMERICAN CANCER SOCIETY 525 NORTH BROAD STREET CANFIELD OH 44406 251798733 501(C)(3) 15000 PREVENTION, WELLNESS, ACCESS TO CARE, HEALTH DISPARITIES AND CANCER RESEARCH YMCA of Akron 50 SOUTH MAIN STREET STE LL 100 AKRON OH 44308 340714727 501(C)(3) 10000 Prevention, Wellness and Health Disparities AKRON URBAN LEAGUE 440 VERNON ODOM BOULEVARD AKRON OH 44307 340714520 501(C)(3) 11500 Prevention, Wellness, Access to Care and Health Disparities HABITAT FOR HUMANITY 2301 ROMIG ROAD AKRON OH 44320 341518873 501(C)(3) 7500 Prevention, Wellness and Health Disparities STEPHEN A COMUNALE JR FAMILY CANCER FOUNDATION C/O 2900 NEWPARK DRIVE BARBERTON OH 44203 204345267 501(C)(3) 15000 Prevention, Wellness, Access to Care and Health Disparities 11 0 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 X X 1 1 1 1 0 0 0 0 0 1 0 T Clifford Deveny MD CEO SHS, Director SHS & SF 0 884308 0 425000 0 193271 0 7626 0 25317 0 1535522 0 0 Peter Bittenbender MD DIR. SHS & DIR. SHMG 665811 0 44018 0 1170 0 8250 0 8512 0 727761 0 0 0 Lynn Hamrich MD DIRECTOR SHS 261545 0 0 0 1286 0 8025 0 16311 0 287167 0 0 0 PHYLIS FERRARA PRESIDENT & CDO, SF 320320 0 0 0 80597 0 9625 0 11566 0 422108 0 0 0 Lydia Cook MD President Summa Health Medical Group 409069 0 0 0 100365 0 9625 0 8807 0 527866 0 0 0 BRIAN DERRICK SVP CFO, TR. SHS & SHMG, Asst. TR SF 0 37227 0 0 0 1376544 0 1052 0 21204 0 1436027 0 0 KEITH T COLEMAN SVP CFO, TR. SHS & SHMG, Asst. TR SF 0 221348 0 0 0 41377 0 0 0 9126 0 271851 0 0 ROBERT A GERBERRY SHS SEC./SR. VP G.Counsel, SF Secret 0 351965 0 0 0 83592 0 9625 0 21347 0 466529 0 0 THOMAS P O'NEILL VP, CFO SHS, Assistant Tresurer 0 374296 0 0 0 86343 0 7321 0 17065 0 485025 0 0 David Custodio MD President, SHS 402743 0 0 0 98446 0 9625 0 23053 0 533867 0 0 0 Michael Hughes MD President Summa Barberton 354089 0 0 0 87148 0 9625 0 16244 0 467106 0 0 0 Lori Rhine RN VP, CNO Akron & St. Thomas 241265 0 0 0 2879 0 8575 0 22037 0 274756 0 0 0 Tammy Scarborough President Ambulatory Care & Clinical 0 324269 0 0 0 76133 0 8094 0 9085 0 417581 0 0 MARK POZSGAY DO ClINICAL PHYSICIAN - SHMG 906111 0 320425 0 1200 0 4125 0 32759 0 1264620 0 0 0 JOHN G ZOGRAFAKIS MD clinICAL PHYSICIAN - SHMG 876158 0 206026 0 1350 0 8079 0 27026 0 1118639 0 0 0 ERIC A ESPINAL MD CliniCAL PHYSICIAN - SHMG 900304 0 101000 0 690 0 4125 0 30762 0 1036881 0 0 0 Derek Klaus MD CLINICAL PHYSICIAN - SHMG 593037 0 445879 0 1170 0 5425 0 28514 0 1074025 0 0 0 Anand Desai MD CLINICAL PHYSICIAN - SHMG 602078 0 362148 0 1170 0 4125 0 5858 0 975379 0 0 0 MARY WARD Former SR VP CNO SHS 0 27298 0 0 0 379036 0 0 0 0 0 406334 0 0 Part I, Line 1a Travel for companions: Spousal travel was paid on behalf of one director. The amount is recognized as additional taxable compensation. Tax indemnification and gross-up payments: Summa Health System grossed up taxes for supplemental executive retirement programs paid to seven officers, and two key employees. The amount of the gross up is recognized as additional taxable compensation. Housing allowance: A housing allowance was paid on behalf of one officer. The amount 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 1, Line 4A Severance or Change-of-control payment: In 2018, the following listed persons received severance payments and benefits from the organization or from a related organization: Brian K. Derrick $1,124,947, Mary Ward $378,828. Severance amounts are treated as taxable compensation. Part 1, Line 4b Supplemental non-qualfied retirement plan A Supplemental executive retirement plan is to provide key employees with addiitional compensation to supplement their retirement benefits and mitigate effects of qualified retirment plan limits. The following listed persons received benefits from the organization or from a related organization: T. Clifford Deveny, MD $161,084, Phylis Ferrara $75,235, Lydia Cook, MD $95,778, Brian Derrick $249,160, Keith T. Coleman $37,836, Robert A. Gerberry $81,793, Thomas P. O'Neill $80,133, David Custodio, MD $93,881, Michael Hughes, MD $81,271, Tammy Scarborough $74,447. 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. A Ohio Higher Educational Facility Commission 346849674 67756AY89 2010-05-11 180125341 See Part VI 1 0 0 B Akron Bath and Copley Jt Twp Hosp Dist 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 009730NX6 2016-12-16 204934207 see Part VI 0 0 0 A 24495000 180162106 17210123 3004911 4929857 154030731 2012 1 0 1 1 B 16503574 32509635 32509635 2012 1 0 1 1 C 53405000 145250000 795890 144454110 2008 1 0 1 1 D 4680000 205384474 1874244 26625195 201939 100525342 76157754 2019 1 1 0 1 A 0 1 1 1 1 1 0.00300 0.00100 0.00400 0 0 1 C 0 1 1 1 1 1 0.03500 0.00500 0.04000 0 0 1 D 0 1 1 1 1 1 0.00600 0.00600 0 1 0.05800 1 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 1 0 0 0 0 1 See Schedule K VI 1.000000000000 1 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 Akron, Bath and Copley Joint Township Hospital District Series 2017 Bonds: An additional Schedule K is included to provide for the issuance of the Series 2017 Bonds and the Series 2018 Bonds. 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 Series 2012 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 principal amount of $50,000,000, and (2) pay issuance costs. Schedule K, Part I, Line C, Column (a) Akron, Bath and Copley Joint Township Hospital District Series 2014 Bonds: The 2014 Bonds consisted of the following three series of Bonds, which were 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 (the "Series 2014A Bonds"), (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 (the "Series 2014B Bonds"), 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 "Development Finance Authority Bonds"). 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 C, Column (f) Series 2014A Bonds, Series 2014B Bonds, 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, (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) pay issuance costs. Schedule K, Part I, Line D, Column (f) Akron, Bath and Copley Joint Township Hospital District Series 2016 Bonds: The purpose of the Series 2016 Bonds was to (1) acquire, construct, improve, and equip certain hospital facilities, (2) currently refund all of the outstanding Series 2014B Bonds, (3) currently refund all of the outstanding Akron, Bath and Copley Joint Township Hospital District, Ohio Hospital Facilities Revenue Bonds, Series 2015 (Summa Health Obligated Group) issued in the original principal amount of $42,255,000, which were issued to acquire, construct, improve, and equip certain hospital facilities and pay issuance costs, and (4) advance refund $24,495,000 of the outstanding principal amount of the Series 2010 Bonds. Schedule K, Part II, Column A, 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, Column (e) is due to investment proceeds of the issue. Schedule K, Part II, Column A, Line 4 Total Proceeds of Issue - Column A: A portion of the reserve fund of this issue was deposited into an escrow fund in connection with the advance refunding of a portion of this issue with the Series 2016 Bonds. Schedule K, Part II, Column D, Line 3 Total Proceeds of Issue - Column D: The difference between the total proceeds of the issue and the issue price provided in Part I, Line 4, Column (e) is due to investment proceeds of the issue. This amount is smaller than the amount reported in the 2017 Schedule K because certain disposition proceeds included as proceeds of the Series 2016 Bonds were part of a remedial action under Treasury Regulations Section 1.141-12. Those disposition proceeds are included in the additional Schedule K as the Series 2018 Bonds. Schedule K, Part II, Column D, Line 7 Issuance Costs from Proceeds - Column D: The issuance costs of the issue provided in Part II, Line 7, Column D is less than the issuance costs provided in the Form 8038 for this issue because of the transfer of unexpended money in the expense fund to the project fund for this issue. Schedule K, Part III, Column D, Line 8a Sale of Bond-Financed Property: Summa elected to use the alternative use of disposition proceeds under Regulations Section 1.141-12. An IRS Form 8038 was filed in connection with that remedial action and, accordingly, Summa has reported that remedial action as a reissued bond for purposes of Schedule K. Schedule K, Part IV, Column C, Line 4b Name of Hedge Provider: Series 2014A Bonds: Goldman Sachs Bank USA. Development Finance Authority Series 2014 Bonds: PNC Bank, National Association. Schedule K, Part IV, Column C, Line 4c Term of Hedge: 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. Schedule K, Part IV, Column A, Line 2c Rebate Calculation: The calculation for computing no rebate due was performed on 05/11/2013. SCHEDULE K, PART IV, COLUMN A, LINE 5B Name of GIC Provider: Morgan Stanley & Company Incorporated Schedule K, Part I, Line A, Column (a) Akron, Bath and Copley Joint Township Hospital District Series 2017A Bond, Series 2017B Bonds, and Series 2017C Bonds: The 2017 Bonds consisted of the following three series of Bonds, which were treated as a single issue of bonds for federal income tax purposes: (1) Akron, Bath and Copley Joint Township Hospital District, Ohio Hospital Facilities Improvement Revenue Bonds, Series 2017A (Summa Health Obligated Group) issued in the original principal amount of $15,000,000, (2) Akron, Bath and Copley Joint Township Hospital District, Ohio Hospital Facilities Improvement Revenue Bonds, Series 2017B (Summa Health Obligated Group) issued in the original principal amount of $75,000,000, and (3) Akron, Bath and Copley Joint Township Hospital District, Ohio Hospital Facilities Improvement Revenue Bonds, Series 2017C (Summa Health Obligated Group) issued in the original principal amount of $50,000,000. Schedule K, Part I, Line B Akron, Bath and Copley Joint Township Hospital District Series 2018 Bonds: The Series 2018 Bonds were an alternative disposition of sale proceeds of a portion of property that was financed with the proceeds of the Series 2016 Bonds. The alternative disposition of bond proceeds was a remedial action done in accordance with Regulations Section 1.141-12. Schedule K, Part II, Column A, Line 3 Akron, Bath and Copley Joint Township Hospital District Series 2018 Bonds: 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, Column (e) is due to investment proceeds of the issue. A Akron Bath and Copley Jt Twp Hosp Dist 341448680 2017-12-22 140000000 see Part VI 0 0 0 B Akron Bath and Copley Jt Twp Hosp Dist 341448680 2018-05-15 16252805 see Part VI 0 0 0 A 142450805 545000 80796809 61653807 2019 0 0 0 1 B 16252805 16252805 2019 0 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 1 Natixis Funding Corp 1.100000000000 1 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Form 990, Part V, Line 2a and 2b The parent organization, Summa Health, EIN 34-1887844, is the employer of record for employees working for Group Return entites. 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") - 16 - 13 Summa Foundation ("SF") - 20 - 18 Summa Physicians, Inc. dba Summa Health Medical Group ("SHMG") - 3 - 2 Totals for Group return - 39 - 33 All of the organizations listed above are subordinates under the control of Summa Health ("SH"). As of December 31, 2018, SH had 16 voting directors, 13 of whom were independent voting directors. Form 990, Part VI, Section A, line 2 Family/Business relationships amongst interested persons: Summa Health System: The following individuals have a business relationship as board members of an entity in which Summa Health System has an ownership interest: Aris Teleradiology Holdings, Inc.: Thomas O'Neill, Tammy Scarborough Select Specialty Hospital, LLC: Thomas O'Neill, Mark Terpylak, DO, Lori Rhine, RN Summa Rehab Hospital: Thomas O'Neill, Mark Terpylak, DO, Tammy Scarborough, David Custodio, MD The following individuals have a business relationship as board members of a Summa Health owned entity: Middlebury Assurance Company: T. Clifford Deveny, MD, James McIlvaine, Robert Gerberry, Thomas O'Neill Summa ACO dba NewHealth Collaborative: T. Clifford Deveny, MD, Keith Coleman, Robert Gerberry, Lydia Cook, MD, Michael Hughes, MD Summa Health System Corp: T. Clifford Deveny, MD, Keith Coleman, Robert Gerberry The following individuals have a business relationship as board members of a Summa Health System Corp., a Summa Health owned entity: Ohio Health Choice: Robert Gerberry, Thomas O'Neill, Mark Terpylak, DO Summa Management Services Org.: Keith Coleman, Robert Gerberry SummaCare and Summa Insurance Company: T. Clifford Deveny, MD, Anthony Lockhart, Jeffrey Copeland, Robert Gerberry, Thomas O'Neill, Lydia Cook, MD Michael M. Hughes, M.D., and Thomas P. O'Neill business relationship Thomas P. O'Neill, Lorie Rhine business relationship Summa Foundation: T. Clifford Deveny, M.D., Paul Testa business relationship 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 Physicians, Inc. dba Summa Health Medical Group: 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 provides 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 and the President of Summa Foundation serve as directors of Summa Foundation. Summa Physicians, Inc. dba Summa Health Medical Group: 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 Health is the sole member of of Summa Health System. As the sole member, Summa Health has the power and authority to approve or disapprove of each of the following on behalf of Summa Health System: (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)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 Physicians, Inc. dba Summa Health Medical Group N/A Form 990, Part VI, Section B, line 11b 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 tax advisor. The review committee included the Senior Vice President, Finance & CFO and the Senior Vice President, Legal Services & General Counsel. This detailed review occurred October 4, 2019. 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 2019 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. 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, 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 nine years, the Compensation Committee has used Kron Ferry, fka Hay Group, a nationally recognized consulting firm, to assist their efforts. The Korn Ferry 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. The Compensation Committee contemporaneously documents its deliberations and decisions regarding compensation arrangements for each position listed below. 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, Strategy & Performance Management Senior Vice President, IT&S & CIO Senior Vice President, Human Resources President, SummaCare Senior Vice President, Population Health, President, ACO/NHC Summa Health System: President, Akron & St. Thomas President, Summa Barberton President, Ambulatory Care and Clinical Service Lines Vice President & CFO Summa Health System Summa Foundation: President Summa Physicians, Inc. dba Summa Health Medical Group: 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 X, Balance sheet Beginning of year balances for Part X, line 2 Savings and temporary cash investments and Line 15 Other assets have been restated to report net receivables from affiliates consistent with the current year's presentation. The result of the classification change had no impact on Unrestricted Net Assets. Form 990, Part XI, line 9: Pension Liability Adjustment -4995000. Post Retirement Benefit Adjustment -190000. Net assets released from restriction 248000. Net asset contribution to(from) affiliated organization 455000. Change in Permanently restricted net assets -39286. Other Changes in Net Assets - adjustments -2200. St Thomas Medical Center Women's Board 444 North Main Street Akron OH 44310 346576575 Support Organization OH 501(c)(3) Line 12a, 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 12b, II N/A 1 Summa Rehab Hospital LLC 29 North Adams Street Akron OH 44304 271952573 Rehab Hospital OH summa Health System Related 14722760 2505360 0 0 0.52000 SUMMA HHAH HOLDINGS LLC C/O 1077 GORGE BLVD Akron OH 44310 823600079 HOME HEALTH AND HOSPICE OH Summa Health System RELATED 18076800 5575800 0 0 0.60000 Ohio Health Choice Inc 1077 Gorge Blvd Akron OH 443092090 341895396 PPO OH Summa Health System Corp C 0 Summa Insurance Company Inc 10 North Main Street Akron OH 44308 341809108 Prop/Cas Ins OH SUMMACARE INC C 0 Summa Health System Corp 1077 Gorge Blvd Akron OH 443092090 341515252 Mgmt Svcs OH Summa Health C 0 Wadsworth Rittman Hos Prof Svc Corp 195 Wadsworth Rd Wadsworth OH 44281 010842997 Prof Med Svcs OH Summa Health System Corp C 0 Middlebury Assurance Company PO Box 1051 KY1-1102 Grand Cayman CJ 980405096 Self Insurance CJ Summa Health C 0 Summacare Inc 10 North Main Street Akron OH 44308 341726655 Prop/Cas Ins OH SUMMA HEALTH SYSTEM CORP C 0 Aris Teleradiology Holdings Inc 5655 Hudson Drive Suite 210 Hudson OH 44236 453697866 Radiology Svc OH Summa Health System C 31158502 17913966 0.58800 1 Summa Accountable Care Organization 1077 Gorge Blvd Akron OH 443092090 273857055 Contracting OH Summa Health C 0 Health Care Centers Physicians Inc 1900 23rd Street Cuyahoga Falls OH 44223 341692767 Inactive OH Summa Health System Corp C 0 Summa Management Services Organization 10 North Main Street Akron OH 44308 461145832 Mgmt Svcs OH Summa Health System Corp C 0 Summa Integrated Services Organization 10 North Main Street Akron OH 44308 461159251 Mgmt Svcs OH Summa Health System Corp C 0 1 0 1 0 0 0 0 0 0 1 1 1 1 0 1 1 1 1 1 Summa Rehab Hospital LLC A 2524310 FMV SUMMACARE INC L 57861116 FMV SUMMACARE INC L 8696134 FMV SUMMA INSURANCE COMPANY INC L 22496405 FMV SUMMA INSURANCE COMPANY INC L 1925327 FMV SUMMACARE INC L 525000 FMV Summa Rehab Hospital LLC L 671020 FMV SUMMACARE INC M 1770231 FMV Middlebury Assurance Company M 6772077 FMV Middlebury Assurance Company M 3001888 FMV Summa Integrated Services Organization M 1769912 FMV