2017-11-14T08:03:48-06:00 2016-12-31 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2016-01-01 341887844 SUMMA HEALTH SUMM 2343125867 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 BRIAN K DERRICK SR VP, CFO, TREAS 2343125867 2017-11-14 1 ZACK FORTSCH P00052725 3126343400 108.171.131.188 2017-11-14 08:03:40 CS P 98AC9AA3F4CBE4CB3038CB857DBC84AADB231605 37AB53F3E1FE5B259FEACB8EAA64376B229EE5AE 2016 2017-02-10 21:41:12Z T CLIFFORD DEVENY MD 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 542887996 0 X WWW.SUMMAHEALTH.ORG X 1999 OH THE MISSION OF SUMMA HEALTH IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO OUR PATIENTS AND TO CONTRIBUTE TO A HEALTHIER COMMUNITY. 13 8 889 14 219221 -138116 0 6382961 127794485 145783419 7287481 9128908 555993 253364 135637959 161548652 437500 419465 0 0 57928031 65912493 0 0 0 73624727 81489372 131990258 147821330 3647701 13727322 788256582 1033172698 360286906 474746763 427969676 558425935 THE MISSION OF SUMMA HEALTH IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO PATIENTS AND MEMBERS AND CONTRIBUTE TO A HEALTHIER COMMUNITY. 0 0 113636943 418465 143347810 SUMMA HEALTH DIRECTS AND SUPPORTS THE PROGRAMS AND ACTIVITIES OF THE CONSOLIDATED SUMMA HEALTH ENTITIES SO THAT ALL SUMMA HEALTH RESOURCES AND ASSETS ARE BEST ALLOCATED AND UTILIZED FOR THE BENEFIT OF THE COMMUNITY. SUMMA HEALTH REPRESENTS THE COLLABORATIVE EFFORTS OF HEALTH CARE PROVIDERS TO BETTER ADMINISTER, MANAGE, PROVIDE AND PLAN FOR THE DELIVERY OF A FULL-RANGE OF HEALTH CARE SERVICES TO ALL PERSONS WITHIN THE COMMUNITIES SERVED BY SUMMA HEALTH WITHOUT REGARD TO THE RACE, SEX, CREED, COLOR, NATIONAL ORIGIN OR ECONOMIC STATUS OF SUCH PERSONS. SEE SUMMA HEALTH GROUP RETURN (EIN 90-0640432) FOR FURTHER DETAILS. 2764422 1000 2216388 SUMMA HEALTH NETWORK, LLC, A DISREGARDED ENTITY OF SUMMA HEALTH, PARTNERS WITH COMMUNITY PHYSICIANS, REGIONAL AND NATIONAL PAYERS TO IMPROVE THE CLINICAL QUALITY AND EFFICIENCY OF CARE, LOWER THE COST OF CARE TO PATIENTS AND EMPLOYERS AND ASSIST PHYSICIANS WITH TECHNOLOGY AND RESOURCES NECESSARY TO ACHIEVE THESE GOALS. 116401365 1 1 0 1 0 0 0 0 0 1 1 0 1 1 0 1 0 1 0 0 1 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 1 740 0 1 889 1 1 1 1 CJ 0 0 0 1 1 0 0 0 0 X 13 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X X BRIAN K DERRICK 2343125871 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 NICHOLAS BROWNING DIRECTOR 2.00 2.00 X 0 0 0 JAMES MCILVAINE CHAIRMAN 2.00 4.00 X X 0 0 0 THOMAS MALONE MD PRESIDENT & CEO 46.00 4.00 X X 1538920 0 22254 DARYL CAMERON DIRECTOR 2.00 2.00 X 0 0 0 STEPHEN COMUNALE DIRECTOR (AS OF 08/2016) 2.00 2.00 X 0 0 0 LYNN HAMRICH MD DIRECTOR 2.00 2.00 X 0 0 0 MICHAEL HUGHES MD DIRECTOR (END 4/2016) 2.00 48.00 X 626882 0 23986 DONALD KLINE DIRECTOR (END 3/2016) 2.00 2.00 X 0 0 0 JAMES KRAVEC MD DIRECTOR 2.00 2.00 X 0 0 0 ANTHONY LOCKHART DIRECTOR 2.00 2.00 X 0 0 0 RICHARD MARSH DIRECTOR (END 3/2016) 2.00 2.00 X 0 0 0 ROBERT SHRODER DIRECTOR (AS OF 04/2016) 2.00 2.00 X 0 0 0 BRIAN SMITH DIRECTOR 2.00 2.00 X 0 0 0 SCOTT WILBER MD DIRECTOR (AS OF 04/2016) 2.00 2.00 X 0 0 0 LEILA VESPOLI DIRECTOR 2.00 2.00 X 0 0 0 VIVIAN VON GRUENIGEN MD DIRECTOR 48.00 2.00 X 503848 0 18487 NORMAN WELLS JR DIRECTOR (END 7/2016) 2.00 2.00 X 0 0 0 BRIAN DERRICK TREASURER, SR VP, CFO 46.00 4.00 X 1061568 0 30014 ROBERT A GERBERRY SECRETARY/GENERAL COUNSEL 46.00 4.00 X 573423 0 7922 VALERIE GIBSON RN COO 4.00 46.00 X 834373 0 35561 KATHLEEN JOBE VP, CNO (END 9/2016) 4.00 46.00 X 0 212115 17269 GREG KALL SR. VP, CIO 50.00 X 537840 0 23060 LORRAINE WASHINGTON SR. VP HUMAN RESOURCES 50.00 X 362428 0 19391 THOMAS P O'NEILL VP, CFO SHS 4.00 46.00 X 530469 0 18584 ERIK STEELE DO CMO, SUMMA HOSPITALS (END 6/2016) 4.00 46.00 X 740597 0 19010 BENJAMIN P SUTTON SR. VP STRATEGY & PERFORMANCE 50.00 X 439669 0 32168 MARK TERPYLAK DO PRESIDENT, SUMMA ACO 4.00 46.00 X 0 650975 29552 MARY WARD SR. VP, CNO 4.00 46.00 X 638815 0 9860 ROB WHITEHOUSE SR. VP MARKETING & COMMUNICATION 50.00 X 366846 0 33485 TAMMY SCARBOROUGH VP AMBULATORY/COO SHMG 4.00 46.00 X 336914 0 15716 JASON NIEHAUS SVP HOSP. OPS(END 7/2016) 4.00 46.00 X 418172 0 18980 DAVID P JOHNSON VP REVENUE CYCLE 4.00 46.00 X 323986 0 18486 CYNTHIA S KELLEY DO VP MEDICAL EDUCATION 4.00 46.00 X 282415 0 18883 JEFFREY R PRICE VP PAYER STRATEGY 4.00 46.00 X 267963 0 30923 10385128 863090 443591 74 0 1 0 MERCY HEALTH 4600 MCAULEY PL CINCINNATI OH 45242 IT & EMR SERVICES 12955682 PROFESSIONAL ANESTHESIA SERVICE 190 NORTH UNION STREET AKRON OH 44304 MEDICAL SERVICES 7870000 ALLSCRIPTS MISYS LLC 8529 SIX FORKS RD RALEIGH NC 27615 IT & EMR SERVICES 5367708 HEALTHSPAN LLC 225 PICTORIA DRIVE SUITE 320 CINCINNATI OH 45246 PROFESSIONAL SERVICES 3889777 UNITY HEALTH NETWORK LLC 3033 STATE ROAD SUITE 101 CUYAHOGA FALLS OH 44223 MEDICAL SERVICES 3602310 141 416219 35022 5931720 391347 6382961 CORPORATE ALLOCATION FEES 900099 135103056 135103056 PROGRAM RELATED INVESTMENTS 900099 5578926 5570189 8737 RENTAL INCOME FROM AFFILIATES 900099 2261610 2051126 210484 HEALTHCARE REVENUE 524298 2216388 2216388 RESEARCH 541700 605950 605950 17489 17489 145783419 10976954 10976954 379230080 381078126 -1848046 -1848046 -1848046 58516 416219 261218 -202702 -202702 PURCHASE DISCOUNTS/FEES EARNED 900099 361989 361989 94077 94077 456066 161548652 145564198 219221 9382272 X 400385 400385 19080 19080 9049460 4700290 4349170 46693198 39222286 7470912 944810 793640 151170 5949380 4997479 951901 3275645 2751542 524103 130712 109798 20914 5587611 5587611 267841 267841 143134 143134 3500 3500 21747982 18268304 3479678 5052828 4244375 808453 6832305 5739136 1093169 26697234 22425677 4271557 933556 784187 149369 599379 503478 95901 335334 281681 53653 496945 417434 79511 11447161 9615615 1831546 DUES & LICENSES 561777 561777 RECRUITMENT 124135 104273 19862 MEDICAL SUPPLIES 81988 68870 13118 TAX EXPENSE -20786 -20786 466736 392058 74678 147821330 116401365 31419965 0 85920722 73872914 10340871 2960318 453072 250086 484630 2408786 2182851 3883545 4500961 81516535 26054085 49376069 55462450 517165254 706332698 54179218 54231356 72112584 125310895 788256582 1033172698 345272849 462135394 1959204 1709204 494271 490271 12560582 10411894 360286906 474746763 X 427969676 514391099 23596900 20437936 427969676 558425935 788256582 1033172698 X 13727322 23382989 93345948 X X 0 1 X 1 1 1 X X 2 SUMMA HEALTH SYSTEM 340714755 3 0 0 0 SUMMA FOUNDATION 341219001 7 1 0 0 2 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION A, LINE 1: SUMMA FOUNDATION IS DESIGNATED AS SUPPORTED ORGANIZATIONS BY NAME. THE ARTICLES OF INCORPORATION DESIGNATES THE OTHER SUPPORTED ORGANIZATIONS, BY CLASS AND PURPOSE, TO INCLUDE ANY OTHER HOSPITAL, HEALTH CARE PROVIDER OR OTHER ENTITY THAT QUALIFIES AS A PUBLICLY SUPPORTED ORGANIZATION WITHIN THE MEANING OF SECTIONS 509(A)(1) OR 509(A)(2) OF THE INTERNAL REVENUE CODE, THAT IS AFFILIATED WITH THE INTEGRATED HEALTH CARE DELIVERY SYSTEM OPERATED AND MANAGED BY SUMMA HEALTH, AND THAT IS RELATED TO SUMMA HEALTH IN A MANNER DESCRIBED IN SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE. PART IV, SECTION A, LINE 5A: SUMMA BARBERTON CITIZENS HOSPITAL, EIN 26-1375072, WAS REMOVED BECAUSE THE ORGANIZATION MERGED OUT OF EXISTENCE WITH THE SURVIVING ENTITY BEING SUMMA HEALTH SYSTEM, EIN 34-0714755, WHICH CONTINUES TO BE LISTED AS A SUPPORTED ORGANIZATION. THE MERGER WAS CONDUCTED UNDER THE AUTHORITY OF THE OHIO REVISED CODE. PART IV, SECTION A, LINE 6: IN 2016 SUMMA HEALTH PROVIDED SUPPORT TO THE AKRON REGIONAL FOOD BANK, THE AKRON URBAN LEAGUE AND THE AKRON AREA YMCA FOR MISSION SUPPORT. PART IV, SECTION C, LINE 1: THE MANAGEMENT OF THE SUPPORTING AND THE SUPPORTED ORGANIZATIONS RESIDES IN THE SAME MANAGEMENT GROUP. THOMAS MALONE, M.D. IS SYSTEM PRESIDENT AND CEO AND AN OFFICER AND DIRECTOR FOR BOTH ORGANIZATIONS, BRIAN DERRICK IS SYSTEM CFO AND AN OFFICER FOR BOTH ORGANIZATIONS, AND ROBERT GERBERRY SERVED AS SECRETARY AND GENERAL COUNSEL AND AN OFFICER FOR BOTH ORGANIZATIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 268 0 0 1 25910 1 116956 0 0 143134 0 PART II-B, LINE 1: IN 2016, SUMMA HEALTH BOARD MEMBERS, MANAGEMENT, PHYSICIANS AND STAFF INTERACTED WITH ELECTED OFFICIALS TO ADVOCATE FOR A CHANGE IN POLICY RELATED TO THE FEDERAL MEDICARE ADVANTAGE STAR RATINGS, THE HOSPITAL COMPARE STAR RATINGS PROGRAMS, TO INFORM STATE OFFICIALS OF THE CHALLENGES ASSOCIATED WITH IMPLEMENTING A PRICE TRANSPARENCY LAW PASSED IN THE STATE OF OHIO, TO COMBAT THE TWIN SCOURGES OF OPIOID ADDICTION AND INFANT MORTALITY, TO ENCOURAGE THE STATE OF OHIO TO CONSIDER ALLOWING ACCOUNTABLE CARE ORGANIZATIONS TO CONTRACT DIRECTLY WITH MEDICAID, TO INFLUENCE THE ROLLOUT OF THE MEDICARE CPC+ AND STATE CPC OHIO PAYMENT REDESIGN PROGRAMS, AND TO ADVOCATE FOR THE INCLUSION OF CAPITAL REQUESTS IN THE STATE CAPITAL BUDGET. PUBLICATIONS AND MEDIA ADVERTISEMENTS INCLUDE THE COSTS OF MAINTAINING A WEBSITE FOR THE AKRON CANTON MEDICAID COALITION. THE AMOUNT ON LINE 1(F) REPRESENTS THE PORTION OF ANNUAL DUES TO ORGANIZATIONS SUCH AS AHA AND OHA ALLOCABLE TO LOBBYING ACTIVITIES. 19720810 66105 651021 20437936 19966435 313575 -559200 19720810 17564266 1927171 474998 19966435 16730853 70706 762707 17564266 15896469 347618 486766 16730853 1.00000 0 0 1157140 1157140 12672981 2062559 10610422 19978 19978 54892011 23974233 30917778 12774425 17293 12757132 55462450 OHIO HEALTH CHOICE, INC 4432361 F MIDDLEBURY ASSURANCE COMPANY 15466593 F SUMMACARE, INC. 1000000 C SUMMA INSURANCE COMPANY 25226327 C SUMMA INTEGRATED SERVICES ORG 8086075 F OPA, LLC 20000 F 54231356 RECEIVABLES FROM AFFILIATES 123351691 UNIVERSITY OF AKRON PLEDGE 1959204 125310895 X PART V, LINE 4: ENDOWMENT FUNDS PROVIDE INCOME TO BE USED TO FULFILL THE TAX-EXEMPT PURPOSES OF SUMMA FOUNDATION. PART X, LINE 2: SUMMA HEALTH AND MOST OF ITS SUBSIDIARIES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. SUMMA ALSO HAS CERTAIN SUBSIDIARIES THAT ARE TAXABLE FOR FEDERAL INCOME TAX PURPOSES. SUMMA CARE ("SC"), TOGETHER WITH AFFILIATES OF SUMMA HEALTH SYSTEM CORPORATION ("SHSC"), FILES A CONSOLIDATED FEDERAL INCOME TAX RETURN IN ACCORDANCE WITH A TAX SHARING AGREEMENT DATED JANUARY 1, 2010. THE ENTITIES UTILIZE A CONSOLIDATED APPROACH TO THE ALLOCATION OF FEDERAL INCOME TAXES, WHEREAS SHSC'S TAX SHARING AGREEMENT WITH ITS SUBSIDIARIES ALLOWS IT TO MAKE CERTAIN CODE ELECTIONS IN ITS CONSOLIDATED FEDERAL TAX RETURN. IN THE EVENT SUCH CODE ELECTIONS ARE MADE, ANY BENEFIT OR LIABILITY IS THE RESPONSIBILITY OF SHSC AND IS ACCRUED AND PAID BY THE PARTICIPATING SUBSIDIARIES. SC IS NOT SUBJECT TO STATE INCOME TAXES AND IT IS LICENSED AS A HEALTH INSURANCE COMPANY UNDER CHAPTER 1751 OF THE OHIO REVISED CODE. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THE RESPECTIVE TAX BASIS AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT OF DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN INCOME IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. SUMMA RECOGNIZES INTEREST INCOME, INTEREST EXPENSE, AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS WITH THE PROVISION FOR INCOME TAX. CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES WHOLLY-OWNED FOREIGN INSURANCE COMPANY FOR SELF INSURANCE 56667998 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 235527 0 0 0 0 0 0 56903525 0 56903525 1 0 1 0 1 0 PART I, LINE 3: METHOD TO ACCOUNT FOR EXPENDITURES ON ORGANIZATION'S FINANCIAL STATEMENTS: CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL SCHEDULE F, PART I, LINE 3(F) PROGRAM SERVICE ACTIVITY: $55,900,359 INVESTMENTS 767,639 EXPENSES $56,667,998 TOTAL GALA 469735 411219 58516 720 8616 155504 66159 27219 469735 411219 58516 720 8616 155504 66159 27219 258218 -199702 1 YMCA OF AKRON 50 SOUTH MAIN STREET STE LL 100 AKRON OH 44308 340714727 501(C)(3) 120000 MISSION SUPPORT UNIVERSITY OF AKRON 302 BUCHTEL COMMON AKRON OH 44301 346002924 GOVERNMENTAL 250000 EDUCATIONAL 1 0 SUMMASHARES 15 5703 MAMMOGRAM SCREENS 24 13377 PART I, LINE 2: THE PROCEDURE FOR MONITORING GRANT FUNDS IS BASED ON THE CRITERIA ESTABLISHED PRIOR TO AWARDING THE GRANT OR ASSISTANCE. ONCE THE CRITERIA IS MET, A PAYMENT WILL BE MADE TO THE UNIVERSITY OR AGENCY UTILIZING THE FUNDS. X 1 1 X X X X 0 0 0 0 0 0 0 1 0 THOMAS MALONE MD PRESIDENT & CEO 860236 0 452933 0 225751 0 5300 0 16954 0 1561174 0 0 0 MICHAEL HUGHES MD DIRECTOR (END 4/2016) 538961 0 45845 0 42076 0 7950 0 16036 0 650868 0 0 0 VIVIAN VON GRUENIGEN MD DIRECTOR 447083 0 699 0 56066 0 3130 0 15357 0 522335 0 0 0 BRIAN DERRICK TREASURER, SR VP, CFO 550023 0 364461 0 147084 0 6836 0 23178 0 1091582 0 0 0 ROBERT A GERBERRY SECRETARY/GENERAL COUNSEL 336156 0 145236 0 92031 0 4846 0 3076 0 581345 0 0 0 VALERIE GIBSON RN COO 505440 0 186400 0 142533 0 7950 0 27611 0 869934 0 0 0 KATHLEEN JOBE VP, CNO (END 9/2016) 0 164862 0 39438 0 7815 0 7225 0 10044 0 229384 0 0 GREG KALL SR. VP, CIO 316101 0 131903 0 89836 0 4859 0 18201 0 560900 0 0 0 LORRAINE WASHINGTON SR. VP HUMAN RESOURCES 287535 0 0 0 74893 0 3532 0 15859 0 381819 0 0 0 THOMAS P O'NEILL VP, CFO SHS 327112 0 109370 0 93987 0 9275 0 9309 0 549053 0 0 0 ERIK STEELE DO CMO, SUMMA HOSPITALS (END 6/2016) 332291 0 341133 0 67173 0 7950 0 11060 0 759607 0 0 0 BENJAMIN P SUTTON SR. VP STRATEGY & PERFORMANCE 259222 0 104372 0 76075 0 9275 0 22893 0 471837 0 0 0 MARK TERPYLAK DO PRESIDENT, SUMMA ACO 0 380971 0 161223 0 108781 0 9275 0 20277 0 680527 0 0 MARY WARD SR. VP, CNO 374220 0 155952 0 108643 0 7950 0 1910 0 648675 0 0 0 ROB WHITEHOUSE SR. VP MARKETING & COMMUNICATION 302333 0 0 0 64513 0 5365 0 28120 0 400331 0 0 0 TAMMY SCARBOROUGH VP AMBULATORY/COO SHMG 267179 0 63274 0 6461 0 6813 0 8903 0 352630 0 0 0 JASON NIEHAUS SVP HOSP. OPS(END 7/2016) 228968 0 143379 0 45825 0 6563 0 12417 0 437152 0 0 0 DAVID P JOHNSON VP REVENUE CYCLE 247369 0 67450 0 9167 0 9275 0 9211 0 342472 0 0 0 CYNTHIA S KELLEY DO VP MEDICAL EDUCATION 276202 0 0 0 6213 0 1084 0 17799 0 301298 0 0 0 JEFFREY R PRICE VP PAYER STRATEGY 219026 0 42255 0 6682 0 8142 0 22781 0 298886 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: SUMMA HEALTH GROSSED UP TAXES FOR SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS PAID TO TWO DIRECTORS, THREE OFFICERS, NINE KEY EMPLOYEES, ONE HIGHEST COMPENSATED EMPLOYEES. THE AMOUNT OF THE GROSS UP IS RECOGNIZED AS ADDITIONAL TAXABLE COMPENSATION. PART I, LINE 7 THE SUMMA HEALTH MANAGEMENT INCENTIVE PROGRAM IS DESIGNED TO REWARD EMPLOYEES FOR MEETING QUALITY, PERFORMANCE AND FINANCIAL TARGETS. THESE TARGETS INCLUDE CLINICAL QUALITY, PATIENT SATISFACTION, EMPLOYEE/PHYSICIAN SATISFACTION, OPERATING MARGIN AND THE STRENGTHENING OF THE BALANCE SHEET. PAYMENT IS BASED ON A FACTOR OF BASE COMPENSATION AND IS SUBJECT TO REVIEW AND APPROVAL BY SUMMA'S COMPENSATION COMMITTEE. THE GOTHAM GROUP LLC STEPHEN COMUNALE, DIRECTOR, REPORTABLE OWNERSHIP INTEREST IN ENTITY 249649 INDEPENDENT CONTRACTOR 0 X 1 150 REPLACEMENT COST X 7 390842 MARKET VALUE X GIFT CARDS 1 200 REPLACEMENT COST X EQUIPMENT 1 155 REPLACEMENT COST 0 1 0 PART I, COLUMN (B): EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS: ARTWORK: NUMBER OF CONTRIBUTIONS SECURITIES - PUBLICALLY TRADED: NUMBER OF CONTRIBUTIONS OTHER: NUMBER OF CONTRIBUTIONS FORM 990, PART VI, SECTION A, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS: RICHARD MARSH, LEILA VESPOLI, AND ANTHONY LOCKHART - BUSINESS RELATIONSHIP. THOMAS P. O'NEILL, MARY WARD AND ERIK N. STEELE, D.O. - BUSINESS RELATIONSHIP THOMAS P. O'NEILL AND JASON NIEHAUS - BUSINESS RELATIONSHIP BRIAN DERRICK, THOMAS MALONE, M.D., JAMES MCILVAINE, ERIC N. STEELE, D.O., AND VIVIAN VON GRUENIGAN, M.D. - BUSINESS RELATIONSHIP NICHOLAS BROWNING AND DARYL CAMERON - BUSINESS RELATIONSHIP MICHAEL M. HUGHES, M.D., AND THOMAS P. O'NEILL - BUSINESS RELATIONSHIP MARY WARD, R.N., AND TAMMY SCARBOROUGH - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS: THE MEMBERS OF SUMMA HEALTH ARE SUMMA HEALTH SYSTEM COMMUNITY ("SUMMA MEMBER") AND HEALTHSPAN PARTNERS ("COMMUNITY MEMBER"). SUMMA MEMBER'S INTEREST IS 70%; COMMUNITY MEMBER'S INTEREST IS 30%. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY: THE MEMBERS OF THE CORPORATION ARE SUMMA HEALTH SYSTEM COMMUNITY ("SUMMA MEMBER") AND HEALTHSPAN PARTNERS ("COMMUNITY MEMBER"). THE MEMBERS HAVE THE FOLLOWING POWERS: 1. COMMUNITY MEMBER TO ELECT 5 DIRECTORS (AT LEAST 1 TO BE A RESIDENT OR COMMUNITY LEADER ACTIVE IN SUMMA'S MARKET AREA AND AT LEAST 1 TO BE A PHYSICIAN; THESE MAY BE SAME INDIVIDUAL) 2. SUMMA MEMBER TO ELECT 10 DIRECTORS (7 ELECTED LAY DIRECTORS AND 3 PHYSICIAN DIRECTORS) A DIRECTOR MAY ONLY BE REMOVED BY THE MEMBER WHICH ELECTED SUCH DIRECTOR, AND IF A MEMBER REMOVES A DIRECTOR ELECTED BY SUCH MEMBER, THEN THAT MEMBER MAY ELECT A DIRECTOR TO FILL THE VACANCY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS: THE FOLLOWING ARE RESERVED POWERS FOR THE MEMBERS OF THE CORPORATION: 1. ACTIONS THAT WOULD ADVERSELY IMPACT THE TAX-EXEMPT STATUS OF THE CORPORATION OR MERCY HEALTH 2. APPOINTMENT OF A NEW CEO 3. DISSOLUTION, MERGER, CONVERSION, OR CONSOLIDATION OF THE CORPORATION, OR SALE/LEASE/DISPOSITION OF SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS 4. SALE, LEASE, DISPOSITION OF CORPORATION'S CORE OPERATING ASSETS AS DEFINED IN DEFINITIVE AGREEMENT 5. ADDITION OF A NEW CORPORATE MEMBER OF THE CORPORATION 6. AMENDMENT TO THE STATEMENT OF COMMON VALUES 7. AMENDMENT TO THE ARTICLES OF INCORPORATION OR CODE OF REGULATIONS RESERVED POWERS 1, 3, 4, 5, 6, AND 7 REQUIRE THE APPROVAL OF EACH OF THE MEMBERS FORM 990, PART VI, SECTION B, LINE 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 IN SEPTEMBER 2017. 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 2017 MEETING FOR FURTHER REVIEW. THE COMMITTEE ON GOVERNANCE IS A STANDING COMMITTEE APPOINTED BY THE SUMMA HEALTH BOARD OF DIRECTORS AND INCLUDES MEMBERS OF THE BOARD OF DIRECTORS. AFTER THESE REVIEWS BY THE COMMITTEE ON GOVERNANCE AND THE COMMUNITY BENEFITS COMMITTEE, AND PRIOR TO FILING WITH THE IRS, AN EMAIL WAS SENT TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS. THIS EMAIL INCLUDED INSTRUCTIONS AND A LINK TO A PASSWORD-PROTECTED WEB SITE ON WHICH THE ENTIRE FORM 990 WAS AVAILABLE FOR VIEWING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST PROCESS SUMMARY: A CONFLICT OF INTEREST QUESTIONNAIRE IS SENT ANNUALLY TO ALL SUMMA HEALTH ENTITIES' BOARDS OF DIRECTORS, KEY EMPLOYEES, SENIOR MANAGERS, MEDICAL DIRECTORS, EMPLOYED PHYSICIANS, CONTRACTED PHYSICIANS, ADMINISTRATIVE DIRECTORS, EXECUTIVE DIRECTORS, DEPARTMENT HEADS, MANAGERS, SUPERVISORS, AND MEMBERS OF PURCHASING COMMITTEES FOR COMPLETION. RESPONSES ARE INDIVIDUALLY REVIEWED FOR DETERMINATION OF POTENTIAL CONFLICTS. THOSE RESPONSES DEEMED TO PRESENT POTENTIAL CONFLICTS ARE THEN PRESENTED TO THE COMMITTEE ON GOVERNANCE (SUB-COMMITTEE OF THE SUMMA HEALTH BOARD OF DIRECTORS). THE COMMITTEE ON GOVERNANCE REVIEWS EACH RESPONSE THAT PRESENTS A POTENTIAL CONFLICT AND DETERMINES WHETHER ADDITIONAL ACTION IS REQUIRED TO ELIMINATE OR MITIGATE THE POTENTIAL CONFLICT. THIS ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE PROCESS IS MANAGED BY THE CORPORATE COMPLIANCE DEPARTMENT PURSUANT TO THE SUMMA HEALTH POLICY ON CONFLICT OF INTEREST AS APPROVED BY THE SUMMA HEALTH BOARD OF DIRECTORS. IN ADDITION TO THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, THE CONFLICT OF INTEREST POLICY IMPOSES A DUTY TO DISCLOSE CONFLICTING INTERESTS ON AN ONGOING BASIS. FORM 990, PART VI, SECTION B, LINE 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OTHER EMPLOYEES: EXECUTIVE COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUMMA HEALTH BOARD OF DIRECTORS MEETS AT LEAST TWICE EACH YEAR TO REVIEW AND APPROVE BASE COMPENSATION AND TOTAL REMUNERATION FOR EXECUTIVE STAFF. EACH VOTING MEMBER OF THE COMPENSATION COMMITTEE IS AN INDEPENDENT DIRECTOR AND IS NOT AFFILIATED WITH MANAGEMENT. THE COMPENSATION COMMITTEE ENGAGES OUTSIDE CONSULTING SUPPORT TO PROVIDE INDEPENDENT MARKET DATA, ADVICE AND COUNSEL TO THE COMPENSATION COMMITTEE. FOR THE PAST SEVEN YEARS, THE COMPENSATION COMMITTEE HAS USED HAY GROUP, A NATIONALLY RECOGNIZED CONSULTING FIRM, TO ASSIST THEIR EFFORTS. THE HAY GROUP PROVIDES THE FOLLOWING SERVICES TO THE COMPENSATION COMMITTEE: (A) EDUCATION OF COMMITTEE MEMBERS REGARDING EXECUTIVE COMPENSATION TRENDS AND BEST PRACTICES IN HEALTHCARE ORGANIZATIONS; (B) ASSESSMENT OF THE MARKET COMPETITIVENESS AND REASONABLENESS OF SUMMA'S EXECUTIVE COMPENSATION PROGRAMS INCLUDING BASE SALARY, INCENTIVE COMPENSATION, CORE AND EXECUTIVE BENEFITS, AS WELL AS THEIR ALIGNMENT WITH THE MISSION AND FUTURE PERFORMANCE EXPECTATIONS; (C) WRITTEN, DETAILED EVALUATION OF THE MARKET REASONABLENESS OF SUMMA'S EXECUTIVE COMPENSATION AND BENEFITS PROGRAM; AND (D) ONGOING SUPPORT AND INDEPENDENT ADVICE TO THE COMPENSATION COMMITTEE ON MATTERS RELATED TO EXECUTIVE COMPENSATION. 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, IT&S & CIO SENIOR VICE PRESIDENT, PLANNING & MARKETING SENIOR VICE PRESIDENT & CHIEF NURSING OFFICER SENIOR VICE PRESIDENT, HUMAN RESOURCES SENIOR VICE PRESIDENT, CHIEF MEDICAL OFFICER CHIEF OPERATING OFFICER PRESIDENT, SUMMACARE FORM 990, PART VI, SECTION C, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC: SUMMA HEALTH MAKES ITS CONFLICTS OF INTEREST POLICY AVAILABLE UPON REQUEST. THE ARTICLES OF INCORPORATION OF SUMMA HEALTH AND ITS RELATED ENTITIES ARE AVAILABLE ON THE WEBSITE OF THE OHIO SECRETARY OF STATE (WWW.SOS.STATE.OH.US). SUMMA HEALTH MAKES ITS FINANCIAL STATEMENTS AVAILABLE ON ITS WEBSITE (WWW.SUMMAHEATLH.ORG). THE FINANCIAL STATEMENTS ARE ALSO AVAILABLE THROUGH THE ELECTRONIC MUNICIPAL MARKET ACCESS. (WWW.EMMA.MSRB.ORG). FORM 990, PART IX, LINE 11G NON-BILLABLE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,778,244. MANAGEMENT AND GENERAL EXPENSES 1,672,047. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,450,291. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 8,023,778. MANAGEMENT AND GENERAL EXPENSES 1,528,339. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,552,117. HEALTH SCREENING: PROGRAM SERVICE EXPENSES 7,274. MANAGEMENT AND GENERAL EXPENSES 1,386. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,660. EQUIPMENT MAINTENANCE: PROGRAM SERVICE EXPENSES 1,400,354. MANAGEMENT AND GENERAL EXPENSES 266,734. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,667,088. PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 58,654. MANAGEMENT AND GENERAL EXPENSES 11,172. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 69,826. FORM 990, PART XI, LINE 9: TRANSFERS TO/FROM AFFILIATES 93,344,677. OTHER ADJUSTMENTS 1,000. RESTRICTED ACTIVITY REPORTED -756,779. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 53,778. CHANGE IN PERMANENTLY RESTRICTED NET ASSETS 703,001. OTHER NET ASSETS ADJUSTMENTS 271. PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. 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