2017-11-14T07:59:11-06:00 2016-12-31 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2016-01-01 900640432 SUMMA HEALTH GROUP RETURN 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 07:58:57 CS P 98AC9AA3F4CBE4CB3038CB857DBC84AADB231605 37AB53F3E1FE5B259FEACB8EAA64376B229EE5AE 2016 2017-02-10 21:41:12Z T CLIFFORD DEVENY MD 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 1036762143 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. X 41 33 8006 1428 8483578 84090 5313648 2449196 1036977973 989432983 7422791 4807420 18594038 17836327 1068308450 1014525926 245767 246200 0 0 454148546 456353797 0 0 3212136 552725056 535589343 1007119369 992189340 61189081 22336586 1139746498 1171917505 672875229 788953590 466871269 382963915 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 415693143 505947812 OUTPATIENT SERVICES FOR 2016: SUMMA HEALTH SYSTEM, AND SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP, PROVIDED MORE THAN 1.5 MILLION OCCASIONS OF SERVICE, INCLUDING 169,601 EMERGENCY DEPARTMENT VISITS, 14,222 OBSERVATION PATIENTS, 13,805 SURGICAL OPERATIONS, AND MORE THAN 1.3 MILLION OTHER OUTPATIENT VISITS. 337606493 410907104 INPATIENT SERVICES FOR 2016: SUMMA HEALTH SYSTEM HAD APPROXIMATELY 700 BEDS IN SERVICE, ADMITTED 34,544 ADULT PATIENTS, AND DELIVERED 3,871 NEWBORNS. THE ADULT PATIENTS RECEIVED 151,793 DAYS OF CARE, INPATIENT SURGERIES TOTALED 6,764, EMERGENCY ADMISSIONS TOTALED 20,602 AND THE AVERAGE LENGTH OF STAY WAS 4.40 DAYS. 45138008 12219755 RESEARCH/EDUCATION FOR 2016: 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 280 MEDICAL SCHOOL GRADUATES TRAIN IN 19 ACCREDITED RESIDENCY PROGRAMS. SUMMA HEALTH PROVIDES CLINICAL LEARNING EXPERIENCES TO MORE THAN 1,110 NURSING AND ALLIED HEALTH STUDENTS. PART III LINE 4D - OTHER PROGRAM SERVICES: SUMMA HEALTH IS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT PROVIDES COORDINATED, VALUE-BASED CARE ACROSS THE CONTINUUM FOR THE PEOPLE AND POPULATIONS WE SERVE. WE HOLD OURSELVES CLINICALLY AND FINANCIALLY ACCOUNTABLE FOR HEALTH OUTCOMES IN OUR COMMUNITIES.SUMMA HEALTH SERVES MORE THAN ONE MILLION PATIENTS EACH YEAR IN COMPREHENSIVE EMERGENCY, ACUTE, CRITICAL, OUTPATIENT AND LONG-TERM/HOMECARE SETTINGS AND REPRESENTS MORE THAN 1,300 REGISTERED, INPATIENT BEDS ON THE CAMPUSES OF SUMMA HEALTH SYSTEM, SUMMA REHAB HOSPITAL, AND WESTERN RESERVE HOSPITAL. IN ADDITION, OUTPATIENT CARE IS PROVIDED IN NEARLY 20 COMMUNITY HEALTH CENTERS AND EMERGENCY DEPARTMENTS (EDS), SOME INTEGRATED IN THE HEALTHCARE FACILITIES, OTHERS ARE FREE-STANDING. SUMMA REHAB HOSPITAL AND WESTERN RESERVE HOSPITAL ARE JOINT VENTURES IN WHICH SUMMA HEALTH HAS AN INTEREST, AND ARE REFERENCED IN THIS DOCUMENT FOR THE PURPOSE OF IDENTIFYING ALL ENTITIES AFFILIATED WITH SUMMA HEALTH. SUMMA'S PROPORTIONATE INTEREST OF THESE JOINT VENTURES' CHARITY CARE AND OTHER COMMUNITY BENEFITS ARE INCLUDED ON SCHEDULE H OF SUMMA HEALTH'S IRS FORM 990 GROUP RETURN.PROVIDING SUPERIOR, MULTI-SPECIALTY PATIENT CARE, MEDICAL RESEARCH AND CONTINUING MEDICAL EDUCATION, SUMMA HEALTH RANKS AS A HIGHLY RECOGNIZED HEALTHCARE PROVIDER IN SEVERAL DISCIPLINES INCLUDING: BARIATRIC SURGERY, CARDIOVASCULAR, EMERGENCY, ONCOLOGY, ORTHOPAEDIC SURGERY, PRIMARY CARE SPORTS MEDICINE, STROKE AND NURSING BY PRESTIGIOUS ORGANIZATIONS SUCH AS:AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCERAMERICAN HEART ASSOCIATIONAMERICAN STROKE ASSOCIATIONNATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERSAMERICAN NURSING CREDENTIALING CENTERCENTERS FOR MEDICARE AND MEDICAID SERVICESPREMIER HEALTHCARE ALLIANCEOHIO PATIENT SAFETY INSTITUTEUS NEWS AND WORLD REPORTAMERICAN COLLEGE OF RADIATIONNURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERSAMERICAN SOCIETY FOR METABOLIC AND BARIATRIC 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 8,000 INDIVIDUALS WITH SUMMA HEALTH SYSTEM ACCOUNTING FOR APPROXIMATELY 6,000 OF THESE EMPLOYEES. SUMMA HEALTH SYSTEM HAS A MEDICAL STAFF OF MORE THAN 1,000 PROFESSIONALS WORKING ON ITS CAMPUSES. SUMMA HEALTH SYTSEM HAS 1,320 REGISTERED BEDS. THE BUILDINGS AND FACILITIES ON ALL CAMPUSES TOTAL APPROXIMATELY 2.2 MILLION SQUARE FEET.SUMMA HEALTH SYSTEM- AKRON CAMPUS OFFERS GENERAL MEDICAL, SURGICAL, OBSTETRICAL, TRAUMA AND CRITICAL CARE SERVICES. THE AKRON CAMPUS PROVIDES ACUTE CARE SERVICES AND A WIDE RANGE OF OUTPATIENT SERVICES ON A CAMPUS OF APPROXIMATELY 60 ACRES. SUMMA HEALTH SYSTEM- ST. THOMAS CAMPUS PROVIDES VARIOUS DIAGNOSTIC SERVICES ALONG WITH BEHAVIORAL HEALTH AND SUBSTANCE ABUSE CARE. SUMMA HEALTH SYSTEM- ST. THOMAS CAMPUS WAS ONE OF THE FIRST IN THE COUNTRY TO RECOGNIZE THE MEDICAL ASPECTS OF ALCOHOLISM AS A DISEASE AND IS THE FOUNDING LOCATION OF ALCOHOLICS ANONYMOUS. THE HOSPITAL OPENED THE NATION'S FIRST ALCOHOLISM TREATMENT WARD AND CONTINUES ITS LONGSTANDING DEDICATION TO THIS PROGRAM TODAY.AS A LEADER IN MEDICAL EDUCATION, SUMMA HEALTH SYSTEM SUPPORTS THE EDUCATION OF ITS PHYSICIANS AND HEALTHCARE PROFESSIONALS. THE AKRON AND ST. THOMAS CAMPUSES ARE TEACHING AFFILIATES OF THE NORTHEAST OHIO MEDICAL UNIVERSITY (NEOMED) AND INCLUDE A STAFF OF PHYSICIANS AND ACCREDITED RESIDENCY AND FELLOWSHIP PROGRAMS THAT FOSTER A DYNAMIC MEDICAL ENVIRONMENT. APPROXIMATELY 80 RESIDENTS AND FELLOWS GRADUATE FROM THE AKRON CAMPUS'S MEDICAL EDUCATION PROGRAMS EACH YEAR. THE BARBERTON CAMPUS HAS A FAMILY PRACTICE RESIDENCY PROGRAM AFFILIATED WITH NEOMED ALONG WITH PROVIDING EDUCATIONAL ROTATIONS FOR MEDICAL STUDENTS.SUMMA HEALTH SYSTEM- BARBERTON CAMPUSSUMMA HEALTH SYSTEM- BARBERTON CAMPUS IS A 500,000 SQUARE FOOT ACUTE CARE TEACHING HOSPITAL LOCATED ON NEARLY 16 ACRES, LOCATED APPROXIMATELY 10 MILES SOUTHWEST OF AKRON, OHIO. THE HOSPITAL HAS 271 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 2016, SUMMA HEALTH PROVIDED CHARITY CARE AT AN ESTIMATED NET COST OF NEARLY $10 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 2016, THE CHARITY CARE PROGRAM (INCLUDING HOSPITAL CARE ASSURANCE PROGRAM) BENEFITED APPROXIMATELY 15,600 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 $23 MILLION.BAD DEBTSUMMA HEALTH IS COMMITED TO PROVIDING QUALITY AND ACCESSIBLE HEALTHCARE. THIS INCLUDES COVERING THE EXPENSE OF PAYMENTS THAT WERE EXPECTED BUT NOT RECEIVED. WHILE SUMMA HEALTH RECOGNIZES BAD DEBT IS PART OF DOING BUSINESS, IT AGREES WITH THE OHIO HOSPITAL ASSOCIATION THAT IT IS IMPORTANT TO REPORT THESE COSTS TO SHOW THE TOTAL PICTURE OF CARE SUMMA HEALTH PROVIDES TO THE COMMUNITY WITHOUT FULL REIMBURSEMENT. IN 2016, THE COST FOR PROVIDING CARE WRITTEN OFF AS A BAD DEBT EXPENSE WAS APPROXIMATELY $16 MILLION.COMMUNITY HEALTH IMPROVEMENT SERVICESAN IMPORTANT PART OF SUMMA HEALTH'S MISSION IS OFFERING A PREVENTION AND WELLNESS PROGRAM TO BUILD A HEALTHIER COMMUNITY. IN 2016, SUMMA HEALTH PROVIDED MORE THAN $4.2 MILLION TO HELP FUND HEALTH IMPROVEMENT ACTIVITIES SUCH AS FREE AND LOW-COST HEALTH SCREENING, HEALTH EDUCATION SERVICES AND WELLNESS PROGRAMMING. SUBSIDIZED HEALTH SERVICES SUMMA HEALTH IS COMMITTED TO PROVIDING SUBSIDIZED HEALTH SERVICES - CLINICIAL SERVICES THAT MEET AN IDENTIFIED COMMUNITY NEED AND ARE PROVIDED DESPITE FINANCIAL LOSS. VITAL SERVICES SUCH AS THE CENTER FOR SENIOR HEALTH, CARE CENTER FOR PATIENTS WITH HIV OR AIDS, AND DIABETES EDUCATION ARE OFFERED, EVEN THOUGH THEY ARE NOT PROFITABLE. INCOME FROM OTHER SERVICES IS USED TO COVER THESE COSTS. IN 2016, THE COST FOR SUBSIDIZED SERVICES WAS APPROXIMATELY $27.7 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 THE LOCAL CHAPTERS OF NATIONAL GROUPS SUCH AS UNITED WAY, THE AMERICAN HEART ASSOCIATION AND THE AMERICAN CANCER SOCIETY, TO AXESSPOINTE COMMUNITY HEALTH CENTER SUMMA HEALTH PARTICIPATES IN NUMEROUS COMMUNITY PROGRAMS AND HELPS OTHER NONPROFITS FULFILL THEIR MISSIONS. IN 2016, THESE CONTRIBUTIONS WERE MORE THAN $1.3 MILLION.RESEARCH AND INNOVATIONSUMMA HEALTH'S QUALITY MEDICAL CARE IS DERIVED IN PART FROM ITS ABILITY TO TRANSLATE RESULTS FROM CAREFULLY PLANNED AND EXECUTED RESEARCH INTO EFFECTIVE PATIENT CARE STRATEGIES. RESEARCH AND INNOVATION IS AN INTEGRAL FOCUS OF THE ACADEMIC AND CLINICAL ENVIRONMENT AT SUMMA HEALTH AND HELPS SET THE HIGHEST STANDARDS FOR MEDICAL CARE IN THE COMMUNITY. SUMMA HEALTH'S REPUTATION FOR EXCELLENCE IN SUCH CRITICAL SPECIALITIES AS CARDIOLOGY, DIABETES, EMERGENCY SERVICES, ORTHOPAEDICS, ONCOLOGY, SENIOR HEALTH, SURGERY, AND WOMEN'S HEALTH CONTINUES TO GROW THROUGH RESEARCH AND INNOVATION. SUMMA HEALTH INVESTED MORE THAN $6.8 MILLION IN RESEARCH IN 2016. IN ADDITION TO SUPPORT FROM SUMMA FOUNDATION, MAJOR RESEARCH PROGRAMS ARE SUPPORTED BY GRANTS FROM THE NATIONAL INSTITUTES OF HEALTH, THE DEPARTMENT OF DEFENSE AND INDUSTRY SPONSORS.EDUCATION SUMMA HEALTH SUPPORTS THE EDUCATION OF PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS. SUMMA HEALTH SYSTEM IS THE LARGEST OF THE MAJOR TEACHING AFFILIATES OF THE NORTHEST OHIO MEDICAL UNIVERSITY (NEOMED, A CONSORTIUM OF THE UNIVERSITY OF AKRON, KENT STATE UNIVERSITY AND YOUNGSTOWN STATE UNIVERSITY), AND OFFERS EDUCATION TO NEOMED'S COLLEGES OF MEDICINE AND PHARMACY STUDENTS, AS WELL AS TO MEDICAL STUDENTS FROM SCHOOLS AROUND THE COUNTRY. IN ADDITION, SUMMA HEALTH OFFERS 19 ACCREDITED RESIDENCY TRAINING PROGRAMS IN NUMEROUS SPECIALTIES, TRAINING THE NEXT GENERATION OF PRIMARY CARE AND SPECIALTY PHYSICIANS FOR THE REGION AND BEYOND. NURSING EDUCATION ALSO IS OFFERED IN COLLABORATION WITH LOCAL AND NATIONAL UNIVERSITY PARTNERS. IN 2016, APPROXIMATELY 279 RESIDENTS AND FELLOWS TRAINED AT SUMMA HEALTH'S THREE MAIN HOSPITALS. ON AVERAGE, APPROXIMATELY 40% OF THESE RESIDENTS REMAIN IN OUR LOCAL AND SURROUNDING COMMUNITIES. SUMMA HEALTH'S 2016 INVESTMENT IN HEALTH PROFESSIONAL EDUCATION TOTALED $27.7 MILLION. SUMMA HEALTH SERVICES:FOLLOWING IS A DESCRIPTION OF SUMMA HEALTH'S NOTABLE ACCOMPLISHMENTS BY PRIMARY SERVICE LINES IN 2016: BARIATRIC CARE- 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 WHICH ARE DEEMED FAVORABLE BY THE ASMBS, AN ORGANIZATION DEDICATED TO EXCELLENCE IN SURGICAL OUTCOMES. CARDIOVASCULAR: SUMMA HEALTH BECAME THE FIRST HOSPITAL IN THE AKRON/CANTON/YOUNGSTOWN AREA AND ONE OF ONLY A HANDFUL ACROSS THE STATE TO OFFER THE WORLD'S SMALLEST PACEMAKER TO PATIENTS WITH ABNORMAL HEART RHYTHMS. THE MICRA TRANSCATHETER PACING SYSTEM (TPS) IS A NEW TYPE OF HEART DEVICE THAT PROVIDES PATIENTS WITH THE MOST ADVANCED PACING TECHNOLOGY AT ONE-TENTH THE SIZE OF A TRADITIONAL PACEMAKER. MICRA IS THE ONLY LEADLESS PACEMAKER APPROVED FOR USE IN THE U.S.SUMMA HEALTH SYSTEM EARNED THE AMERICAN HEART ASSOCIATION (AHA) DESIGNATION AS A MISSION: LIFELINE HEART ATTACK RECEIVING CENTER.THE (AHA)/AMERICAN STROKE ASSOCIATION RECOGNIZED SUMMA HEALTH SYSTEM- AKRON CAMPUS AS A GOLD PLUS ACHIEVEMENT HOSPITAL FOR SUCCESSFULLY IMPLEMENTING A HIGHER STANDARD OF CARE FOR HEART FAILURE PATIENTS THROUGH THE GET WITH THE GUIDELINES -HEART FAILURE QUALITY IMPROVEMENT PROGRAM.NEUROSCIENCE - SUMMA HEALTH SYSTEM- AKRON CAMPUS HAS BEEN CERTIFIED AS AN ADVANCED PRIMARY STROKE CENTER BY THE JOINT COMMISSION SINCE 2007. OUR STROKE CENTER WAS RECOGNIZED NATIONALLY TO RECEIVE THE AMERICAN HEART ASSOCIATION AND AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES STROKE GOLD PLUS QUALITY ACHIEVEMENT AWARD SINCE 2009. IN 2016, OUR AKRON CAMPUS'S DOOR-TO-DRUG TIME WAS 13 MINUTES FASTER THAN THE NATIONAL GOAL (47 MINUTE AVERAGE).NURSING:SUMMA HEALTH SYSTEM- AKRON AND ST. THOMAS CAMPUSES WERE REDESIGNATED WITH 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:THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) SELECTED SUMMA HEALTH AS ONE OF NEARLY 200 PHYSICIAN GROUP PRACTICES AND 17 HEALTH INSURANCE COMPANIES TO PARTICIPATE IN A CARE DELIVERY MODEL THAT SUPPORTS AND ENCOURAGES HIGHER QUALITY, MORE COORDINATED CANCER CARE. THE MEDICARE ARM OF THE ONCOLOGY CARE MODEL INCLUDES MORE THAN 3,200 ONCOLOGISTS AND WILL COVER APPROXIMATELY 155,000 MEDICARE BENEFICIARIES NATIONWIDE. 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 :IN AN EFFORT TO HELP PROSPECTIVE PARENTS FIND HOSPITALS THAT DELIVER QUALITY MATERNITY CARE, ANTHEM BLUE CROSS AND BLUE SHIELD IN OHIO DESIGNATED SUMMA HEALTH SYSTEM-AKRON CAMPUS AS ONE OF THE FIRST HOSPITALS TO RECEIVE THE BLUE DISTINCTION CENTER FOR MATERNITY CARE DESIGNATION, A NEW DESIGNATION UNDER THE BLUE DISTINCTION SPECIALTY CARE PROGRAM. SYSTEM: SUMMA HEALTH'S ACCOUNTABLE CARE ORGANIZATION, NEWHEALTH COLLABORATIVE, WAS RECOGNIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR ACHIEVING SIGNIFICANT MULTI-MILLION DOLLAR SAVINGS IN THE MEDICARE SHARED SAVINGS PROGRAM.FOR THE 12TH CONSECUTIVE YEAR, SUMMA HEALTH WAS NAMED AS ONE OF THE 99 BEST WORKPLACES IN NORTHEAST OHIO, AS DETERMINED IN THE ANNUAL NORTHCOAST 99 AWARDS, SPONSORED BY THE EMPLOYERS RESOURCE COUNCIL.SUMMA HEALTH WAS NAMED ONE OF "HEALTHCARE'S MOST WIRED ORGANIZATIONS BY HOSPITALS & HEALTH NETWORKS (H&HN) FOR ACHIEVEMENT IN THE USE OF HEALTHCARE IT.SUMMA HEALTH FLOURISH MADE HEALTHLINE'S LIST OF THE BEST WOMEN'S HEALTH BLOGS OF 2016. HEALTHLINE'S EDITORS SELECTED EACH WINNER BASED ON THEIR REACH TO EDUCATE, INSPIRE, AND EMPOWER THEIR READERS WITH FREQUENT UPDATES AND HIGH QUALITY INFORMATION. 43925589 246200 53462646 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 2016, SUMMA HEALTH PROVIDED CHARITY CARE TO THE INDIGENT (INCLUDING UNREIMBURSED MEDICAID) AT THE COST OF APPROXIMATELY $33 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 CONSISTED 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 AND MORE THAN 700 SUPPORT STAFF IN MORE THAN 30 SPECIALTIES AND SUB-SPECIALTIES. SUMMA HEALTH MEDICAL GROUPPROMOTES STRONG AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIAN SERVICES ARE MET. IN 2016, SUMMA HEALTH MEDICAL GROUP CONTINUED ITS DELVELOPMENT OF PRIMARY CARE PODS AND THE MEDICAL HOME MODEL OF CARE, TO FURTHER ENHANCE THE FOCUSED PATIENT CARE MODEL, BETTER COMMUNICATE QUALITY INITIATIVES AND ENHANCE PHYSICIAN RECRUITMENT.SUMMA FOUNDATION - PROGRAM SERVICE ACCOMPLISHMENTS:THROUGH PHILANTHROPY, SUMMA FOUNDATION SUPPORTS PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. SUMMA HEALTH FOUNDATION OFFERS A SPECTRUM OF PHILANTHROPIC OPTIONS FOR DONORS DESIGNED TO CREATE A POSITIVE IMPACT ON SUMMA HEALTH'S OPERATIONS, PROGRAMS, PROJECTS AND PERCEPTIONS AND TO AFFECT POSITIVE CHANGE IN THE COMMUNITIES SUMMA HEALTH SERVES. PHILANTHROPIC COMMITMENTS TO THE SUMMA HEALTH FOUNDATION IN 2016 TOTALED $8.5 MILLION.COMMUNITY BENEFIT AND DIVERSITY :THIS DEPARTMENT LEADS EFFORTS TO ADDRESS HEALTH DISPARITIES AND OTHER IMPORTANT COMMUNITY NEEDS AND RAISE AWARENESS OF HEALTH AND HEALTHCARE ISSUES AFFECTING THE COMMUNITIES SERVED BY SUMMA HEALTH. COMMUNITY BENEFIT AND DIVERSITY PROVIDE WELLNESS AND EDUCATIONAL TOOLS, FACILITATE ECONOMIC DEVELOPMENT PROGRAMS, DEVELOP COMMUNITY PARTNERSHIPS, COMMUNICATE SUMMA HEALTH'S BENEFIT TO THE COMMUNITY AND ENGAGE THE COMMUNITY AND ITS WORKFORCE WITHIN THE SYSTEM AND THROUGHOUT THE REGION.GOVERNMENT RELATIONS: THIS DEPARTMENT IS DEDICATED TO ELEVATING SUMMA HEALTH AS A CREDIBLE LEADER AND PARTNER IN THE HEALTH POLICY PLANNING PROCESS. THIS DEPARTMENT COLLABORATES WITH NUMEROUS DEPARTMENTSTO BEST POSITION SUMMA EDUCATION, RESEARCH AND CLINICAL INNOVATION PRIORITIES WITH PUBLIC SECTOR FUNDING OPPORTUNITIES. 43925589 246200 53462646 842363233 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 1 1 0 0 1 0 0 8006 1 1 1 0 0 0 0 1 1 0 0 0 0 X 41 33 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH FL X X BRIAN K DERRICK 2343125871 1077 GORGE BLVD PO BOX 2090 AKRON OH 443092090 X NICHOLAS BROWNING DIRECTOR SHS & SHMG 2.00 2.00 X 0 0 0 DARYL CAMERON DIRECTOR SHS 2.00 2.00 X 0 0 0 STEPHEN COMUNALE DIRECTOR SHS (AS OF 08/2016) 2.00 2.00 X 0 0 0 LYNN HAMRICH MD DIRECTOR SHS 2.00 2.00 X 0 0 0 JAMES KRAVEC MD DIRECTOR SHS 2.00 2.00 X 0 0 0 ANTHONY LOCKHART DIRECTOR SHS 2.00 2.00 X 0 0 0 THOMAS MALONE MD CEO SHS, DIRECTOR SHS & SF 4.00 46.00 X 0 1538920 22254 JAMES MCILVAINE CHAIR SHS & CHAIR SHMG 4.00 2.00 X X 0 0 0 ROBERT SHRODER DIRECTOR SHS (AS OF 04/2016) 2.00 2.00 X 0 0 0 BRIAN SMITH DIRECTOR SHS & SHMG 2.00 2.00 X 0 0 0 LEILA VESPOLI DIRECTOR SHS 2.00 2.00 X 0 0 0 VIVIAN VON GRUENIGEN MD DIRECTOR SHS 2.00 48.00 X X 0 503848 18487 NORMAN WELLS JR DIRECTOR SHS (END 7/2016) 2.00 2.00 X 0 0 0 SCOTT WILBER MD DIRECTOR SHS (AS OF 04/2016) 2.00 2.00 X 0 0 0 MICHAEL HUGHES MD DIRECTOR SHS(END 4/2016) 48.00 2.00 X 0 626882 23986 DONALD KLINE DIRECTOR SHS (END 3/2016) 2.00 2.00 X 0 0 0 RICHARD MARSH DIRECTOR SHS(END 3/2016) 2.00 2.00 X 0 0 0 KEN BABBY DIRECTOR SF 2.00 X 0 0 0 JULIA BIANCHI DIRECTOR SF 2.00 X 0 0 0 JASON BUTTERWORTH DIRECTOR SF 2.00 X 0 0 0 THOMAS CLARK DIRECTOR/CHAIR SF 4.00 X X 0 0 0 GEORGE DAVERIO JR DIRECTOR SF 2.00 X 0 0 0 C GORDON EWERS DIRECTOR SF 2.00 X 0 0 0 PHYLIS FERRARA PRESIDENT & CDO, SF 50.00 X X 505135 0 19022 SAMIR GIBARA DIRECTOR SF 2.00 X 0 0 0 WILLIAM GINTER DIRECTOR SF 2.00 X 0 0 0 MARK GOLDFARB DIRECTOR SF 2.00 X 0 0 0 IRIS HARVEY DIRECTOR SF 2.00 X 0 0 0 ROBERT HEMPHILL MD DIRECTOR SF 2.00 X 0 0 0 SCOTT HONNOLD DIRECTOR/TREAS SF (END 8/2016) 2.00 X X 0 0 0 MARY ANN JACKSON DIRECTOR SF 2.00 X 0 0 0 PHILIP KAUFMANN DIRECTOR SF 2.00 X 0 0 0 JEANNINE MARKS DIRECTOR SF 2.00 X 0 0 0 JONATHON PAVLOFF DIRECTOR SF 2.00 X 0 0 0 KATHLEEN RAYNOR DIRECTOR SF 2.00 X 0 0 0 ROBERT RICE DIRECTOR SF 2.00 X 0 0 0 MONA SARKAR DIRECTOR/SECTY SF 2.00 X X 0 0 0 GEORGE STRICKLER DIRECTOR SF 2.00 X 0 0 0 PAUL TESTA DIRECTOR SF 2.00 X 0 0 0 R MARK WERNIG DIRECTOR SF 2.00 X 0 0 0 KAREN BUDD DIRECTOR SF 2.00 X 0 0 0 BETSY CLARK DIRECTOR SF 2.00 X 0 0 0 LYDIA COOK MD PRESIDENT SUMMA HEALTH MEDICAL GROUP 50.00 X 470001 0 10240 BRIAN DERRICK SVP CFO, TR. SHS, ASST. TR. SF&SHMG 4.00 46.00 X 0 1061568 30014 ROBERT A GERBERRY SECRETARY/SR VP GENERAL COUNSEL 4.00 46.00 X 0 573423 7922 VALERIE GIBSON RN PRESIDENT SHS, COO 46.00 4.00 X 0 834373 35561 THOMAS P O'NEILL VP, CFO SHS, ASSISTANT TREASURER SHS 46.00 4.00 X 0 530469 18584 JASON NIEHAUS SVP HOSP. OPS & SITE ADMIN (END 7/16) 46.00 4.00 X 0 418172 18980 MARY WARD SR VP CNO SHS 46.00 4.00 X 0 638815 9860 KATHLEEN JOBE CNO SHS (END 9/2016) 46.00 4.00 X 212115 0 17269 DAVID CUSTODIO MD CMO SHS 50.00 X 426787 0 31683 CYNTHIA KELLEY DO VP MED ED & CHF ACADE. OFFICER SHS 46.00 4.00 X 0 282415 18883 TAMMY SCARBOROUGH COO SUMMA HEALTH MEDICAL GROUP 46.00 4.00 X 0 336914 15716 ERIK STEELE DO CMO SHS (END 6/2016) 46.00 4.00 X 0 740597 19010 MATTHEW WAYNE MD CMO SUMMA HEALTH MEDICAL GROUP 50.00 X 381119 0 6878 MARK POZSGAY DO CLINICAL PHYSICIAN - SHMG 50.00 X 1119725 0 29874 JOHN G ZOGRAFAKIS MD CLINICAL PHYSICIAN - SHMG 50.00 X 900718 0 34806 ERIC A ESPINAL MD CLINICAL PHYSICIAN - SHMG 50.00 X 1108464 0 33260 ANAND B DESAI MD CLINICAL PHYSICIAN - SHMG 50.00 X 952908 0 30394 TIFFANY D MARCHAND MD CLINICAL PHYSICIAN - SHMG 50.00 X 864658 0 16291 6941630 8086396 468974 409 0 1 1 0 759558 4560 1026119 658959 374548 2449196 NET PATIENT REVENUE LESS BAD DEBT 621110 916854915 916494321 360594 PROGRAM RELATED INVESTMENTS 900099 9140536 8577180 563356 REFERENCE LAB 621500 5971716 5971716 RENTAL INCOME FROM AFFILIATES 900099 4693887 4693887 52771929 52771929 989432983 1013268 1013268 -38878 -38878 7727090 6698254 1028836 1028836 1028836 19085070 15252040 3833030 3833030 3833030 140440 759558 285923 -145483 -145483 CAFETERIA SALES 722210 5014801 654411 4360390 PURCHASING REBATES 900099 2964972 2964972 PARKING 812930 1661002 1661002 7312199 933501 6378698 16952974 1014525926 982537317 8483578 21055835 204401 204401 41799 41799 2174990 1824817 350173 27793 27793 379834454 316784313 60789362 2260779 6885418 5776866 1108552 42567045 35373179 6787940 405926 24864097 20860977 4003120 2258547 1894921 363626 277489 277489 4979 4979 91590051 65371761 26180469 37821 248378 207936 39902 540 12343215 10294501 1975465 73249 1714297 1384247 265630 64420 15610694 13097372 2513322 1392967 1161234 222835 8898 1322996 1108920 212796 1280 14028838 11770195 2258643 45533949 38202983 7330966 579929 486560 93369 MEDICAL SUPPLIES 150596089 150588815 7274 MANAGEMENT FEES 128058997 107441498 20617499 SHMG PRACTICE SUPPORT 34174477 28672386 5502091 TAXES 864033 724924 139109 34989418 29060835 5576634 351949 992189340 842363233 146613971 3212136 93309 107155 301098262 411735118 7720160 151756363 142106435 11451568 3492773 11012611 12500792 4351869 7584082 1218107802 812934868 417791226 405172934 82850601 70571814 12937471 12295574 41370447 39752531 2228740 2228740 95083871 64369557 1139746498 1171917505 89946402 77708308 1535914 1830076 378662903 474491066 202730010 234924140 672875229 788953590 X 422063212 382588725 24717317 8389 20090740 366801 466871269 382963915 1139746498 1171917505 X 22336586 -5258437 -100985503 X X 0 1 X 1 1 1 X 1 SUMMA HEALTH SYSTEM 340714755 3 1 0 0 1 0 0 5122826 7808474 8525120 5313648 1438055 28208123 5122826 7808474 8525120 5313648 1438055 28208123 2703161 25504962 1814584 1047164 236286 212488 98245 3408767 31616890 7348164 0.80670 0.79820 X 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 ORGAIZATION 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. THE SOFTWARE USED TO PREPARE THE SUMMA HEALTH GROUP RETURN DOES NOT ALLOW FOR MULTIPLE PUBLIC CHARITY STATUS. ACCORDINGLY, 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 34-219001. 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: PUBLIC SUPPORT PERCENTAGE FOR 2016, SCHEDULE A, PART II, LINE 14 IS 80.67% PUBLIC SUPPORT PERCENTAGE FOR 2015, SCHEDULE A, PART II, LINE 15 IS 79.82% SCHEDULE A, PART IV, SECTIONS A, D, AND E: 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 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: SUPPORTED ORGANIZATIONS LISTED BY NAME: SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP(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 YES. 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. 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, NO 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: SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP (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 HOSPITALS 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 HOSPITALS LISTED IN PART I LINE 12G MEET COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIAN SERVICES, THE IMPORTANT RELATIONSHIPS BETWEEN THE TWO SUPPORTED HOSPITALS AND THEIR PHYSICIANS WOULD HAVE TO BE MANAGED BY EACH HOSPITAL INDIVIDUALLY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 4979 0 0 0 4979 0 PART II-B, LINE 1: THE AMOUNT ON LINE 1(F) REPRESENTS THE PORTION OF ANNUAL DUES TO ORGANIZATIONS SUCH AS AHA AND OHA ALLOCABLE TO LOBBYING ACTIVITIES. 19720810 66105 651021 20437936 19966435 313575 -559200 19720810 17564267 1927170 474998 19966435 16730854 70706 762707 17564267 15896470 347618 486766 16730854 1.00000 0 0 71644404 71644404 665252173 438172995 227079178 4248767 2320829 1927938 451824435 351914333 99910102 25138023 20526711 4611312 405172934 DEFERRED PENSION & COMP 289787 NON-PERF ASSET AIR RIGHTS 491870 OTHER ACCOUNTS RECEIVABLE 69321 BENEFICIAL INTEREST IN PROPERTY 3036179 DUE FROM RELATED ORGANIZATIONS 60482400 64369557 LEASE ESCALATION LIABILITY 258575 CAPITAL LEASE OBLIGATIONS 24621195 ASSET RETIREMENT OBLIGATION FI 2652880 INTEREST RATE SWAP 11940639 POST RETIREMENT BENEFITS 905008 CONTINGENT LIABILITIES 490082 MALPRACTICE LIABILITY 11717550 UNSECURED PAYABLES 177672598 PURCHASE OPTION LIABILITY 4665613 234924140 X PART V, LINE 4: ENDOWMENT FUNDS PROVIDE INCOME TO BE USED TO FULFILL THE TAX-EXEMPT PURPOSES OF SUMMA FOUNDATION. PART X, LINE 2: SUMMA HEALTH AND MOST OF ITS SUBSIDIARIES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM ALSO HAS CERTAIN SUBSIDIARIES THAT ARE TAXABLE FOR FEDERAL INCOME TAX PURPOSES. SUMMACARE ("SC"), TOGETHER WITH AFFILIATES OF SUMMA HEALTH SYSTEM CORPORATION ("SHSC"), FILE A CONSOLIDATED FEDERAL INCOME TAX RETURN IN ACCORDANCE WITH A TAX SHARING AGREEMENT DATED JANUARY 1, 2010. THE ENTITIES UTILIZE A CONSOLIDATED APPROACH TO THE ALLOCATION OF FEDERAL INCOME TAXES, WHEREAS SHSC'S TAX SHARING AGREEMENT WITH ITS SUBSIDIARIES ALLOWS IT TO MAKE CERTAIN CODE ELECTIONS IN ITS CONSOLIDATED FEDERAL TAX RETURN. IN THE EVENT SUCH CODE ELECTIONS ARE MADE, ANY BENEFIT OR LIABILITY IS THE RESPONSIBILITY OF SHSC AND IS ACCRUED AND PAID BY THE PARTICIPATING SUBSIDIARIES. SC IS NOT SUBJECT TO STATE INCOME TAXES AND IT IS LICENSED AS A HEALTH INSURANCE COMPANY UNDER CHAPTER 1751 OF THE OHIO REVISED CODE. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS OF EXISTING ASSETS AND LIABILITIES AND THE RESPECTIVE TAX BASIS AND OPERATING LOSS AND TAX CREDIT CARRYFORWARDS. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. THE EFFECT OF DEFERRED TAX ASSETS AND LIABILITIES OF A CHANGE IN TAX RATES IS RECOGNIZED IN INCOME IN THE PERIOD THAT INCLUDES THE ENACTMENT DATE. SUMMA RECOGNIZES INTEREST INCOME, INTEREST EXPENSE, AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS WITH THE PROVISION FOR INCOME TAX. CENTRAL AMERICA AND THE CARIBBEAN 1 0 PROGRAM SERVICES SELF INSURANCE 10043592 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 247093 1 0 0 0 1 0 10290685 0 10290685 1 0 1 0 1 0 PART I, LINE 3: CENTRAL AMERICAN AND THE CARIBBEAN: ACCRUAL PART I, LINE 3(F): EXPENDITURES: INSURANCE PREMIUMS PAID $10,043,592 GALA 679952 589012 90940 440 107151 0 75000 3325 GOLF OUTING 220046 170546 49500 17303 96 26167 47431 9010 899998 759558 140440 17743 107247 26167 122431 12335 285923 -145483 1 1 X 1 X 1 X 1 1 0 1 1 32286061 22206367 10079694 0.00960 158193760 135277942 22915818 0.02170 190479821 157484309 32995512 0.03130 4311432 116975 4194457 0.00400 40807543 13111023 27696520 0.02630 27282472 27282472 0.02590 7727336 883485 6843851 0.00650 1315629 1315629 0.00120 81444412 14111483 67332929 0.06390 271924233 171595792 100328441 0.09520 16666 0 16666 0.00000 873 0 873 0.00000 17539 17539 0.00000 1 15509000 193003795 196322948 -3319153 X 1 1 1 SUMMA WESTERN RESERVE HOSPITAL LLC GENERAL HOSPITAL 0.40000 0.00000 0.60000 3 DIGESTIVE HEALTH CENTER LLC DIGESTIVE DISEASE 0.05000 0.00000 0.44000 4 MEDINA-SUMMIT ASC LLC AMBULATORY SURGERY CENTER 0.20000 0.00000 0.70000 3 1 SUMMA HEALTH SYSTEM 525 EAST MARKET STREET AKRON OH 44304 WWW.SUMMAHEALTH.ORG 1275 X X X X X A 3 SUMMA WESTERN RESERVE HOSPITAL LLC 1900 23RD STREET CUYAHOGA FALLS OH 44223 WWW.WESTERNRESERVEHOSPITAL.ORG 1280 X X X X A 4 SUMMA REHAB HOSPITAL LLC 29 NORTH ADAMS STREET AKRON OH 44304 WWW.SUMMAREHABHOSPITAL.COM 1503 X X REHABILITATION B FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 16 1 1 1 1 X SEE SUPPLEMENTAL INFORMATION X 1 13 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE ATTACHED SUPPLEMENTAL INFORMATION X SEE ATTACHED SUPPLEMENTAL INFORMATION X SEE ATTACHED SUPPLEMENTAL INFORMATION X X X X X X 1 X 0 X X X X 1 X 0 0 FACILITY REPORTING GROUP - B 0 0 1 X X X X X X X X X 16 1 1 1 1 X SEE SUPPLEMENTAL INFORMATION X 1 13 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE ATTACHED SUPPLEMENTAL INFORMATION X SEE ATTACHED SUPPLEMENTAL INFORMATION X SEE ATTACHED SUPPLEMENTAL INFORMATION X X X X X X 1 X 0 X 0 X X 0 0 PART V, SECTION B, LINE 7A FACILITY REPORTING GROUP A & B GROUP A: HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2016GROUP B:HTTP://WWW.SUMMAREHABHOSPITAL.COM/SUPPORT_GROUPS.ASPX PART V, SECTION B, LINE 10A FACILITY REPORTING GROUP A & B GROUP A:HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2013-2016GROUP B:HTTP://WWW.SUMMAREHABHOSPITAL.COM/SUPPORT_GROUPS.ASPX PART V SECTION B LINE 16A: FACILITY REPORTING GROUP A & B GROUP A: HTTPS://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/ FINANCIALASSISTANCEPOLICYGROUP B: HTTP://WWW.SUMMAREHABHOSPITAL.COM/INPATIENT_SERVICES/FINANCIAL_ASSISTANCE_POLICY.ASPX PART V SECTION B LINE 16B FACILITY REPORTING GROUP A & B GROUP A:HTTP://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/ FINANCIALASSISTANCEPOLICYGROUP B:HTTP://WWW.SUMMAREHABHOSPITAL.COM/INPATIENT_SERVICES/FINANCIAL_ASSISTANCE_POLICY.ASPX PART V SECTION B LINE 16C FACILITY REPORTING GROUP A & B GROUP A:HTTPS://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/PLAINLANGUAGEFINANCIALASSISTANCEPOLICYGROUP B:HTTP://WWW.SUMMAREHABHOSPITAL.COM/INPATIENT_SERVICES/FINANCIAL_ASSISTANCE_POLICY.ASPX PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: SUMMA HEALTH SYSTEM, - FACILITY 3: SUMMA WESTERN RESERVE HOSPITAL, LLC FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT BROAD INTERESTS OF COMMUNITY SERVED:SUMMA HEALTH SYSTEM, SUMMA WESTERN RESERVE HOSPITAL, LLC (GROUP A):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 PERSEPECTIVE 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 MINISTIRESSENATOR 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 THROUGHT 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 UNIVERISYT 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-ANDDIVERSITY/COMMUNITYNEEDSASSESSMENT2016. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE OTHER HOSPITAL FACILITIES:SUMMA HEALTH SYSTEM, SUMMA WESTERN RESERVE HOSPITAL, LLC (GROUP A): SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF EACH OF ITS THREE HOSPITAL FACILITIES LISTED IN PART V, SECTION A. IN ADDITION SUMMAHEALTH COLLABORATED WITH CLEVELAND CLINIC AKRON GENERAL AND AKRON CHILDREN'S HOSPITAL IN CONDUCTING THE CHNA. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:SUMMA HEALTH SYSTEM, SUMMA WESTERN RESERVE HOSPITAL, LLC (GROUP A):KENT STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: HOW THE HOSPITAL FACILITY IS ADDRESSING NEEDS IDENTIFIED IN ITS CHNA:SUMMA HEALTH SYSTEM, SUMMA WESTERN RESERVE HOSPITAL (GROUP A):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, PREVENTIION 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 CETNER 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 OPPORTUNTIIES 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 DETERMININANTS 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-ANDDIVERSITY/COMMUNITYNEEDSASSESSMENT2016. PART V, SECTION B FACILITY REPORTING GROUP B FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 4: SUMMA REHAB HOSPITAL, LLC FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT BROAD INTERESTS OF COMMUNITY SERVED:SUMMA REHABILITATION HOSPITAL (GROUP B):INTERVIEWS WERE CONDUCTED WITH COMMUNITY LEADERS IN MARCH -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 PERSEPECTIVE 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 MINISTIRESSENATOR 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 THROUGHT 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 UNIVERISYT 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-ANDDIVERSITY/COMMUNITYNEEDSASSESSMENT2016. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE OTHER HOSPITAL FACILITIES:SUMMA REHABILITATION HOSPITAL (GROUP B):SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF EACH OF ITS THREE 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. FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:SUMMA REHABILITATION HOSPITAL (GROUP B):KENT STATE UNIVERSITY COLLEGE OF PUBLIC HEALTH FACILITY REPORTING GROUP - B PART V, SECTION B, LINE 11: HOW THE HOSPITAL FACILITY IS ADDRESSING NEEDS IDENTIFIED IN ITS CHNA:SUMMA REHABILITATION HOSPITAL (GROUP B):DUE TO THE NATURE OF THE ADULT REHABILITATION SPECIALTY SERVICES PROVIDED BY SUMMA REHAB HOSPITAL, LLC,(" HOSPITAL") THE IDENTIFIED HEALTH NEED IN WHICH THEY HAVE THE OPPORTUNITY TO ADDRESS IN THIS IMPLEMENTATION PLAN FOR THE GREATEST IMPACT IS ACCESS. THE COMMUNITY RESOURCES PROVIDED BY A VARIETY OF INSTITUTIONS INCLUDING SUMMA AKRON CITY, ST. THOMAS HOSPITALS LED TO THE DETERMINATION BY SUMMA REHAB HOSPITAL, LLC TO NOT ADDRESS ANY OTHER IDENTIFIED HEALTH NEED. 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-ANDDIVERSITY/COMMUNITYNEEDSASSESSMENT2016. THE COMMUNITY RESOURCES PROVIDED BY A VARIETY OF INSTITUTIONS AND AGENCIES INCLUDING AKRON CHILDREN'S HOSPITAL AND SUMMA HEALTH SYSTEM, LED TO THE DETERMINATION BY SUMMA REHAB HOSPITAL, LLC TO NOT ADDRESS ANY OTHER IDENTIFIED HEALTH NEEDS. 20 1 - SUMMA HEALTH WADSWORTH-RITTMAN MEDICAL C 195 WADSWORTH ROAD WADSWORTH OH 44281 OUTPATIENT SERVICES 2 - SUMMA HEALTH MEDINA MEDICAL CENTER 3780 MEDINA ROAD MEDINA OH 44256 LAB, IMAGING, THERAPY, SLEEP MEDICINE, RADIATION ONCOLOGY & OUTPATIENT SURGE 3 - SUMMA HEALTH AT GREEN FAMILY YMCA 3838 MASSILLON ROAD UNIONTOWN OH 44685 LAB, IMAGING, REHABILITATION, THERAPY AND OTHER HEALTH SERVICES. 4 - SUMMA HEALTH WHITE POND MEDICAL CENTER 1 PARK WEST BLVD STE 130 AKRON OH 44320 LAB, IMAGING, AND OTHER SPECIALTY HEALTH PROGRAMS. 5 - SUMMA HEALTH HUDSON MEDICAL CENTER 5655 HUDSON DRIVE STE 200 HUDSON OH 44236 LAB, IMAGING, REHABILITATION, WOUND CARE & SPORTS MEDICINE 6 - SUMMA HEALTH NEUROSCIENCE CENTER 701 WHITE POND DR STE 210 AKRON OH 44320 NEUROLOGY SERVICES 7 - SUMMA HEALTH GREEN MEDICAL CENTER 1835 FRANKS PARKWAY UNIONTOWN OH 44685 LAB, IMAGING, AND OTHER SPECIALTY HEALTH PROGRAMS. 8 - SUMMA HEALTH HOME INFUSION 2743 GILCHRIST ROAD STE 200 AKRON OH 44305 HOME CARE & INFUSION SERVICES 9 - SUMMA HEALTH CENTER AT GREEN - SLEEP LAB 1700 BOETTLER ROAD STE 215 UNIONTOWN OH 44685 SLEEP AND NEUROLOGY SERVICES 10 - SUMMA HEALTH THERAPY AT ANNA DEAN PROFES 28 CONSERVATORY DR STE A BARBERTON OH 44203 OUTPATIENT REHAB AND THERAPY 11 - SUMMA HEALTH CUYAHOGA FALLS MEDICAL CENT 1860 STATE ROAD CUYAHOGA FALLS OH 44223 LAB AND IMAGING SERVICES 12 - SUMMA HEALTH AT WADSWORTH COMMUNITY CENT 621 SCHOOL DRIVE WADSWORTH OH 44281 IMAGING, REHABILITATION, AND ORTHOPAEDIC SPORTS MEDICINE 13 - SUMMA HEALTH THERAPY AT SHAW JEWISH COMM 750 WHITE POND DR STE 500 AKRON OH 44320 OCCUPATIONAL & REHAB SERVICES 14 - SUMMA HEALTH THERAPY AT TALLMADGE RECREA 46 NORTH MUNROE ROAD TALLMADGE OH 44278 PHYSICAL THERAPY AND SPORTS HEALTH 15 - SUMMA HEALTH WELLNESS CENTER 5625 HUDSON DRIVE HUDSON OH 44236 MEDICAL-BASED FITNESS PROGRAMS REHABILITATION & THERAPY 16 - SUMMA HEALTH THERAPY AT LAKE ANNA YMCA 500 WEST HOPOCAN AVENUE BARBERTON OH 44203 THERAPY, REHABILITATION, AND SPORTS MEDICINE 17 - SUMMA HEALTH IGNATIA HALL SOUTH 3730 WHIPPLE AVE NW STE 5 CANTON OH 44718 OUTPATIENT ADDICTION MEDICINES 18 - SUMMA HEALTH EQUITY CENTER 1493 S HAWKINS AVENUE AKRON OH 44320 CHRONIC DISEASE MANAGEMENT, HEALTH, NUTRITION, EXERCISE & EDUCATION SERVICES 19 - SUMMA HEALTH THERAPY AT KOHL FAMILY YMCA 477 EAST MARKET ST STE 100 AKRON OH 44304 THERAPY, REHABILITATION, AND SPORTS MEDICINE 20 - WESTERN RESERVE HOSPITAL THERAPY AT NATA 2345 4TH STREET CUYAHOGA FALLS OH 44221 ORTHOPAEDIC & SPORTS THERAPY 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 $21,287,376. 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: A COST-TO-CHARGE RATIO IS USED TO DETERMINE THE AMOUNT REFLECTED ON LINE 2. FOR A DESCRIPTION OF THE ACCOUNTING FOR BAD DEBT, SEE "NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE" ON PAGE 12 OF THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS UNDER NOTE 1, "SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES." PART III, LINE 4: FOOTNOTE IN ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBING BAD DEBT EXPENSE:SUMMA HEALTH'S AUDITED FINANCIAL STATEMENTS CONTAIN A FOOTNOTE THAT DESCRIBES THE PROVISION FOR DOUBTFUL ACCOUNTS. SUMMA HEALTH HAS ADOPTED ASU 2011-07 WHICH RESULTS IN BAD DEBT EXPENSE BEING REFLECTED AS A DEDUCTION FROM REVENUE RATHER THAN AN OPERATING EXPENSE. NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, 1. SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, NET PATIENT SERVICE REVENUE AND PATIENT ACCOUNTS RECEIVABLE (PAGE 12) STATES SUMMA HEALTH MAINTAINS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EXPECTED 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. PART III, LINE 8: DESCRIBE EXTENT ANY SHORTFALL FROM LINE 7 TREATED AS COMMUNITY BENEFIT AND COSTING METHOD USED:MEDICARE ALLOWABLE COST ARE BASED ON INFORMATION PROVIDED ON WORKSHEET B, PART I, COLUMN 26, LINE 118 FROM THE VARIOUS HOSPITALS' MEDICARE COST REPORTS. COSTING METHOD USED WAS TOTAL ALLOWABLE COST LESS ALL COSTS DEEMED NON-ALLOWABLE BY MEDICARE REGULATIONS. ANY MEDICARE SHORTFALL INCURRED BY SUMMA HEALTH IS NOT REPORTED AS A COMMUNITY BENEFIT. PART III, LINE 9B: DID COLLECTION POLICY CONTAIN PROVISIONS ON COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR ASSISTANCE:SUMMA WILL NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST ANY PATIENT WHO IS WITHOUT ACCESS TO HEALTH INSURANCE AND WITHOUT OTHER SIGNIFICANT INCOME OR NET WORTH. BEFORE INITIATING LEGAL ACTION FOR NON-PAYMENT, OUR HOSPITALS WILL, IN CONJUNCTION WITH THE PATIENT, MAKE SURE THAT THE PATIENT IS NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM AND DOES NOT QUALIFY UNDER THE HOSPITALS' CHARITY CARE POLICY. PART VI, LINE 2: NEEDS ASSESSMENT:IN ADDITION TO THE CHNA DESCRIBED IN PART V, SECTION B, THE HEALTH CARE NEEDS OF THE COMMUNITY ARE COLLABORATIVELY ASSESSED BY SURVEY PROCESSES CONDUCTED BY SUMMA HEALTH, SUMMIT COUNTY PUBLIC HEALTH, CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON, THE UNITED WAY, SOCIAL SERVICES ADVISORY BOARD OF SUMMIT COUNTY, AND CLEVELAND CLINIC -AKRON GENERAL MEDICAL CENTER. PART VI, LINE 3: PATIENT EDUCATION:IN ACCORDANCE WITH THE RULES SET FORTH BY OHIO ADMINISTRATIVE CODE SECTION 2101:3-2-07.17 NOTICES, SUMMA HEALTH SYSTEM'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. EACH STATEMENT SENT TO THE PATIENT CONTAINS AN EXPLANATION OF THE FREE CARE PROGRAM AS WELL AS AN APPLICATION ON THE BACK SIDE OF THE STATEMENT. PART VI, LINE 4: COMMUNITY INFORMATION:BASED ON 2015 PATIENT ADMISSION DATA, SUMMA HEALTH CARE DELIVERY IS PRIMARILY IN SUMMIT COUNTY. SUMMIT COUNTY REPRESENTS 75.32% OF THE 2015 ADMISSIONS FROM SUMMA HEALTH. WHILE SUMMA ALSO TREATS PATIENTS FROM MEDINA, NOTHERN STARK, AND WAYNE COUNTIES, MOST PATIENTS COME FROM SUMMIT COUNTY. THERE ARE 541,968 PEOPLE LIVING IN SUMMIT COUNTY. SINCE 2010, THE POPULATION HAS INCREASED SLIGHTLY, BY LESS THAN A PERCENT. THERE ARE 31 CITIES, VILLAGES, AND TOWNSHIPS IN SUMMIT COUNTY, WITH THE LARGEST BEING THE CITY OF AKRON. COMPARED TO THE STATE OF OHIO, SUMMIT COUNTY HAS A SLIGHTLY SMALLER PROPORTION OF CHILDREN (UNDER 18 YEARS OLD) AND A SLIGHTLY HIGHER PROPORTION OF OLDER ADULTS. IN SUMMIT COUNTY 20.5% PERCENT OF THE POPULATION IS NON WHITE, COMPARED TO 17.3% IN THE STATE. EDUCATIONAL ATTAINMENT IS SLIGHTLY HIGHER IN SUMMIT COUNTY THANT THE STATE OF OHIO, WITH 90.7% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 29.9% HAVING A BACHELOR'S DEGREE OR HIGHER. SIMILARLY, ANNUAL PER CAPITA INCOME IN SUMMIT COUNTY IS SLIGHLTY HIGHER THAN THE STATE OF OHIO, THE PERCENT OF SUMMIT COUNTY RESIDENTS LIVING IN POVERTY IS 2.2% LOWER THAN THAT OF THE STATE. MORE THAN 50% OF THE HOUSEHOLDS IN SUMMIT COUNTY MAKE LESS THAN $50,000 ANNUALLY AND 15.0% AND 14.5% OF HOUSEHOLDS MAKE LESS THAN $15,000 ANNUALLY RESPECTIVELY. FOR THE CALENDAR YEAR 2015, THE AVERAGE MONTHLY UNEMPLOYMENT RATE FOR SUMMIT COUNTY WAS 4.9% RESPECTIVELY. LOW INCOMES AND AN ESSENTIALLY STAGNANT UNEMPLOYMENT RATE ADD TO SUMMA'S BURDEN FOR CHARITY CARE. DESPITE THESE CHALLENGES, DEMAND FOR SUMMA'S SERVICES IN THESE COMMUNITIES IS PROJECTED TO GROW. WHILE THE TOTAL POPULATION OF SUMMIT COUNTY IS EXPECTED TO DECLINE (BY -1.2%), OVER THE 5-YEAR PERIOD 2013-2018. MORE IMPORTANTLY, THE AGE GROUP THAT DEMAND HEALTHCARE SERVICES THE MOST (AGE 65 AND OLDER) IS EXPECTED TO GROW SIGNIFICANTLY. THIS AGE GROUP IS EXPECTED TO INCREASE 16.0% IN SUMMIT COUNTY OVER THE FIVE YEAR PERIOD. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:AMONG THE WAYS THE HOSPITALS WITHIN SUMMA HEALTH PROMOTE THE HEALTH OF THE COMMUNITY ARE BY MAINTAINING AN OPEN MEDICAL STAFF AND A COMMUNITY ENGAGEMENT COMMITTEE (COMMUNITY BENEFIT COMMITTEE). SUMMA'S HOSPITALS ADDRESS HEALTH DISPARITIES THROUGH PRACTICE, RESEARCH, EDUCATION AND COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS. CONTRIBUTIONS, BOTH FINANCIAL AND IN-KIND, ARE MADE TO INITIATIVES AND PROGRAMMING (I.E. FEDERALLY QUALIFIED HEALTH CENTER, OPEN M, CENTER FOR COMMUNITY HEALTH IMPROVEMENT) THAT ARE DEEMED TO PROMOTE THE HEALTH, WELLNESS AND IMPROVED QUALITY OF LIFE FOR THE COMMUNITIES SUMMA HEALTH SERVES. PART VI, LINE 6: DESCRIPTION OF AFFILIATED GROUP:SUMMA HEALTH, 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 2016, SUMMA HEALTH PROVIDED INPATIENT CARE THROUGH FACILITIES LOCATED ON SIX CAMPUSES AND IN ADDITION, OUTPATIENT CARE IS EXTENDED THROUGHOUT THE REGION IN A NUMBER OF OUTPATIENT CENTERS, BOTH HOSPITAL-BASED AND FREESTANDING. SUMMA HEALTH SYSTEM'S AKRON 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 249-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 WESTERN RESERVE HOSPITAL, LLC ("SWRH") IS A JOINT VENTURE BETWEEN SUMMA HEALTH SYSTEM AND THE WESTERN RESERVE HEALTH PARTNERS AND PROVIDES A FULL RANGE OF ACUTE MEDICAL SERVICES. SWRH PROVIDES ITS HOSPITAL OPERATIONS IN THE CITY OF CUYAHOGA FALLS, OHIO. SWRH PROVIDES A RANGE OF SERVICES INCLUDING A 24-HOUR EMERGENCY ROOM, AMBULATORY SURGERY, DIAGNOSTIC TESTING, ETC. AND ADHERES TO THE CHARITY CARE POLICY OF SUMMA HEALTH. SUMMA REHAB HOSPITAL, LLC, A JOINT VENTURE BETWEEN SUMMA HEALTH SYSTEM AND VIBRA HEALTHCARE, OPENED ON THE CAMPUS OF SUMMA AKRON CITY HOSPITAL IN 2012. THIS 60-BED FACILITY PROVIDES INPATIENT REHABILITATION CARE AND SERVICES AND ADHERES TO SUMMA'S CHARITY CARE POLICY. ESTABLISHED IN 1993, SUMMACARE OFFERS HEALTH CARE COVERAGE TO MEMBERS INCLUDING MEMBERS INSURED THROUGH ITS STATUS AS A MEDICARE ADVANTAGE ORGANIZATION. SUMMACARE IS RECOGNIZED BY THE HEALTH INDUSTRY RESEARCH COMPANY AS A HEALTH PLAN WITH EFFECTIVE DISEASE MANAGEMENT PROGRAMS FOR ASTHMA, HEALTH FAILURE AND DIABETES. SUMMACARE, ALONG WITH ITS THIRD PARTY ADMINISTRATIVE SERVICES PRODUCTS COVERS APPROXIMATELY 120,000 MEMBERS. SUMMA FOUNDATION IS A NONPROFIT ORGANIZATION ADVANCING TRANSFORMATIONAL PHILANTHROPY, COMMUNITY UNDERSTANDING AND GOODWILL FOR THE PROGRAMS AND PRIORITIES OF SUMMA HEALTH. SUMMA HEALTH NETWORK, LLC IS THE INTEGRATED PHYSICIAN-HOSPITAL ORGANIZATION AFFILIATED WITH SUMMA HEALTH. WITH MORE THAN 1,400 PHYSICIANS PARTICIPATING, SUMMA HEALTH NETWORK OVERSEES MUTUALLY BENEFICIAL CONTRACTS WITH INSURANCE COMPANIES, PREFERRED PROVIDER ORGANIZATIONS, THIRD-PARTY ADMINISTRATORS AND OTHER PAYORS ON BEHALF OF ITS PHYSICIANS AND HOSPITAL MEMBERS. SUMMA ACCOUNTABLE CARE ORGANIZATION (D/B/A NEWHEALTH COLLABORATIVE ("NHC")) IS A CLINICIAN-LED COLLABORATIVE, ORGANIZED TO COMPASSIONATELY CARE FOR AND SERVE PATIENTS IN AN ACCOUNTABLE, VALUE AND EVIDENCE-BASED MANNER. IN ACCORDANCE WITH THE AFFORDABLE CARE ACT, NHC CREATES INCENTIVES FOR PROVIDERS TO FURTHER ENHANCE THE QUALITY OF CARE. OHIO HEALTH CHOICE, INC. (OHC) IS OHIO'S OLDEST PREFERRED PROVIDER ORGANIZATION (PPO) NETWORK IN THE STATE. OHC IS CO-OWNED BY SUMMA HEALTH AND MERCY MEDICAL CENTER, AND IS COMPRISED OF APPROXIMATELY 200 HOSPITALS, 8,000 PRIMARY CARE PROVIDERS, 18,000 SPECIALISTS, COVERING MEMBERS ACROSS ALL 88 COUNTIES IN OHIO. SUMMA PHYSICIANS, INC. (D/B/A SUMMA HEALTH MEICAL GROUP ("SHMG")) IS A MULTI-SPECIALTY PHYSICIAN PRACTICE. EMPLOYING CLOSE TO 300 PHYSICIANS IN MULTIPLE SPECIALTIES. SPI PROMOTES STRONGER AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIANS SERVICES ARE MET. SCHEDULE H, PART VI, LINE 7 FACILITY REPORTING GROUP A & B STATE FILING OF COMMUNITY BENEFIT REPORT:THE STATE OF OHIO DOES NOT REQUIRE THE FILING OF THE COMMUNITY BENEFIT REPORT FOR 2016. HOWEVER, INFORMATION FROM THE COMMUNITY BENEFIT REPORT IS SHARED ANNUALLY WITH THE OHIO HOSPITAL ASSOCIATION. 1 AKRON CANTON REGIONAL FOOD BANK 350 OPPORTUNITY PARKWAY AKRON OH 443072234 311369388 501(C)(3) 10000 MISSION SUPPORT AMERICAN HEART ASSOCIATION 3505 EMBASSY PARKWAY STE 100 AKRON OH 44333 135613797 501(C)(3) 103000 RESEARCH AND EDUCATION CITY OF AKRON 166 SOUTH HIGH STREET AKRON OH 44308 346000020 GOVERNMENTAL 10000 COMMUNITY EVENT THE UNIVERSITY OF AKRON 302 BUCHTEL COMMON AKRON OH 44301 346002924 GOVERNMENTAL 7900 EDUCATIONAL AKRON URBAN LEAGUE 440 VERNON ODOM BLVD AKRON OH 44307 340714520 501(C)(3) 11000 SCHOLARSHIP PROGRAM SUSAN G KOMEN FOR THE CURE 26210 EMERY ROAD CLEVELAND OH 44128 751835298 501(C)(3) 13500 CANCER WELLNESS SUPPORT AKRON COMMUNITY FOUNDATION 345 WEST CEDAR STREET AKRON OH 44307 341087615 501(C)(3) 9000 MISSION SUPPORT STEWARTS CARING PLACE 2955 WEST MARKET STREET AKRON OH 44333 200181338 501(C)(3) 10000 MISSION SUPPORT AMERICAN CANCER SOCIETY 525 NORTH BROAD STREET CANFIELD OH 44406 251798733 501(C)(3) 20000 CANCER RESEARCH STEPHEN A COMUNALE JR FAMILY CANCER FOUNDATION PO BOX 13805 AKRON OH 44334 204345267 501(C)(3) 10000 CANCER WELLNESS SUPPORT 10 SUMMASHARES 15 15442 DIABETES PROGRAM 12 6421 MAMMOGRAM SCREENS 67 19936 PART I, LINE 2: THE PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IS BASED ON THE CRITERIA ESTABLISHED PRIOR TO AWARDING THE GRANT OR ASSISTANCE. ONCE THE CRITERIA IS MET A PAYMENT WILL BE MADE TO THE ORGANIZATION UTILIZING THE FUNDS. X X 1 1 0 0 0 0 0 0 0 1 0 THOMAS MALONE MD CEO SHS, DIRECTOR SHS & SF 0 860236 0 452933 0 225751 0 5300 0 16954 0 1561174 0 0 VIVIAN VON GRUENIGEN MD DIRECTOR SHS 0 447083 0 699 0 56066 0 3130 0 15357 0 522335 0 0 MICHAEL HUGHES MD DIRECTOR SHS(END 4/2016) 0 538961 0 45845 0 42076 0 7950 0 16036 0 650868 0 0 PHYLIS FERRARA PRESIDENT & CDO, SF 297988 0 121921 0 85226 0 9275 0 9747 0 524157 0 0 0 LYDIA COOK MD PRESIDENT SUMMA HEALTH MEDICAL GROUP 362816 0 23357 0 83828 0 723 0 9517 0 480241 0 0 0 BRIAN DERRICK SVP CFO, TR. SHS, ASST. TR. SF&SHMG 0 550023 0 364461 0 147084 0 6836 0 23178 0 1091582 0 0 ROBERT A GERBERRY SECRETARY/SR VP GENERAL COUNSEL 0 336156 0 145236 0 92031 0 4846 0 3076 0 581345 0 0 VALERIE GIBSON RN PRESIDENT SHS, COO 0 505440 0 186400 0 142533 0 7950 0 27611 0 869934 0 0 THOMAS P O'NEILL VP, CFO SHS, ASSISTANT TREASURER SHS 0 327112 0 109370 0 93987 0 9275 0 9309 0 549053 0 0 JASON NIEHAUS SVP HOSP. OPS & SITE ADMIN (END 7/16 0 228968 0 143379 0 45825 0 6563 0 12417 0 437152 0 0 MARY WARD SR VP CNO SHS 0 374220 0 155952 0 108643 0 7950 0 1910 0 648675 0 0 KATHLEEN JOBE CNO SHS (END 9/2016) 164862 0 39438 0 7815 0 7225 0 10044 0 229384 0 0 0 DAVID CUSTODIO MD CMO SHS 351617 0 67133 0 8037 0 9275 0 22408 0 458470 0 0 0 CYNTHIA KELLEY DO VP MED ED & CHF ACADE. OFFICER SHS 0 276202 0 0 0 6213 0 1084 0 17799 0 301298 0 0 TAMMY SCARBOROUGH COO SUMMA HEALTH MEDICAL GROUP 0 240685 0 63274 0 32955 0 6813 0 8903 0 352630 0 0 ERIK STEELE DO CMO SHS (END 6/2016) 0 332291 0 341133 0 67173 0 7950 0 11060 0 759607 0 0 MATTHEW WAYNE MD CMO SUMMA HEALTH MEDICAL GROUP 320154 0 33516 0 27449 0 3204 0 3674 0 387997 0 0 0 MARK POZSGAY DO CLINICAL PHYSICIAN - SHMG 953338 0 165217 0 1170 0 7518 0 22356 0 1149599 0 0 0 JOHN G ZOGRAFAKIS MD CLINICAL PHYSICIAN - SHMG 763761 0 135607 0 1350 0 9275 0 25531 0 935524 0 0 0 ERIC A ESPINAL MD CLINICAL PHYSICIAN - SHMG 861157 0 246857 0 450 0 2826 0 30434 0 1141724 0 0 0 ANAND B DESAI MD CLINICAL PHYSICIAN - SHMG 659013 0 292125 0 1770 0 3975 0 26419 0 983302 0 0 0 TIFFANY D MARCHAND MD CLINICAL PHYSICIAN - SHMG 613168 0 250320 0 1170 0 6677 0 9614 0 880949 0 0 0 PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: SUMMA HEALTH SYSTEM GROSSED UP TAXES FOR SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAMS PAID TO ONE DIRECTOR, EIGHT OFFICERS, AND FIVE KEY EMPLOYEES. THE AMOUNT OF THE GROSS UP IS RECOGNIZED AS ADDITIONAL TAXABLE COMPENSATION. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: SOCIAL CLUB DUES WERE PAID ON BEHALF OF ONE OFFICER. ANY PERSONAL USE IS RECOGNIZED AS ADDITIONAL TAXABLE COMPENSATION. PART I, LINE 3 ARRANGEMENTS USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: THE COMPENSATION OF THE PRESIDENT AND CEO IS ESTABLISHED BY SUMMA HEALTH, THE RELATED PARENT ORGANIZATION FOR ALL MEMBERS IN THE SUMMA HEALTH SYSTEM GROUP RETURN. SUMMA HEALTH HAS A COMPENSATION COMMITTEE THAT USES AN INDEPENDENT COMPENSATION CONSULTANT, MARKET SURVEYS, AND AN ANNUAL REVIEW PROCESS TO ESTABLISH COMPENSATION FOR THE POSITION OF PRESIDENT AND CEO. PART I, LINE 7 NON-FIXED PAYMENTS: THE SUMMA HEALTH SYSTEM MANAGEMENT INCENTIVE PROGRAM IS DESIGNED TO REWARD EMPLOYEES FOR MEETING QUALITY, PERFORMANCE AND FINANCIAL TARGETS. THESE TARGETS INCLUDE CLINICAL QUALITY, PATIENT SATISFACTION, EMPLOYEE/PHYSICIAN SATISFACTION, OPERATING MARGIN, AND THE STRENGTHENING OF THE BALANCE SHEET. PAYMENT IS BASED ON A FACTOR OF BASE COMPENSATION AND IS SUBJECT TO REVIEW AND APPROVAL BY SUMMA'S COMPENSATION COMMITTEE. FORM 990 PART VII, SECTION A, LINE 5 INFORMATION PERSON RECEIVING COMPENSATION FROM AN UNRELATED ORGANIZATION FOR SERVICES RENDERED TO THE ORGANIZATION: SUMMA HEALTH SYSTEM PAID HEALTHSPAN PARTNERS, AN UNRELATED ORGANIZATION, FOR A PORTION OF THE COMPENSATION LISTED ON FORM 990, PART VII AND SCHEDULE J, PART II, FOR LYDIA COOK. A OHIO HIGHER EDUCATIONAL FACILITY COMMISSION 346849674 67756AY89 2010-05-11 180125341 SEE PART VI 1 0 0 B AKRON BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT 341448680 2012-07-25 32509635 SEE PART VI 0 0 0 C SEE SCHEDULE K PART VI 341448680 2014-10-02 145250000 SEE PART VI 1 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 16907176 3004911 4929857 154030731 2012 1 0 1 1 B 11590681 32509635 32509635 2012 1 0 1 1 C 45985000 145250000 795890 144454110 2008 1 0 1 1 D 204934207 1874244 26625195 277015 34153268 76157754 65846732 1 1 0 1 A 0 1 1 1 1 1 0.01500 0.00100 0.01600 0 0 1 C 0 1 1 1 1 1 0.03500 0.00400 0.03900 0 0 1 D 0 1 1 1 1 1 0.04000 0.00000 0.04000 0 0 1 A 0 0 0 1 0 0 1 MORGAN STANLEY & COMPANY 2.200000000000 1 0 1 B 0 0 1 0 1 1 RBS CITIZENS BANK 12.000000000000 0 0 0 0 1 C 0 0 1 0 1 1 SEE SCHEDULE K VI 20.000000000000 0 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: OHIO HIGHER EDUCATIONAL FACILITY COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 05/11/2013 SCHEDULE K, PART I, 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 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 BONDSISSUER NAME: THE 2014 BONDS CONSIST OF THE FOLLOWING THREE SERIES OF BONDS, WHICH ARE TREATED AS A SINGLE ISSUE OF BONDS FOR FEDERAL INCOME TAX PURPOSES: (1) AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT, OHIO HOSPITAL FACILITIES REFUNDING REVENUE BONDS, SERIES 2014A (SUMMA HEALTH SYSTEM OBLIGATED GROUP) ISSUED IN THE ORIGINAL PRINCIPAL AMOUNT OF $93,685,000, (2) AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT, OHIO HOSPITAL FACILITIES REFUNDING REVENUE BONDS, SERIES 2014B (SUMMA HEALTH SYSTEM OBLIGATED GROUP) ISSUED IN THE ORIGINAL PRINCIPAL AMOUNT OF $37,890,000, AND (3) DEVELOPMENT FINANCE AUTHORITY OF SUMMIT COUNTY PORT FACILITIES REVENUE REFUNDING BONDS, SERIES 2014 (SUMMA HEALTH SYSTEM OBLIGATED GROUP PROJECT) ISSUED IN THE ORIGINAL PRINCIPAL AMOUNT OF $13,675,000. THE SERIES 2014A BONDS AND THE DEVELOPMENT FINANCE AUTHORITY BONDS WERE EACH ISSUED ON OCTOBER 2, 2014, AND THE SERIES 2014B BONDS WERE ISSUED ON NOVEMBER 18, 2014. THE AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT'S EIN IS 34-1448680, AND THE DEVELOPMENT FINANCE AUTHORITY'S EIN IS 34-1765940. SCHEDULE K, PART I, LINE C, COLUMN (F) SERIES 2014A, SERIES 2014B, AND SERIES 2014 BONDS: THE PURPOSE OF THE SERIES 2014A BONDS WAS TO CURRENTLY REFUND THE SERIES 2004B BONDS, WHICH WERE ISSUED TO (1) CONSTRUCT AND EQUIP A CRITICAL CARE PAVILION, (2) CONSTRUCT AND EQUIP OTHER HOSPITAL FACILITIES, (3) REFUND PRIOR ISSUES WITH THE FOLLOWING ISSUE DATES (A) DECEMBER 22, 1992 AND (B) JUNE 10, 1993, (4) PAY THE INITIAL COSTS OF A LIQUIDITY FACILITY, AND (5) PAY ISSUANCE COSTS. THE PURPOSES OF THE SERIES 2014B BONDS WERE TO (1) CURRENTLY REFUND THE SERIES 2004A BONDS, WHICH WERE ISSUED TO (A) CONSTRUCT AND EQUIP A CRITICAL CARE PAVILION, (B) CONSTRUCT AND EQUIP OTHER HOSPITAL FACILITIES, (C) REFUND PRIOR ISSUES WITH THE FOLLOWING ISSUE DATES (I) JULY 1, 1999, (II) JULY 28, 2000, AND (III) MARCH 12, 2002, (D) FUND A DEBT SERVICE RESERVE FOR SERIES 2004A BONDS, AND (E) PAY ISSUANCE COSTS, AND (2) FUND CAPITALIZED INTEREST ON THE SERIES 2014B BONDS. THE PURPOSE OF THE DEVELOPMENT FINANCE AUTHORITY SERIES 2014 BONDS WAS TO CURRENTLY REFUND THE SERIES 2006 BONDS, WHICH WERE ISSUED TO (1) ACQUIRE A PROJECT SITE FOR AND CONSTRUCT AND EQUIP A WELLNESS INSTITUTE, AND (2) TO PAY ISSUANCE COSTS. SCHEDULE K, PART I, LINE D, COLUMN (F) AKRON, BATH AND COPLEY JOINT TOWNSHIP HOSPITAL DISTRICT SERIES 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, COL. (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 IV, COLUMN C, LINE 4B NAME OF HEDGE PROVIDER - COLUMN C: 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 - COLUMN C: THE TERM OF THE HEDGE WITH GOLDMAN SACHS BANK USA IS 20 YEARS. THE TERM OF THE HEDGE WITH PNC BANK, NATIONAL ASSOCIATION IS 30 YEARS. SCHEDULE K, PART IV, COLUMN A, LINE 2C REBATE CALCULATION: THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 05/11/2013. CYNTHIA BROWNING FAMILY MEMBER OF NICHOLAS BROWNING, SUMMA HEALTH BOARD MEMBER. 18310 EMPLOYMENT 0 X 3 357001 MARKET VALUE X 1 10311 REPLACEMENT COST X EVENTS 3 6736 REPLACEMENT COST X EQUIPMENT 1 500 REPLACEMENT COST 0 1 0 PART I, COLUMN (B): EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS: SECURITIES - PUBLICALLY TRADED: NUMBER OF CONTRIBUTIONS DRUGS AND MEDICAL SUPPLIES: NUMBER OF CONTRIBUTIONS OTHER: NUMBER OF CONTRIBUTIONS INVESTMENTS, CONTRIBUTION RECEIVABLES, OTHER RECEIVABLES, LAND IMPROVEMENTS, AND BUILDINGS. 2017-10-01 86990952 BOOK VALUE 341887844 SUMMA HEALTH 1077 GORGE BLVD AKRON OH 44309 501(C)(3) 0 0 0 0 SCHEDULE N, PART II SIGNIFICANT DISPOSITION OF ASSETS: SUMMA FOUNDATION, EIN 34-1219001, A MEMBER OF THE SUMMA HEALTH GROUP RETURN, TRANSFERED ASSETS TO SUMMA HEALTH, EIN 34-1887844, THE PARENT ORGANIZATION. 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") - 13 - 8 SUMMA FOUNDATION ("SF") - 25 - 23 SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP ("SHMG") - 3 - 2 TOTALS FOR GROUP RETURN - 41 - 33 ALL OF THE ORGANIZATIONS LISTED ABOVE ARE SUBORDINATES UNDER THE CONTROL OF SUMMA HEALTH ("SH"). AS OF DECEMBER 31, 2016, SH HAD 13 VOTING DIRECTORS, 8 OF WHOM WERE INDEPENDENT VOTING DIRECTORS. FORM 990, PART VI, SECTION A, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS: SUMMA HEALTH SYSTEM: RICHARD MARSH, LEILA VESPOLI, AND ANTHONY LOCKHART - BUSINESS RELATIONSHIP LYDIA COOK, M.D., DAVID CUSTODIO, M.D., 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., VIVIAN VON GRUENIGAN, M.D., AND MATTHEW WAYNE, 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., DAVID CUSTODIO, M.D., AND TAMMY SCARBOROUGH - BUSINESS RELATIONSHIP SUMMA FOUNDATION: SAMIR GIBARA AND SCOTT HONNOLD - BUSINESS RELATIONSHIP GEORGE DAVERIO, JR. AND C. GORDON EWERS - BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 4 THE CODE OF REGULATIONS OF SUMMA FOUNDATION WAS AMENDED AS FOLLOWS: THE MEMBER OF SUMMA FOUNDATION WAS CHANGED FROM SUMMA HEALTH SYSTEM TO SUMMA HEALTH. THE LIST OF MATTERS WHICH MUST BE SUBMITTED TO, AND RECEIVE THE APPROVAL OF BOTH THE BOARD OF DIRECTORS AND THE MEMBER WAS AMENDED TO BE THOSE MATTERS DESCRIBED AS "RESERVED POWERS WITH RESPECT TO SUBSIDIARY CORPORATIONS" IN THE CODE OF REGULATIONS OF THE MEMBER. THE PRESIDENT OF SUMMA FOUNDATION WAS DESIGNATED A SPECIAL VOTING DIRECTOR OF THE BOARD OF DIRECTORS OF SUMMA FOUNDATION. THE QUORUM DEFINITION WAS CHANGED TO BE A MAJORITY OF THE CURRENT DIRECTORS. THE COMPOSITION OF THE EXECUTIVE COMMITTEE WAS CHANGED TO BE THE CHAIR, VICE-CHAIR, AND THREE (3) OTHER DIRECTORS. THE BOARD OF THE FOUNDATION AUTHORIZED AND DIRECTED THE TRANSFER OF THE LONG TERM INVESTMENTS OF SUMMA FOUNDATION TO SUMMA HEALTH. 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 SERVES AS A DIRECTOR 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 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. 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, EMPLOYED PHYSICIANS, CONTRACTED PHYSICIANS, ADMINISTRATIVE DIRECTORS, EXECUTIVE DIRECTORS, DEPARTMENT HEADS, MANAGERS, SUPERVISORS, AND MEMBERS OF PURCHASING COMMITTEES FOR COMPLETION. RESPONSES ARE INDIVIDUALLY REVIEWED FOR DETERMINATION OF POTENTIAL CONFLICTS. THOSE RESPONSES DEEMED TO PRESENT POTENTIAL CONFLICTS ARE THEN PRESENTED TO THE GOVERNANCE COMMITTEE (SUB-COMMITTEE OF THE SUMMA HEALTH BOARD OF DIRECTORS). THE GOVERNANCE COMMITTEE REVIEWS EACH RESPONSE THAT PRESENTS A POTENTIAL CONFLICT AND DETERMINES WHETHER ADDITIONAL ACTION IS REQUIRED TO ELIMINATE OR MITIGATE THE POTENTIAL CONFLICT. THIS ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE PROCESS IS MANAGED BY THE CORPORATE COMPLIANCE DEPARTMENT PURSUANT TO THE SUMMA HEALTH POLICY ON CONFLICT OF INTEREST AS APPROVED BY THE SUMMA HEALTH BOARD OF DIRECTORS. IN ADDITION TO THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, THE CONFLICT OF INTEREST POLICY IMPOSES A DUTY TO DISCLOSE CONFLICTING INTERESTS ON AN ONGOING BASIS. FORM 990, PART VI, SECTION B, LINE 15 PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL AND OTHER EMPLOYEES: EXECUTIVE COMPENSATION: THE COMPENSATION COMMITTEE OF THE SUMMA HEALTH BOARD OF DIRECTORS MEETS AT LEAST TWICE EACH YEAR TO REVIEW AND APPROVE BASE COMPENSATION AND TOTAL REMUNERATION FOR EXECUTIVE STAFF. EACH VOTING MEMBER OF THE COMPENSATION COMMITTEE IS AN INDEPENDENT DIRECTOR AND IS NOT AFFILIATED WITH MANAGEMENT. THE COMPENSATION COMMITTEE ENGAGES OUTSIDE CONSULTING SUPPORT TO PROVIDE INDEPENDENT MARKET DATA, ADVICE AND COUNSEL TO THE COMPENSATION COMMITTEE. FOR THE PAST SIX YEARS, THE COMPENSATION COMMITTEE HAS USED HAY GROUP, A NATIONALLY RECOGNIZED CONSULTING FIRM, TO ASSIST THEIR EFFORTS. THE HAY GROUP PROVIDES THE FOLLOWING SERVICES TO THE COMPENSATION COMMITTEE: (A) EDUCATION OF COMMITTEE MEMBERS REGARDING EXECUTIVE COMPENSATION TRENDS AND BEST PRACTICES IN HEALTHCARE ORGANIZATIONS; (B) ASSESSMENT OF THE MARKET COMPETITIVENESS AND REASONABLENESS OF SUMMA'S EXECUTIVE COMPENSATION PROGRAMS INCLUDING BASE SALARY, INCENTIVE COMPENSATION, CORE AND EXECUTIVE BENEFITS, AS WELL AS THEIR ALIGNMENT WITH THE MISSION AND FUTURE PERFORMANCE EXPECTATIONS; (C) WRITTEN, DETAILED EVALUATION OF THE MARKET REASONABLENESS OF SUMMA'S EXECUTIVE COMPENSATION AND BENEFITS PROGRAM; AND (D) ONGOING SUPPORT AND INDEPENDENT ADVICE TO THE COMPENSATION COMMITTEE ON MATTERS RELATED TO EXECUTIVE COMPENSATION. 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 SUMMA HEALTH SYSTEM: PRESIDENT 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 XI, LINE 9: PENSION LIABILITY ADJUSTMENT 2,526,000. POST RETIREMENT BENEFIT ADJUSTMENT -169,000. NET ASSETS RELEASED FROM RESTRICTION 288,000. NET ASSET CONTRIBUTION TO(FROM) AFFILIATED ORGANIZATION -103,344,606. OTHER CHANGES IN NET ASSETS 9,000. RESTRICTED ACTIVITY REPORTED 864,364. CHANGE IN TEMPORARILY RESTRICTED NET ASSETS -1,165,000. CHANGE IN PERMANENTLY RESTRICTED NET ASSETS 10,996. OTHER CHANGES IN NET ASSETS - ADJUSTMENTS -5,257. PART XII, LINE 2C THE ORGANIZATION HAS NOT CHANGED EITHER ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. 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