2014-11-11T08:42:56-06:00 2013-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 4000 INDIANAPOLIS IN 46204 990 2013-01-01 900640432 Summa Health System Group Return % BRIAN K DERRICK SUMM 3303753196 525 East Market Street Suite Akron OH 443041619 Brian K Derrick CFO 3303753196 2014-11-06 true Jennifer D Rhoderick P00395735 3303753196 2013 2015-11-30 17:44:51Z Thomas J Strauss 525 East Market Street Akron OH 44304 1326232013 true true 5864 X www.summahealth.org X Summa Health System and its related organizations' mission is to provide the highest quality,compassionate care to patients and members and contribute to a healthier community. X 78 44 8712 807 10060672 3918418 6541029 8800411 1107704787 1101296459 21233432 13934346 14763435 19701542 1150242683 1143732758 286406 260359 0 0 513798749 488396107 0 0 1788976 593269146 600542226 1107354301 1089198692 42888382 54534066 1193991987 1221959811 727643905 636147164 466348082 585812647 X SUMMA HEALTH SYSTEM'S MISSION IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO PATIENTS AND MEMBERS AND CONTRIBUTE TO A HEALTHIER COMMUNITY. false false 346049828 0 437836567 Inpatient Services - For 2013, Summa Akron City & St. Thomas Hospitals (SACSTH), Summa Barberton Citizens Hospital (SBH) and The Wadsworth-Rittman Area Hospital Association (WRH) had 790 beds in service, admitted 42,187 adult patients and delivered 3,771 newborns. The adult patients received 201,431 days of care, inpatient surgeries total 7,233, emergency admits totaled 30,232 and the average length of stay was 4.77 days. 478704295 0 605676490 Outpatient Services - In 2013, Summa Akron City & St. Thomas Hospitals, Summa Barberton Citizens Hospital, The Wadsworth-Rittman Area Hospital Association and Summa Physicians, Inc. provided 1,541,061 occasions of service, including 145,671 emergency room visits, 16,228 surgical operations, and 1,379,162 other outpatient visits. 38983039 0 13581713 Research/Education - Summa Health System 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 System fosters a learning environment for the next generation of caregivers. At three of Summa Health System's hospitals, over 200 medical schools graduates train in 17 accredited residency training programs. Summa Health System provides clinical learning experiences to more than 250 nursing and allied health students. 34935380 260359 44201689 898672542 true true false true false false false false true true true false false true true true false true false false true false false false true false true true true true true true false false false false false false false false true true true false true false true true true true false true true X 768 0 true 8712 true true true false false false false true true false false false false false X 78 44 true false true false true true true true true false false true true true true true false true true true true FL OH X X BRIAN K DERRICK 3303753196 525 EAST MARKET STREET Akron OH 44304 John Adams Director SF 2.0 0.0 X 0 0 0 Karen Ayers DO Director SBH (end 9/13) 2.0 0.0 X 0 0 0 Michael Bage MD Director SACSTH (end 9/13) 48.0 2.0 X 502517 0 15755 Susan Baker Director SACSTH, SBH, WRH 2.0 0.0 X 0 0 0 Danielle Barran Director SF 2.0 0.0 X 0 0 0 William Bauman MD Director SACSTH, SBH, WRH, SPI 50.0 0.0 X 615922 0 15856 Julia Bianchi Director SF 2.0 0.0 X 0 0 0 Michael Bianco MD Director WRH (end 9/13) 2.0 0.0 X 0 0 0 James Biggar Dir/Treas SACSTH (end 9/13) 2.0 0.0 X X 0 0 0 Michelle Blanda MD Director SACSTH (end 9/13) 2.0 0.0 X 0 0 0 Nicholas Browning Director SACSTH (end 9/13) 2.0 2.0 X 0 0 0 Jason Butterworth Director SF 2.0 0.0 X 0 0 0 Candace Campbell-Jackson Director SACSTH, SBH, WRH 2.0 0.0 X 0 0 0 Dennis Chack Director SACSTH (end 1/13) 2.0 0.0 X 0 0 0 Douglas Chonko DO Director CFGH (end 12/13) 2.0 0.0 X 0 0 0 Thomas Clark Director/Chair SF 4.0 0.0 X X 0 0 0 Jacob Cohen MD Director SACSTH (end 9/13) 2.0 0.0 X 0 0 0 Norman Crocker MD Director WRH (end 9/13) 2.0 0.0 X 2400 0 0 George Daverio Director SF 2.0 0.0 X 0 0 0 Robert Debski MD Director SACSTH, SBH, WRH 50.0 0.0 X 275450 0 8969 David Dellinger DO Director CFGH (end 12/13) 2.0 0.0 X 0 0 0 Dennis Dick Dir/Treas CFGH (end 12/13) 2.0 0.0 X X 0 0 0 Vince DiGirolamo Dir SACSTH, Dir/Treas SF (9/13 4.0 2.0 X 0 0 0 R James Dom Dera MD Director SACSTH, SBH, WRH 2.0 12.0 X 2700 53000 0 C Gordon Ewers Director SF 2.0 0.0 X 0 0 0 Edward Ferris MD Director SACSTH (end 9/13) 2.0 0.0 X 0 0 0 Daniel Figliola Director CFGH (end 12/13) 2.0 0.0 X 0 0 0 Daniel Finelli MD Dir/Vice Chr SACSTH, SBH, WRH 4.0 2.0 X X 0 0 0 Jason Fried DO Director CFGH (end 12/13) 2.0 0.0 X 0 0 0 Steven Gaich MD Director SPI 50.0 0.0 X 323915 0 10260 Samir Gibara Director SF 2.0 0.0 X 0 0 0 Mark Goldfarb Director SF 2.0 0.0 X 0 0 0 Eric Graf Dir/Secty/Treas WRH (end 9/13) 2.0 0.0 X X 0 0 0 Russell Gregory Dir/Vice Chr SACSTH, SBH, WRH 2.0 2.0 X X 0 0 0 Stephen Hailer Director/Chair CFGH (end 12/13 4.0 2.0 X X 0 0 0 Thomas Harnden Director/Chair SBH (9/13) 4.0 2.0 X X 0 0 0 Robert Harrigan Dir SACSTH & COO (end 9/13) 46.0 4.0 X X 0 1050809 83645 Iris Harvey Director SF 2.0 0.0 X 0 0 0 Robert Hemphill MD Director SF 2.0 0.0 X 0 0 0 Scott Honnold Director SF 2.0 0.0 X 0 0 0 Thomas Hudson Director WRH (end 9/13) 2.0 0.0 X 0 0 0 Rodney Ison MD Director SBH (end 9/13) 2.0 0.0 X 18830 18000 0 Mary Ann Jackson Director SF 2.0 0.0 X 0 0 0 Philip Kaufmann Director SF 2.0 0.0 X 0 0 0 James Kennedy MD Director SBH (end 9/13) 2.0 0.0 X 0 0 0 Phillip Khalil DO Director CFGH (end 12/13) 2.0 0.0 X 0 0 0 A Gus Kious MD Director/Pres SPI (end 12/13) 50.0 0.0 X X 331767 0 17006 Thomas Knoll Dir/Chair SACSTH, SBH, WRH 4.0 46.0 X X 0 123662 0 Joseph Koenig MD Director SPI 50.0 0.0 X 771014 0 17405 James Kraynak Dir/Vice Chr CFGH (end 12/13) 2.0 0.0 X X 0 0 0 Mark Krohn Director SF 2.0 0.0 X 0 0 0 Dennis Liddle Dir/Secty/Treas SBH (end 9/13) 2.0 0.0 X X 0 0 0 David Lieberth Director SACSTH, SBH, WRH 2.0 2.0 X 0 0 0 Dina Lloyd Dir/Vice Chr SBH (end 9/13) 2.0 0.0 X X 0 0 0 Anthony Lockhart Dir/Chair SACSTH (end 9/13) 4.0 4.0 X X 0 0 0 Hitesh Makkar MD Director SACSTH, SBH, WRH 2.0 0.0 X 40678 0 0 Joseph McShannic MD Director SACSTH (end 9/13) 50.0 0.0 X 532139 0 21232 Dale Murphy MD Director SPI 46.0 4.0 X 0 478498 40145 Vivian Celeste Neal Dir SACSTH, SBH, WRH, SF 2.0 0.0 X 0 0 0 Joseph Nienaltowski DO Director CFGH (end 12/13) 2.0 2.0 X 0 0 0 Thomas ONeill Director SPI, CFO SACSTH 46.0 4.0 X X 0 409249 34443 Charles Parsons Director SACSTH, SBH, WRH 2.0 0.0 X 0 0 0 Martin Paul Director SACSTH, SBH, WRH 2.0 0.0 X 0 0 0 Jonathon Pavloff Director SF 2.0 0.0 X 0 0 0 Mark Pluskota MD Director SBH (end 9/13) 2.0 0.0 X 0 0 0 William Powel III Director SPI, System Secty 4.0 46.0 X X 0 575932 61741 Dwight Powers Director WRH (end 9/13) 2.0 0.0 X 0 0 0 Kathleen Raynor Director SF 2.0 0.0 X 0 0 0 Froncie Repetti Director SACSTH (end 9/13) 2.0 0.0 X 0 0 0 Ronald Russ DO Director CFGH (end 12/13) 2.0 0.0 X 0 0 0 Mona Sarkar Director/Secty SF 2.0 0.0 X X 0 0 0 Robert Schaal MD Director SACSTH (end 9/13) 2.0 2.0 X 0 0 0 Anthony Solaro Director WRH (end 9/13) 2.0 0.0 X 0 0 0 Erik Steele DO Director SACSTH, SBH, WRH 46.0 4.0 X 0 349981 2606 Thomas Strauss Dir SF, System Pres/CEO 4.0 46.0 X X 0 1273746 108510 George Strickler Director SF 2.0 0.0 X 0 0 0 Vicki Sussman Director WRH (end 9/13) 2.0 0.0 X 0 0 0 Susan Taft Director SACSTH, SBH, WRH 2.0 0.0 X 0 0 0 Terry Taylor Director SBH (end 9/13) 2.0 0.0 X 0 0 0 Paul Testa Director SF 2.0 0.0 X 0 0 0 Douglas Trochelman MD Director SACSTH (end 9/13) 46.0 4.0 X 766450 0 16124 Susan Ullman Dir/Vice Chr WRH (end 9/13) 2.0 0.0 X X 0 0 0 Sharon VanNostran DO Director SACSTH (end 9/13) 2.0 0.0 X 0 0 0 Joseph Varley MD Director SACSTH (end 9/13) 50.0 0.0 X 363845 0 19233 Norman Wells Director CFGH (end 12/13) 2.0 4.0 X 0 0 0 Scott Weiner MD Director SACSTH, SBH, WRH 50.0 0.0 X 891150 0 18228 Darrell Widmer MD Director WRH (end 9/13) 50.0 0.0 X 200641 0 7202 Stephen Wilt Director/Vice Chr SF 2.0 0.0 X X 0 0 0 Charles Alderson CFO, SBH & WRH 50.0 0.0 X 205935 0 11072 Thomas DeBord President SBH & WRH 50.0 0.0 X 316075 0 39646 Brian Derrick System CFO 4.0 46.0 X 0 797298 40264 Phylis Ferrara President/CDO, SF 50.0 0.0 X 198223 0 1101 Bryan Fredericks COO, SPI 50.0 0.0 X 280819 0 12648 Kathleen Jobe Chief Nursing Officer, SBH 50.0 0.0 X 196356 0 10098 Thomas Malone MD President SACSTH 46.0 4.0 X 0 166020 812 Steve Schmidt COO, SF 50.0 0.0 X 259262 0 34616 Shane Seymour CDO, SF (end 6/13) 50.0 0.0 X 0 168598 4089 Adrian Dan MD HCE - Bariatric Surgery 50.0 0.0 X 849180 0 16209 John Zografakis MD HCE - Bariatric Surgery 50.0 0.0 X 806782 0 18040 Joel Porter MD HCE - Colorectal Surgery 50.0 0.0 X 799610 0 11284 Eric Miller MD HCE - Orthopaedic Surgery 50.0 0.0 X 764460 0 9225 Mehool Patel MD HCE - Oncology, Hematology 50.0 0.0 X 709135 0 6649 Jay Williamson MD Former President, SPI 50.0 0.0 X 219314 0 10961 11244569 5464793 725074 420 true true false Professional Anesthesia Service 190 North Union Street AKRON OH 44304 Medical services 8725263 Siemens Medical Solutions 51 Valley Stream Parkway MALVERN PA 19355 Contract services 5767737 Sodexo Inc Affiliates 10 Earhart Drive WILLIAMSVILLE NY 14221 Catering services 5034256 Allscripts Healthcare LLC Three Ravinia Drive ATLANTA GA 30346 IT & EMR Services 4976234 Akron Radiology Inc 525 East Market Street AKRON OH 44304 Medical Services 3309425 45 1052375 212252 1102000 6433784 104909 8800411 NET PATIENT REVENUE 621110 1044128075 1044024191 103884 PROGRAM RELATED INVESTMENTS 900099 22241190 21884264 356926 MEDICAL EDUCATION 611600 12188317 12188317 REFERENCE LAB 621500 8766906 8766906 ARRA MEANINGFUL USE 900099 7925431 7925431 6046540 5778641 267899 1101296459 9352825 30985 9321840 26717 26717 0 12507565 308103 7758858 64340 4748707 243763 4992470 -29494 5021964 177106901 1608802 172947391 1213508 4159510 395294 4554804 331926 4222878 156431 1052375 515158 -358727 -358727 0 0 CAFETERIA SALES 721210 5558245 231640 5326605 PARKING 812930 1587215 1587215 GIFT/FLOWER SHOP 453220 1010216 1010216 6912123 6912123 15067799 1143732758 1091800844 10060672 33070831 X 228377 228377 31982 31982 0 0 7602813 6542854 1059959 526079 526079 0 393389512 329124429 63157370 1107713 5545783 4652912 892871 55882280 46669864 8955719 256697 25449640 21352248 4097392 2880484 2416726 463758 91036 0 91036 338457 0 338457 252047 0 252047 0 16188 0 16188 215748725 141831697 73736717 180311 593051 481147 92330 19574 30465580 25458927 4885443 121210 19856803 16629286 3191080 36437 0 19674079 16506553 3167526 1469111 1210152 232222 26737 0 2162591 1808616 347065 6910 13493340 13493340 0 40900564 34315573 6584991 8404586 7051448 1353138 MEDICAL SUPPLIES 134872984 134872984 BAD DEBT PROVISION 89167141 89167141 STATE FRANCHISE FEE 12039765 12039765 TAX EXPENSE 1224403 1224403 6891291 5753782 1104122 33387 1089198692 898672542 188737174 1788976 1802242 60183 170463959 190532021 5664789 6995713 162255507 175269983 0 0 0 0 23595042 24277038 13552762 10793973 10389016 9388108 1117235348 690351299 455914691 426884049 203858864 270068608 5214254 9386412 20436783 30770383 2579662 2462688 118264416 65070652 1193991987 1221959811 171468917 79128980 919847 0 2615753 2374731 350982844 343097418 4614 0 0 0 18985571 17859615 0 0 182666359 193686420 727643905 636147164 X 426876312 538731106 22365155 29111026 17106615 17970515 466348082 585812647 1193991987 1221959811 X 54534066 9592823 55337676 X false true X true true true X X false false false SUMMA AKRON CITY AND ST THOMAS HOSPITALS 340714755 03 true 845165 SUMMA BARBERTON CITIZENS HOSPITAL 261375072 03 true 100000 CUYAHOGA FALLS GENERAL HOSPITAL 340718383 09 true 0 THE WADSWORTH-RITTMAN AREA HOSPITAL ASSN 346549371 03 true 0 4 945165 4540510 6941569 5638036 5122826 7808474 30051415 0 0 4540510 6941569 5638036 5122826 7808474 30051415 754159 29297256 1527282 1494312 1752613 1814584 1047164 7635955 0 0 37687370 7669714 0.77738 0.75437 X Part III - Support Schedule for 509(A)(2) Organization Cuyahoga Falls General Hospital ("CFGH") is a public charity organization under section 509(A)(2). Due to software limitations, Schedule A Part III for CFGH could not be completed. (Schedule A Part II is completed for Summa Foundation). Based on the Public Support Test under Part III, the public support percentage for 2013 for CFGH which should be shown in Section C, Line 15, is 69.21%. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true true 12340 true 80 true 500 true 24800 true 211827 true 2500 false 252047 false Part II-B, Line 1 In 2013, Summa Health System board members, management, physicians and staff interacted with public sector leadership to influence select health policy and funding priorities. On a federal level, Summa leadership partnered with federal delegation members and staff on issues pertaining to the sustainable growth rate, graduate medical education, Medicare payments, and insurance reform. Summa also devoted a greater percentage of its advocacy resources to advance the Medicaid expansion issue within Ohio. Summa staff also interacted with state legislators and staff on issues related to insurance reform, workforce development, Medicaid payments and reform, and the Ohio capital bill. Part II-B, Line 1(f) The amount on Line 1(f) represents the portion of annual dues to organizations such as AHA and OHA allocable to lobbying activities. false true X 16730854 70706 762707 17564267 15896470 347618 486766 16730854 15633841 113108 149521 15896470 13145135 2481325 7380 15633840 13311624 -183166 16677 13145135 1.00000 false false 68801142 68801142 602732665 367376640 235356025 3792595 1677673 2114922 414956421 304727591 110228830 26952525 16569395 10383130 426884049 MALPRACTICE FUND 14612401 BONDS ASSURED GUARANTY 4331974 BOND ISSUE COSTS 1861929 BENEFICAL INTEREST IN WRHF 934010 DEFERRED PENSION & COMP 273152 NON-PERF ASSET AIR RIGHTS 1124370 BENEFICAL INTEREST IN PERP. TR 5002300 DUE FROM RELATED ORGANIZATIONS 33919214 OTHER ACCOUNTS RECEIVABLE 108536 BENEFICAL INTEREST IN PROPERTY 2902766 65070652 0 LEASE ESCALATION LIABILITY 628566 CAPITAL LEASE OBILIGATIONS 58100778 ASSET RETIREMENT OBLIGATION FI 2408284 INTEREST RATE SWAP 5819572 POST RETIREMENT BENEFITS 1293340 CONTINGENT LIABILITIES 2583856 MALPRACTICE LIABILITY 14411030 UNSECURED PAYABLES 101975263 PURCHASE OPTION LIABILITY 4698787 OTHER OBLIGATIONS 1766944 193686420 X Part IV, Line 2B Custodial funds held by Summa Foundation on behalf of Cuyahoga Falls General Hospital Foundation. Part V, Line 4 Endowment funds provide income to be used to fulfill the tax-exempt purposes of Summa Foundation. Part X, Line 2, FIN 48 Footnote: The System 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. Summa Insurance Company ("SIC"), 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. SIC is not subject to state income taxes as 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 on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The System recognizes interest income, interest expense, and penalties related to uncertain tax positions with the provision for income tax. Central America and the Caribbean Program Services Self Insurance 11195331 11195331 11195331 true false true false false false Part I, Line 3(1), Col. F Insurance premiums paid $11,195,331 Sapphire Ball 895740 780430 115310 0 0 145795 114172 98572 49544 Golf Outing 240400 206410 33990 0 4524 48435 23427 4900 9966 1 72666 65535 7131 0 0 7734 1715 0 6374 1208806 1052375 156431 0 4524 201964 139314 103472 65884 515158 -358727 true true X true X true X true true true false true true 22673393 7074188 15599205 0.01430 129094267 105829555 23264712 0.02130 151767660 112903743 38863917 0.03560 1253825 10400 1243425 0.00110 33020952 13915467 19105485 0.01750 26414921 0 26414921 0.02420 6502710 1393396 5109314 0.00470 2318996 0 2318996 0.00210 69511404 15319263 54192141 0.04960 221279064 128223006 93056058 0.08520 7380 0 7380 8491 0 8491 57940 0 57940 0.00010 73811 0 73811 0.00010 true 22326352 0 406906959 394190262 12716697 X true true Crystal Clinic Ortho Orthopaedic Service 0.49650 0.50350 Summa Western Reserv General Hospital 0.40000 0.60000 Ohio Sleep Disorders Sleep Medicine 0.66670 0.33330 Digestive Health Ctr Digestive Disease 0.05000 0.44000 Medina-Summit ASC Ambulatory Surgery Center 0.20000 0.70000 6 1 Summa Akron City & St Thomas Hospital 525 East Market Street Akron OH 44304 www.summahealth.org X X X X X 1 2 Summa Barberton Citizens Hospital 155 Fifth Street NE Barberton OH 44203 www.summahealth.org X X X X X 1 3 The Wadsworth-Rittman Area Hospital 195 Wadsworth Road Wadsworth OH 44281 www.summahealth.org X X X X 1 4 Summa Western Reserve Hospital LLC 1900 23rd Street Cuyahoga Falls OH 44223 www.westernreservehospital.org X X X X 1 5 Crystal Clinic Orthopaedic Center LLC 444 North Main Street Akron OH 44310 www.crystalclinic.com X X X 2 6 Summa Rehab Hospital LLC 29 North Adams Street Akron OH 44304 www.summarehabhospital.com X X Rehabilitation 2 Group 1 true X X X X X X X X X 13 true true true X www.summahealth.org (see Part V for URL) X X X X X X X X X false false true true 200. true 400. true X X X X X X false true X X X X X X true false X X X X true X false false Group 2 true X X X X X X X X X 13 true true true X www.summahealth.org (see Part V for URL) X X X X X X X X X false false true true 200. true 400. true X X X X X X false true X X X X true false X X X X false X X false false Part V, Section B, Line 3 (GROUPS 1 & 2) In conducting its 2013 Community Health Needs Assessment, the facilities took into account input from persons who represent the community by interviewing community leaders, including those with specialized knowledge in the area of public health, and by conducting focus groups with residents in the community to solicit their views of the significant health needs of the community. A list of the persons interviewed, by organization and title, can be found on page 13 of the CHNA report available at the URL http://www.summahealth.org/about-us/about-summa/community-benefit-and-dive rsity/communityneedsassessment2013. Part V, Section B, Line 4 (GROUPS 1 & 2) Summa Health System conducted the CHNA on behalf of each of its six hospital facilities listed in Part V, Section A. In addition, Summa Health System collaborated with Akron General Health System and Akron Children's Hospital in conducting the CHNA. Part V, Section B, Line 7 (GROUPS 1 & 2) Most of the health needs identified in the CHNA report are addressed in the various implementation strategies by one or more of the hospital facilities listed in Part V, Section A. Not all facilities are addressing all of the needs. A specific list of the needs being addressed by each hospital on a facility-by-facility basis is available in Summa Health System's Implementation Strategy available on at the URL http://www.summahealth.org/about-us/about-summa/community-benefit-and-dive rsity/communityneedsassessment2013. Needs identified in the CHNA but not addressed by any of the hospital facilities listed in Part V, Section A include: obtaining healthy foods, childhood chronic disease, child development, child lifestyle risk factors, child mental health and substance abuse, child safety, child access to care, and child environmental risk factors. Obtaining healthy foods was not addressed by the hospital facilities due to the other community resources available, including the Akron Canton Regional Food Bank. Similarly, due to other community resources available to assist children, specifically Akron Children's Hospital, the aforementioned health needs relating to children were not addressed by the hospital facilities. Part V, Section B, Line 14(g) (GROUP 1) In addition to the measures indicated, Summa's hospitals also provide a description of the Financial Assistance Policy in the Patient Handbook, which is provided to all patients upon admission into the hospital facility. Also see Schedule H, Part VI, Line 3 for more information. Part V, Section B, Line 19 (GROUP 2) The hospital facilities in reporting Group 2 are specialty hospital facilities and do not have emergency departments. Each facility is located in close proximity to the hospital facilities in reporting Group 1 where emergency patients are treated. 20 Summa Health Center at Lake Medina 3780 Medina Road Medina OH 44256 Lab, imaging, therapy, sleep medicine, radiation oncology & outpatient surgery Summa Health Center at Green 3838 Massillon Road Green OH 44685 Lab, imaging, rehabilitation, therapy & other health service Summa Health Center at White Pond 1 Park West Suite 130 Akron OH 44320 Lab, imaging, and other specialty health programs Summa Health Center at Western Reserve 5655 Hudson Drive Hudson OH 44236 Lab, imaging, rehabilitation, wound care & sports medicine Summa Health Center at Lake Anna 500 West Hopocan Avenue Barberton OH 44203 Therapy, rehabilitation and sports medicine Summa Health Center at Anna Dean 28 Conservatory Drive Barberton OH 44203 Outpatient rehab and therapy Summa Health Center at Cuyahoga Falls 1860 State Road Cuyahoga Falls OH 44223 Lab and imaging services Summa Wellness Institute 5625 Hudson Drive Hudson OH 44236 Medical-based fitness programs rehabilitation & therapy Summa Services - Wadsworth Community Ctr 621 School Drive Wadsworth OH 44281 Imaging, rehabilitation and orthopaedic sports medicine Summa Neurosciences at White Pond 750 White Pond Drive Akron OH 44320 Neurology services Summa Sleep Medicine Center - Green 1700 Boettler Road Ste 215 Uniontown OH 44685 Sleep and neurology services Summa Rehabilitation Svcs at White Pond 750 White Pond Drive Akron OH 44320 Occupational & rehab services Natatorium Rehabilitation and Wellness 2345 4th Street Cuyahoga Falls OH 44223 Orthopaedic & sports therapy Summa Rehab at Tallmadge Rec Center 46 North Munroe Tallmadge OH 44278 Physical therapy and sports health Summa Urgent Care & Corporate Health 2875 West Market Street Fairlawn OH 44333 Urgent care & corporate health Summa Urgent Care at Stow 3913 Darrow Road Ste 100 Stow OH 44224 Urgent care & occupational health services Cedar Pines 185 West Cedar Street Ste 100 Akron OH 44307 Cardiology & stress tests Ignatia Hall South 3730 Whipple Avenue Ste 5 Canton OH 44718 Outpatient addiction medicine Summa Home Infusion 2743 Gilchrist Road Ste 200 Akron OH 44305 Home care & infusion services Summa Ctr for Health Equity-New Seasons 1493 S Hawkins Avenue Akron OH 44320 Chronic disease management, health, nutrition, exercise & education services Part I, Line 7, Column (f) Total bad debt expense included on Form 990, Part IX, line 25, column (a) but subtracted for purposes of calculating the percentage on Part I, Line 7, Column (f) is $89,167,141. Part I, Line 7(g) The amount of subsidized health services reported on Line 7(g) attributable to Summa Physicians, Inc. ("SPI") is $13,504,563. Part III, Lines 2 & 4 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 15 of the attached consolidated Audited Financial Statements under footnote 2, "Accounting Policies". Part III, Line 8 Medicare allowable costs 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 System is not reported as a community benefit. Part III, Line 9(b) 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. The hospital reserves the right to place a lien on the patient's (guarantor's) real estate; however, the hospital will not execute foreclosure proceedings if this is the patient's (guarantor's) primary residence. Part VI, Line 2 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 System, Summit County Public Health, Healthy Connections Network, Children's Hospital Medical Center of Akron, the United Way, Social Services Advisory Board of Summit County, and Akron General Medical Center. Part VI, Line 3 In accordance with the rules set forth by Ohio Administrative Code Section 5101:3-2-07.17 Notices, Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizens Hospital, The Wadsworth-Rittman Area Hospital Association, and Summa Western Reserve Hospital, LLC have notices posted in the emergency room, admission areas, cashier's office, and other appropriate areas. The notices specify the rights of individuals to receive without charge, basic medically necessary hospital-level services. A financial counselor who is assigned to patients at the point of admission reviews the availablity 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 Summa Health System has care delivery sites in three counties in Northeast Ohio: Summit, Portage and Medina. Based on the 2010 Census, these counties constitute a population of approximately 854,000 individuals. Summit County has the largest population (547,000) and accounts for more than 60% of the persons served by Summa. Medina (150,000) and Portage (158,000) Counties have similar populations, with Portage being slightly larger. Each accounts for less than 20% of the persons served by Summa. More than 50% of households in Summit and Portage Counties make less than $50,000 dollars annually and 15.0% and 14.5% of households make less than $15,000 dollars annually respectively. For the calendar year 2013, the average monthly unemployment rates for Medina, Portage, and Summit Counties were 6.5%, 7.2%, and 7.2% 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 in Summit County is expected to decline (by -1.2%), the population in Portage is expected to remain flat, and Medina is projected to see growth (1.4%) over the 5-year period 2013 to 2018. More importantly, the age group that demand healthcare services the most (age 65 and older) is expected to grow significantly. In Medina County alone, this group is expected to increase 18.2%, while Portage and Summit are expected to grow 16.0% and 11.8% respectively over the five year period. Part VI, Line 5 Among the ways the hospitals within Summa Health System promote the health of the community are by maintaining an open medical staff and a community board (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 System serves. Part VI, Line 6 Summa Health System 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 System is renowned for excellence in patient care and for exceptional approaches to healthcare delivery. Summa Health System represents more than 1,700 registered inpatient beds. In addition, outpatient care is extended throughout the region in a number of outpatient centers, both hospital-based and freestanding. Based on two campuses, Summa Akron City and St. Thomas Hospitals is located in downtown Akron, Ohio and has served, together with Summa Health System, as the largest safety-net hospital in the community for many years. Summa Barberton Citizens Hospital ("SBH") joined Summa Health System in December, 2007 when Summa Health System completed its acquisition of Barberton Citizens Hospital. SBH is a 311-bed general acute care community hospital that offers inpatient services, outpatient services and community outreach programs. SBH is located in the town of Barberton in southern Summit County. The Wadsworth-Rittman Area Hospital Association ("WRH") affiliated with Summa Health System in November 2007, and then merged with Summa Health System in 2008. WRH is a community-based acute care facility in Wadsworth, Medina County, Ohio, situated to the west of Summit County. WRH serves communities in Medina and Wayne counties. Summa Western Reserve Hospital, LLC ("SWRH") is a joint venture between Summa Akron City and St. Thomas Hospitals and the Western Reserve Hospital Partners and provides a full range of acute medical services. SWRH provides its hospital operations on the campus of Summa Cuyahoga Falls General Hospital. SWRH provides a full range of services, including a 24-hour emergency room and adheres to the charity care policy of Summa Health System. The Crystal Clinic Orthopaedic Center, LLC ("CCOC"), a joint venture between Summa Akron City and St. Thomas Hospitals and the Crystal Clinic, integrates the inpatient and outpatient services and physician practices of the Akron-area's leading orthopaedic programs and operates as a "hospital within a hospital" at Summa St. Thomas Hospital. CCOC also adheres to Summa's charity care policy in providing both inpatient and outpatient services, including surgery, orthopaedic oncology, total joint replacement and others. CCOC offers outpatient ambulatory surgery at the Crystal Clinic surgery center in Montrose and physician practice locations in Akron and its suburbs of Barberton, Kent, Cuyahoga Falls, Medina, Green and Stow. Summma Rehab Hospital, LLC, a joint venture between Summa Akron City and St. Thomas Hospitals 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 through its status as a Medicare Advantage organization. It is recognized by the Health Industry Research Company as a health plan with effective disease management programs for asthma, health failure and diabetes. SummaCare now covers more than 150,000 members. Summa Foundation is a nonprofit organization advancing transformational philanthropy, community understanding and goodwill for the programs and priorities of Summa Health System. Incorporating fund development, government relations, community benefit and diversity, the Foundation creates and implements innovative partnerships, health policy opportunities and funding strategies to support Summa Health System's education, research and patient care agenda. Summa Health Network, LLC is the integrated physician-hospital organization affiliated with Summa Akron City and St. Thomas Hospitals, Summa Barberton Hospital, The Wadsworth-Rittman Area Hospital Assn, Summa Western Reserve Hospital, LLC and Robinson Memorial Hospital (through an affiliation agreement with Summa Health System). 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 Health Network also offers a comprehensive performance incentive and clinical integration networks that partner with payors to improve the quality of care delivered to patients and to lower the cost of care. Summa Accountable Care Organization (d/b/a NewHealth Collaborative ("NHC")) is a clinician-led collaborative that partners with communities 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 lower the growth in health care costs while meeting performance standards on quality of care. Ohio Health Choice, Inc. is Ohio's oldest Preferred Provider Organization (PPO) network and one of the largest in the state. Co-owned by Summa Health System and Mercy Medical Center, Ohio Health Choice is a leader in the managed healthcare industry and is comprised of 198 hospitals, 8,000 primary care providers, 18,000 specialists and contracts with 94 third party administrators covering members across all 88 counties in Ohio. Summa Physicians Inc. ("SPI") is a Summa Health System entity of multi-specialty physicians and practices. Currently, SPI employs close to 300 physicians in multiple specialties. SPI promotes stronger affiliation and employment of physicians to ensure community and hospital needs for physician services are met. Part VI, Line 7 The State of Ohio does not require the filing of the Community Benefit report. However, information from the Community Benefit report is shared annually with the Ohio Hospital Association. true American Heart Association 5455 N High Street Columbus OH 43214 135613797 501(c)(3) 100000 Research/education Open M Summit County Free Clinic 941 Princeton Street Akron OH 44311 341046107 501(c)(3) 19500 Health & Wellness Habitat for Humanity of Summit County 2301 Romig Road Akron OH 44320 341518873 501(c)(3) 12500 Community support University of Akron 198 Fir Hill Akron OH 44325 346002924 Governmental 26350 Research & education Susan G Komen Northeast Ohio 26210 Emery Rd Ste 307 Cleveland OH 44128 751835298 501(c)(3) 20000 Cancer research Greater Akron Chamber 1 Cascade Plaza 17th Floor Akron OH 44308 341156576 501(c)(6) 8600 Education WD 5 1 Dental Clinic Fund 29 7954 Book NA Ophthalmology Cataract Surgery 13 13838 Book NA SummaShares 15 10190 Book NA Part I, Line 2, General Information on Grants and Assistance 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 University or agency utilizing the funds. Part II, Line 1(2) For furtherance of Summa Akron City and St. Thomas Hospitals charitable purposes including providing medical education and healthcare services to the surrounding community. X X X X true true true true false false false false false true false Michael Bage MD Director SACSTH (end 9/13) 410711 0 91156 0 650 0 7650 0 8105 0 518272 0 0 0 William Bauman MD Director SACSTH, SBH, WRH, SPI 593820 0 20802 0 1300 0 7650 0 8206 0 631778 0 0 0 Robert Debski MD Director SACSTH, SBH, WRH 275450 0 0 0 0 0 0 0 8969 0 284419 0 0 0 Steven Gaich MD Director SPI 316013 0 7902 0 0 0 7650 0 2610 0 334175 0 0 0 Robert Harrigan Dir SACSTH & COO (end 9/13) 0 438797 0 195934 0 416078 0 77637 0 6008 0 1134454 0 60441 A Gus Kious MD Director/Pres SPI (end 12/13) 260537 0 6395 0 64835 0 15325 0 1681 0 348773 0 0 0 Joseph Koenig MD Director SPI 571411 0 199108 0 495 0 8925 0 8480 0 788419 0 0 0 Joseph McShannic MD Director SACSTH (end 9/13) 459379 0 72760 0 0 0 6375 0 14857 0 553371 0 0 0 Dale Murphy MD Director SPI 0 183477 0 45629 0 249392 0 36014 0 4131 0 518643 0 30317 Thomas ONeill Director SPI, CFO SACSTH 0 250655 0 62719 0 95875 0 30445 0 3998 0 443692 0 26959 William Powel III Director SPI, System Secty 0 350982 0 102721 0 122229 0 54327 0 7414 0 637673 0 39937 Erik Steele DO Director SACSTH, SBH, WRH 0 228256 0 50000 0 71725 0 0 0 2606 0 352587 0 0 Thomas Strauss Dir SF, System Pres/CEO 0 763884 0 194287 0 315575 0 102035 0 6475 0 1382256 0 85619 Douglas Trochelman MD Director SACSTH (end 9/13) 626005 0 138845 0 1600 0 8925 0 7199 0 782574 0 0 0 Joseph Varley MD Director SACSTH (end 9/13) 356031 0 6514 0 1300 0 7650 0 11583 0 383078 0 0 0 Scott Weiner MD Director SACSTH, SBH, WRH 870092 0 19558 0 1500 0 8925 0 9303 0 909378 0 0 0 Darrell Widmer MD Director WRH (end 9/13) 196777 0 2564 0 1300 0 5679 0 1523 0 207843 0 0 0 Charles Alderson CFO, SBH & WRH 167625 0 0 0 38310 0 5972 0 5100 0 217007 0 0 0 Thomas DeBord President SBH & WRH 232239 0 23266 0 60570 0 34017 0 5629 0 355721 0 10496 0 Brian Derrick System CFO 0 464776 0 202792 0 129730 0 31054 0 9210 0 837562 0 0 Phylis Ferrara President/CDO, SF 96977 0 75000 0 26246 0 0 0 1101 0 199324 0 0 0 Bryan Fredericks COO, SPI 237250 0 0 0 43569 0 8077 0 4571 0 293467 0 0 0 Kathleen Jobe Chief Nursing Officer, SBH 159597 0 0 0 36759 0 5656 0 4442 0 206454 0 0 0 Thomas Malone MD President SACSTH 0 80705 0 50000 0 35315 0 0 0 812 0 166832 0 0 Steve Schmidt COO, SF 190743 0 26670 0 41849 0 31883 0 2733 0 293878 0 13987 0 Shane Seymour CDO, SF (end 6/13) 0 102296 0 2781 0 63521 0 0 0 4089 0 172687 0 0 Adrian Dan MD HCE - Bariatric Surgery 710561 0 137669 0 950 0 7656 0 8553 0 865389 0 0 0 John Zografakis MD HCE - Bariatric Surgery 730297 0 74885 0 1600 0 8925 0 9115 0 824822 0 0 0 Joel Porter MD HCE - Colorectal Surgery 575444 0 224166 0 0 0 8925 0 2359 0 810894 0 0 0 Eric Miller MD HCE - Orthopaedic Surgery 710261 0 52699 0 1500 0 2550 0 6675 0 773685 0 0 0 Mehool Patel MD HCE - Oncology, Hematology 531383 0 177602 0 150 0 1225 0 5424 0 715784 0 0 0 Jay Williamson MD Former President, SPI 194329 0 0 0 24985 0 6650 0 4311 0 230275 0 0 0 Part I, Line 1a Summa Health System grossed-up taxes for supplemental executive retirement programs paid to certain officers, key employees and the highly compensated. Health and social club dues, tax preparation services and housing allowances were paid on behalf of certain officers. The personal use is reflected as wages. Part I, Line 3 Compensation of the President & CEO is established by Summa Health System ("SHS"), the related parent organization for all members in the Summa Health System Group Return. SHS has a compensation committee which uses an independent compensation consultant, market surveys, and an annual review process to establish compensation for the position of President & CEO. Part I, Line 4a In 2013, Robert Harrigan received $148,922 in severance and benefits from a related organization. Part I, Line 4b Summa Health System has a 457(f) program for the executive staff which rewards certain officers, directors and key employees for meeting key long-term strategic objectives of the organization. Amounts paid in 2013: Thomas J. Strauss $97,336, Robert Harrigan $68,712, William A. Powel, III $45,402, Brian K. Derrick $23,404, Joseph Zarconi, MD $38,735, Thomas P. O'Neill $21,520, A. Gus Kious $12,789, Dale P. Murphy, MD $30,624, Steve Schmidt $25,366, and Thomas DeBord $25,242. Part I, Line 7 Summa Health System management incentive program was designed to reward employees for meeting quality performance and financial targets. These include clinical quality, patient satisfaction, employee/physician satisfaction, net operating income, and strengthening of the balance sheet. Payment is based on a factor of base compensation and is subject to review and approval by Summa's Compensation Committee. A Akron Bath Copley Jt Twp Hosp Dist 341448680 009730LT7 2004-06-10 160904918 See Schedule K, Part VI, Rider 2 false false false B Summit County Port Authority 341765940 86605VAE9 2006-10-31 15405000 See Schedule K, Part VI, Rider 6 false false false C Ohio Higher Educational Facility Comm 346849674 67756AY89 2010-05-11 180125341 See Schedule K, Part VI, Rider 8 false false false D Akron Bath Copley JT TWP Hosp Dist 341448680 2012-07-01 32509635 See Schedule K, Part VI, Rider 11 false false false A 23865000 0 164278376 3107915 2238718 0 2285007 3930806 0 89411463 59931009 0 2006 true true true true B 1460000 0 15405000 0 867000 0 308100 153159 0 14076741 0 0 2008 false false true true C 0 0 180152058 18190573 3004911 0 0 4929857 0 144468307 0 9558410 2012 true false false true D 4654253 0 32509635 0 0 0 0 0 0 0 32509635 0 2012 true false true true A false true true true true true 0.15560 0.00060 0.15620 false false false true B true true false false 0.01060 0.02870 0.03930 false false false true C false true true true true true 0.01820 0.00140 0.01960 false false false true D 0 false false false true A false true true false 0 true see rider 5 3.1 true false true B false true true true see rider 7 30. false false false 0 false true C false true false false 0 true see rider 10 2.2 true false true D false true true true see rider 13 12. false false false 0 false true A true B true C true D true Form 990, Schedule K, Part I, Line A, Col.(c) The CUSIP number assigned to the final maturity of the Series 2004A Bonds is 009730LT7. The CUSIP number assigned to the final maturity of the Series 2004B Bonds is 009730LU4. (Note: The Series 2004A Bonds and the Series 2004B Bonds are treated as a single issue of bonds for federal tax purposes). Form 990, Schedule K, Part I, Line A, Col.(f) The purposes of the Series 2004A Bonds were 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) July 1, 1999, (b) July 28, 2000 and (c) March 12, 2002, (4)fund a debt service reserve for the issue, and (5) pay issuance costs. The purposes of the Series 2004B Bonds were to (1) construct and equip a critical care pavilion, (2) contruct 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. (Note: The Series 2004A Bonds and the Series 2004B Bonds are treated as a single bond issue for federal tax purposes). Form 990, Schedule K, Part III, Col. A, Line 6 The private business use percentage on Schedule K, Part III, Col. A, Line 6 is projected to be less than 5% over the life of the bonds due to the expected termination of certain lease arrangements. Form 990, Schedule K, Part IV, Col. A, Line 2c Series 2004A Bonds Date arbitrage rebate computation performed was June 10, 2013. Series 2004B Bonds Date arbitrage rebate computation performed was June 10, 2013. Form 990, Schedule K, Part IV, Col. A, Line 5b Series 2004A Bonds Project Fund GIC - Financial Security Assurance Debt Service Reserve Fund GIC - Merrill Lynch Capital Services, Inc. Series 2004B Bonds Aegon/Transamerica Form 990, Schedule K, Part I, Line B, Col.(f) The purposes of the Series 2006 Bonds were to (1) acquire a project site for and construct and equip a wellness institute, and (2) pay issuance costs. Form 990, Schedule K, Part IV, Col. B, Line 4b Huntington National Bank Form 990, Schedule K, Part I, Line C, Col.(f) 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. Form 990, Schedule K, Part IV, Col. C, Line 2c Date arbitrage rebate computation performed was May 11, 2013. Form 990, Schedule K, Part IV, Col. C, Line 5b Morgan Stanley & Company Incorporated Form 990, Schedule K, Part I, Line D, Col. (f) The purposes of the Series 2012 Bonds were to (1) refund the Hospital Facilities Revenue Bonds, Series 1998A issued on December 23, 1998 in the original amount of $50,000,000, and (2) to pay the costs of issuance of the Bonds. Form 990, Schedule K, Part IV, Col. D, Line 2c Date arbitrage rebate computation performed was July 25, 2013. Form 990, Schedule K, Part IV, Col. D, Line 4b RBS Citizens Bank Kelly Bianco Family member 22153 See Part V false Brian Bauman MD Family member 443041 See Part V false Cynthia Browning Family member 60885 See Part V false Akron Radiology Inc See Part V 3309425 See Part V false Inpatient Medical Services Inc See Part V 790679 See Part V false Paragon Health Associates LLC See Part V 1096558 See Part V false Primary Care Physicians See Part V 2370183 See Part V false Professional Anesthesia Service Inc See Part V 8725263 See Part V false Ritzman Pharmacies Inc See Part V 1174609 See Part V false Summa Emergency Associates Inc See Part V 1480786 See Part V false Summit County Internists See Part V 605938 See Part V false Schedule L, Part IV, Business Transactions Kelly Bianco is a family member of Michael Bianco, MD, Director of WRH. Kelly Bianco was paid reasonable compensation as an employee of WRH. Brian Bauman, MD is a family member of William Bauman, MD, Director of SPI. Brian Bauman, MD was paid reasonable compensation as an employee of SPI. Cynthia Browning is a family member of Nicholas Browning, Director of SACSTH. Cynthia Browning was paid reasonable compensation as an employee of SACSTH. Daniel Finelli, MD, Director of SACSTH, SBH & WRH, is a director of Akron Radiology, Inc. Amount paid represents fees for services performed by Akron Radiology, Inc. Robert Schaal, MD, Director of SACSTH, is an officer of Inpatient Medical Services, Inc. Amount paid represents fees for services performed by Inpatient Medical Services, Inc. Edward Ferris, MD, Director of SACSTH, is part owner of Paragon Health Associates, LLC. Amount paid represents fees for services performed by Paragon Health Associates, LLC. Sharon VanNostran, DO, Director of SACSTH, is an officer of Primary Care Physicians. Amount paid represents fees for services performed by Primary Care Physicians. Jacob Cohen, MD, Director of SACSTH, is an officer of Professional Anesthesia Service, Inc. Amount paid represents fees for services performed by Professional Anesthesia Service, Inc. Thomas Knoll, Director of SACSTH, SBH & WRH, is a director of Ritzman Pharmacies, Inc. Amount paid represents fees for goods and services from Ritzman Pharmacies, Inc. Michelle Blanda, MD, Director of SACSTH, is an officer of Summa Emergency Associates, Inc. Amount paid represents fees for services performed by Summa Emergency Associates, Inc. Dale Murphy, MD, Director of SPI, is an officer of Summit County Internists. Amount paid represents fees for services performed by Summit County Internists. X 7 79785 FMV X 44 16625 FMV X Events 4 8500 Comparable Prices false true false CFGH Fixed assets (net), A/R and other 2013-12-31 43556851 book value 340714755 Summa Akron City and St Thomas Hosp 525 East Market Street Akron OH 44304 501(c)(3) true false false false true true true true true false Form 990, Schedule N, Part I, Line 2e The following individual was a director of both Cuyahoga Falls General Hospital and Summa Akron City and St Thomas Hospitals at the time of the merger, and remained a director of the Summa Akron City and St Thomas Hospitals: Candace Campbell-Jackson, director. Form 990, Schedule N, Part I, Line 6b The tax-exempt bond liabilities associated with CFGH were transferred to SACSTH. Form 990, Page 1, Part I, Lines 3 & 4 Form 990, Page 6, Part VI, Lines 1a & 1b Entity Name Number of Voting Number of Independent Directors Voting Directors Summa Akron City & St. Thomas 16 8 Hospitals ("SACSTH") Summa Foundation ("SF") 23 20 Summa Physicians, Inc. ("SPI") 7 0 Summa Barberton Citizens 16 8 Hospital ("SBH") The Wadsworth-Rittman Area 16 8 Hospital Assn ("WRH") All of the organizations listed above are subordinates under the control of Summa Health System ("SHS"). As of December 31, 2013, SHS had 15 voting directors, 9 of whom are independent voting directors. Form 990, Page 2, Part III, Line 4d Other Programs Services included: (a) Program-related investments in the following joint venture hospitals: Summa Western Reserve Hospital, LLC, Crystal Clinic Orthopaedic Center, LLC, and Summa Rehab Hospital, LLC. (b) Payments received under the American Reinvestment and Recovery Act for "Meaningful Use" due to successful implementation of electronic medical records. (c) Registration fees, including membership fees to Summa Wellness Institute ("SWI"). SWI is a medically supervised fitness facility blending fitness, wellness and rehabilitation in a clean, service-oriented environment. SWI features professional expertise and programming necessary to safely and effectively assist all people, regardless of current health status, to develop, initiate and maintain an active lifestyle that minimizes risk and promotes health and wellness and is one more step in Summa Health System's mission to provide the highest quality care to our patients and members and contribute to a healthier community. Form 990, Page 2, Part III, Program Service Accomplishments Summa Health System 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 System serves more than one million patients each year in comprehensive emergency, acute, critical, outpatient and long-term/homecare settings and represents more than 1,700 registered, inpatient beds on the campuses of Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizen's Hospital, The Wadsworth-Rittman Area Hospital Association, Summa Rehab Hospital*, Summa Western Reserve Hospital*, and Crystal Clinic Orthopaedic Center*. In addition, outpatient care is provided in more than 16 community health centers and Emergency Departments (EDs), some integrated in the healthcare facilities, others are free-standing. *Summa Rehab Hospital, *Summa Western Reserve Hospital and *Crystal Clinic Orthopaedic Center are joint ventures in which Summa Health System has an interest, and are referenced in this document for the purpose of indentifying all entities affiliated with Summa Health System. Summa's proportionate interest of these joint ventures' charity care and other community benefits are included on Schedule H of Summa Health System's IRS Form 990 Group Return. Providing superior, multi-specialty patient care, medical research and continuing medical education, Summa Health System ranks as a highly recognized healthcare provider in several disciplines including: cardiovascular, emergency, oncology, stroke and nursing by prestigious organizations such as: The Society of Chest Pain Centers American College of Surgeons American Heart Association American Stroke Association National Accreditation Program of Breast Centers American Nurses Credentialing Center Premier Healthcare Alliance The Joint Commission Summa Health System is Summit County's largest employer and a leading economic engine for the region. Summa Health System includes the following: Summa Akron City and St. Thomas Hospitals: Summa Akron City and St. Thomas Hospitals is a single legal entity that includes two hospital campuses and several off-site locations. Summa Akron City and St. Thomas Hospitals operates both hospital locations as well as the hospital-based off-site locations under the same Medicare provider number. Summa Akron City and St. Thomas Hospitals has more than 5,800 individuals and has a medical staff of more than 1,000 professionals working on its campuses. Summa Akron City and St. Thomas Hospitals has 979 registered beds and 46 licensed bassinets. The buildings and facilities on both campuses total 1.7 million square feet. Summa Akron City Hospital offers general medical, surgical, obstetrical, trauma, and critical care services. Summa Akron City Hospital provides acute care services on a campus of approximately 60 acres. The campus is home to specialty health centers offering a wide range of outpatient services. In 2013, Summa Akron City Hospital opened a new Geriatric Unit in the Emergency Department. Summa Akron City Hospital received the following recognition in 2013: The Pallative Care Program was granted "Advanced Certification in Pallative Care" by The Joint Commission, its highest level of achievement. The program is the only one in Ohio to earn this recognition. Also, Women's Services received the Ohio Patient Safety Institute Acute Care Best Practice Award for the reduction of maternal morbidity and mortality related to hemorrhage. Summa St. Thomas Hospital provides acute care services along with behavioral health and substance abuse care. Summa St. Thomas Hospital 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. Summa Akron City and St. Thomas Hospitals serves as a major teaching affiliate for Northeast Ohio Medical University (NEOMED), sponsoring and/or co-sponsoring 17 residencies and fellowships along with providing educational rotations for medical students. Summa Barberton Citizen's Hospital: Summa Barberton Citizen's Hospital is a 500,000 square foot acute care teaching hospital located on nearly 16 acres, located approximately 10 miles southwest of Akron, Ohio. The hospital has more than 1,400 employees and has approximately 400 medical staff. It has 235 registered adult beds and 14 available bassinets. Summa Barberton Citizen's Hospital opened its new Emergency Department in March 2013. This was followed by the implementation of an ICU/CCU Intensivist Program in August and a 24/7 STEMI Program in October. The Wadsworth-Rittman Area Hospital Association: The Wadsworth-Rittman Area Hospital Association is a 200,000 square foot acute care community hospital located on approximately 38 acres. Located approximately 20 miles west of Akron, Ohio, the Wadsworth-Rittman Area Hospital Association has 101 registered beds, more than 360 employees, and has a medical staff of more than 200 professionals. In 2013, Summa Center at Wadsworth opened to consolidate outpatient PT/OT/speech services at the Center, which also houses outpatient radiology and sports medicine. Charity Care In 2013, Summa Health System provided charity care at an estimated net cost of nearly $15.6 million. This amount represented the net cost associated with providing the care and does not include bad debt. Patients with incomes 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 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 2013, the charity care program (including Hospital Care Assurance Program) benefitted approximately 39,000 patient encounters. Medicaid Shortfall Historically, 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 System's unpaid costs for Medicaid totaled more than $23.2 million. Bad Debt Summa Health System is committed to providing quality and accessible healthcare. This includes covering the expenses of payments that were expected but not received. While Summa Health System recognizes bad debt is part of the cost 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 System provides to the community without full reimbursement. In 2013, the cost for providing care written off as bad debt was approximately $22.3 million. Community Health Improvement Services An important part of Summa Health System's mission is offering a prevention and wellness program to build a healthier community. In 2013, Summa Health System provided more than $1.2 million to help fund health improvement activities such as free and low-cost health screenings, health education services and wellness programming. Subsidized Health Services Summa Health System is committed to providing subsidized health services - clinical services that meet an identified community need and are provided despite financial loss. Vital services such as The 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 2013, the cost for subsidized services was approximately $26.4 million. Part III program services (continued) Financial and In-kind Donations Annually, Summa Health System 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 Akron Community Health Resources (Akron's only federally-funded health center) Summa Health System participates in numerous community programs and helps other nonprofits fulfill their missions. In 2013, these contributions exceeded $2.3 million. Research Summa Health System'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 System and helps set the highest standards for medical care in the community. Summa Health System's reputation for excellence in such critical specialties as cardiology, diabetes, emergency services, orthopaedics, oncology, senior health, surgery, and women's health continues to grow through research and innovation. Summa Health System invested more than $5.1 million in research in 2013. 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 System supports the education of physicians and other healthcare professionals. Summa Akron City and St. Thomas Hospitals is the largest of the major teaching affiliates of the Northeast 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 offers 17 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 our local university partners. In 2013, 245 residents and fellows trained at Summa's three main hospitals. On average, approximately 40% of these residents remain in our local and surrounding communities. Summa's 2013 investment in health professions education totaled $19.1 million. Summa Health System is one of five founding medical and educational institutions responsible for the creation of the Austen BioInnovation Institute in Akron (ABIA), a unique collaboration that expands upon the region's rich legacy in industrial and materials science to pioneer the next generation of life enhancing and life saving innovations. Summa Health System Services: Following is a description of Summa Health System's notable accomplishments by primary service lines in 2013: Behavioral Health - The Center for the Treatment and Study of Traumatic Stress developed and implemented on of Ohio's only intensive outpatient programs designed specifically to deal with the symptoms of post traumatic stress disorder. Cardiovascular - An upgraded Heart Rhythm Services (HRS) Lab opened in January on the campus of Summa Akron City Hospital. Summa's Cardiovascular Institute applied for, and was accepted to, the Centers for Medicare and Medicaid Innovation's Bundled Payments for Care Initiative Program. Emergency/Trauma Services - EMS developed and implemented EMS direct activation of the cardiac catheterization lab for chest pain patients, resulting in an overall decrease time of ten minutes. This resulted in recognition by the American Heart Association's Platinum Achievement Award. Neuroscience - In addition to The Joint Commission's stroke recertification, the "Target Stroke Award" and "Get with the Guidelines Gold Plus Award" were received from AHA. Oncology - Summa Health System approved the VERO Linear Accelerator to expand the radiosurgery program, making Summa Akron City Hospital the first community hospital in the country to have this specialized technology. Respiratory - Expanded its smoking cessation program across the system, and implemented a screening chest scan (CT) program for lung cancer. Seniors, Post Acute and Transitional Care - In addition to the Pallative Care recognition by The Joint Commission, Summa's hospitals achieved NICHE (Nurses Improving Care for Health System Elders) designation for the upcoming year. Women's Services - Met or exceeded the Ohio hospital averages in six perinatal measures, leading to the OHA's Patient Safety Institute's Best Practice Award noted above. Also successfully implemented a large informatics upgrade to the obstetrical electronic documentation and fetal surveillance system to improve safety and reporting reliability. Summary Although reimbursement for services rendered is critical to the operations and stability of Summa Health System, not all individuals possess the ability to purchase essential medical services. Summa Health System 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 program. 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 2013, Summa Health System provided charity care to the indigent (including unreimbursed Medicaid) at the net cost of more than $38.8 million. This amount does not include services provided and written off as bad debt. In addition to uncompensated medical care, Summa Health System provided wellness programs, community education programs and special programs for the elderly, handicapped, and medically underserved. Summa Health System also operated a variety of broad community support activities. Many of these programs were offered at a reduced price or provided to the community free of charge. Summa Health System 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 System'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. Part III program services (cont.) Summa Physicians Inc. - Program Service Accomplishments Summa Physicians Inc. (SPI) is a Summa Health System entity comprised of multi-specialty physicians and practices. In 2013, SPI added 35 physicians in various specialties including cardiology and oncology. In total, SPI employs nearly 300 physicians and 730 support staff in more than 30 specialties and sub-specialties. SPI promotes strong affiliation and employment of physicians to ensure community and hospital needs for physician services are met. In 2013, SPI developed primary care pods to better communicate quality initiatives and enhance physician recruitment. Summa Foundation - Program Service Accomplishments Through philanthropy, Summa Foundation supports medical education, research, technology, and clinical innovation. Encompassing fundraising, resource development, community benefit, diversity and government relations, Summa Foundation works to develop new, diversified and increased resources and build relationships that influence health policy to advance the regional priorities of Summa Health System. Development The Foundation's development department offers a spectrum of philanthropic options for donors designed to create a positive impact on Summa Health System's operations, programs, projects and perceptions and to affect positive change in the communities Summa Health System serves. Development houses the grant and proposal development offices created to identify the resources and expertise of external and internal partners to generate funding for research, education and clinical and system projects. Philanthropic commitments to the Summa Foundation in 2013 were nearly $10 million, including a $4 million gift designated for Summa's Cardiovascular Institute to support the creation of a hybrid operating room. 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 System. Community benefit and diversity provide wellness and educational tools, facilitate economic development programs, develop community partnerships, communicate Summa Health System'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 System as a credible leader and partner in the health policy planning process. This department collaborates with the system development team to best position Summa education, research and clinical innovation priorities with public sector funding opportunities. Form 990, Page 5, Part V, Lines 1a & 2a In 2013, Summa Health System, the parent organization, acted as the corporate services operating entity for the system. Operational changes implemented for the system included the centralized payroll management and accounts payable disbursements now transacted by the parent. For more information, see the IRS Form 990 for Summa Health System (parent), EIN 34-1887844. Form 990, Page 6, Part VI, Line 1a Summa Akron City and St. Thomas Hospitals: N/A Summa Barberton Citizens Hospital: N/A Summa Wadsworth-Rittman Hospital: Prior to adopting an Amended and Restated Code of Regulations in October 2013, Summa Wadsworth-Rittman Hospital had an Executive Committee comprised of the Board Chair, President, Vice Chair, Treasurer, Secretary, and others as elected by the Board of Directors. All members of the Executive Committee are members of the Board of Directors. The Executive Committee was authorized to exercise the powers of the Board at such time as the Board is not in session, subject to restrictions imposed by previous decisions of the Board and to the provisions of the Summa Wadsworth-Rittman Hospital Code of Regulations. All interim actions by the Executive Committee were reported at the Board's next meeting succeeding such action. The Executive Committee prepared and made such recommendations to the Board as are pertinent to the welfare of the Summa Wadsworth-Rittman Hospital. The Amended and Restated Code of Regulations for Summa Wadsworth-Rittman Hospital, adopted in October 2013, did not include a provision for an Executive Committee. Summa Foundation: Summa Foundation has an Executive Committee comprised of the Chair, Vice Chair, Secretary, Treasurer, and one additional Director of the Summa Foundation. All members of the Executive Committee are Directors of Summa Foundation. The Executive Committee is authorized to exercise the powers of the Board at such time as the Board is not in session, subject to restrictions imposed by previous decisions of the Board and to the provisions of the Summa Foundation Code of Regulations. All interim actions by the Executive Committee are reported at the Board's next meeting succeeding such action. The Executive Committee prepares and makes such recommendations to the Board as are pertinent to the welfare of the Summa Foundation. Summa Physicians, Inc.: The Code of Regulations provides for an Executive Committee to be comprised of three (3) directors. The Executive Committee may make governance decisions between Board meetings. Cuyahoga Falls General Hospital (merged December 31, 2013): Prior to its merger into Summa Akron City and St. Thomas Hospitals, Cuyahoga Falls General Hospital had an Executive Committee comprised of the Board Chair and two (2) other directors named by the Chair. All members of the Executive Committee are Directors of Cuyahoga Falls General Hospital. The Executive Committee had the power to transact all regular business of Cuyahoga Falls General Hospital between meetings of the Board of Directors, subject only to prior limitations established by the Board of Directors and the Member's Reserved Powers. Form 990, Page 6, Part VI, Line 2 Summa Akron City and St. Thomas Hospitals: Nicholas Browning, Anthony Lockhart, Thomas Strauss, R. Douglas Trochelman, M.D., Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Nicholas Browning, Anthony Lockhart, Thomas Strauss, and R. Douglas Trochelman, M.D., are Directors of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Dennis Chack, Anthony Lockhart, and Thomas Clark have a business relationship through First Energy: Dennis Chack is employed as an officer of First Energy and Anthony Lockhart and Thomas Clark are retired officers of First Energy. Thomas Knoll, Thomas Strauss, and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: all are on the Board of Managers of Summa Western Reserve Hospital. Robert Harrigan, Thomas O'Neill, and Erik Steele, D.O. have a business relationship through Crystal Clinic Orthopaedic Center, LLC: Robert Harrigan, Thomas O'Neill and Erik Steele, D.O. all were on the Board of Managers of Crystal Clinic Orthopaedic Center, LLC during the year. Robert Harrigan and Thomas Strauss have a business relationship through Summa Accountable Care Organization: both are Directors of Summa Accountable Care Organization. Michael Bage, M.D. and Hitesh Makkar, M.D have a business relationship through Continuity Medical, LLC. Thomas Knoll, Brian Derrick, William A. Powel, III, and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation. Summa Barberton Citizens Hospital: Thomas Strauss, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss is a Director of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Thomas Knoll, Thomas Strauss, and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: all are on the Board of Managers of Summa Western Reserve Hospital. Thomas Knoll, Brian Derrick, William A. Powel, III, and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation. Summa Wadsworth-Rittman Hospital: Thomas Strauss, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss is a Director of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Eric Graf and Thomas Knoll have a business relationship through Ritzman Pharmacies: Eric Graf is the CEO of Ritzman Pharmacies and Thomas Knoll is a Director of Ritzman Pharmacies. Thomas Knoll, Thomas Strauss, and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: all are on the Board of Managers of Summa Western Reserve Hospital. Thomas Knoll, Brian Derrick, William A. Powel, III, and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation. Summa Foundation: Thomas Strauss, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss is a Director of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Samir Gibara and Scott Honnold have a business relationship through Goodyear Tire and Rubber Company: Samir Gibara is a retired officer of Goodyear and Scott Honnold is a current officer of Goodyear. George Daverio, Jr. and C. Gordon Ewers have a business relationship through Merrill Lynch: George Daverio, Jr. is retired from Merrill Lynch and C. Gordon Ewers is an officer at Merrill Lynch. Jason Butterworth and Mark Krohn have a business relationship through Brennan, Manna & Diamond: both are partners at this law firm. Summa Physicians, Inc.: Dale Murphy, M.D. and William A. Powel, III have a business relationship through Middlebury Assurance Corporation: both are Directors of Middlebury Assurance Corporation. Cuyahoga Falls General Hospital: Thomas Strauss, Norman Wells, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss and Norman Wells are Directors of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Stephen Hailer, Thomas Strauss, Joseph Nienaltowksi, D.O., and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: Stephen Hailer, Thomas Strauss, and William A. Powel, III are on the Board of Managers of Summa Western Reserve Hospital and Joseph Nienaltowski, D.O. is Director, Patient Experience at Summa Western Reserve Hospital, LLC. Douglas Chonko, D.O. and Ronald Russ, D.O. have a business relationship through Kent Management Group: each is employed by Kent Management Group. William A. Powel, III, Brian Derrick and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation. Form 990, Page 6, Part VI, Line 4 Summa Akron City and St. Thomas Hospitals: The following material changes were made to the Code of Regulations during the 2013 tax year: (i)Reduced the number of Directors from 23 to 16; specified that one of the Directors must be on the Medical Staff of the Corporation (ii) Specified that the Chief Medical Officer of Summa Health System is a Special Voting Director (iii) Redefined quorum to be number of current Directors multiplied by 50% (rounded up to whole number). Previously, quorum defined as 40%. (iv) Defined the reserved powers to be the same reserved powers that Summa Health System has over all of its subsidiaries (v) Changed title of Corporation's President from "President & COO" to "President" (vi) Deleted the requirement that the Code of Regulations be reviewed biennially Summa Barberton Citizens Hospital: The following material changes were made to the Code of Regulations during the 2013 tax year: (i) Changed the sole member of the Corporation from Summa Barberton Wadsworth Rittman Hospitals, LLC to Summa Health System. (ii) Increased the number of Directors from 14 to 16; specified that one of the Directors must be on the Medical Staff of the Corporation (iii) Specified that the Chief Medical Officer of Summa Health System is a Special Voting Director (iv) Redefined quorum to be number of current Directors multiplied by 50% (rounded up to whole number). Previously, quorum defined as a majority of the current Directors. (v) Defined the reserved powers to be the same reserved powers that Summa Health System has over all of its subsidiaries Summa Wadsworth-Rittman Hospital: The following material changes were made to the Code of Regulations during the 2013 tax year: (i) Changed the sole member of the Corporation from Summa Barberton Wadsworth Rittman Hospitals, LLC to Summa Health System. (ii) Increased the number of Directors from 14 to 16; specified that one of the Directors must be on the Medical Staff of the Corporation (iii) Specified that the Chief Medical Officer of Summa Health System is a Special Voting Director (iv) Redefined quorum to be number of current Directors multiplied by 50% (rounded up to whole number). Previously, quorum defined as a majority of the current Directors. (v) Defined the reserved powers to be the same reserved powers that Summa Health System has over all of its subsidiaries (vi) Deleted a provision delineating specific charitable organizations for the distribution of assets upon a dissolution of the Corporation Summa Foundation: N/A Summa Physicians, Inc.: N/A Cuyahoga Falls General Hospital (merged December 31, 2013): Cuyahoga Falls General Hospital merged with Summa Akron City and St. Thomas Hospitals effective as of December 31, 2013. Summa Akron City and St. Thomas Hospitals was the surviving entity. Prior to the merger, the following changes were made to the Code of Regulations during the 2013 tax year: (i) Re-defined the Reserved Powers to be the same Reserved Powers that Summa Health System has over each subsidiary corporation (ii) Reduced the number of Directors on the Board of Directors from 15 to 6 (iii) Specified that at least 3 of the 6 Directors are to be Community Directors (iv) Specified that President & CEO of Summa Health System is a Director (v) Deleted all defined committees except for the Executive Committee; specified that the Executive Committee is comprised of the Board Chair and 2 other Directors named by the Chair (vi) Changed the title of the President & COO to President; specified that the President & CEO of Summa Health System shall be the President of the Corporation Form 990, Page 6, Part VI, Line 6 Summa Akron City and St. Thomas Hospitals: Summa Health System is the sole member of Summa Akron City and St. Thomas Hospitals. Summa Barberton Citizens Hospital: Prior to adopting an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Barberton Citizens Hospital was Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. Following the adoption of an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Barberton Citizens Hospital is Summa Health System. Summa Wadsworth-Rittman Hospital: Prior to adopting an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Wadsworth-Rittman Hospital was Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. Following the adoption of an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Wadsworth-Rittman Hospital is Summa Health System. Summa Foundation: Summa Health System is the sole member of Summa Foundation. Summa Physicians, Inc.: Summa Physicians, Inc. has stockholders; the stock is held in trust for the benefit of Summa Health System. Cuyahoga Falls General Hospital (merged December 31, 2013): Summa Health System was the sole member of Cuyahoga Falls General Hospital. Form 990, Page 6, Part VI, Line 7a Summa Akron City and St. Thomas Hospitals: Prior to the adoption of Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation were elected as set forth below: (i) The medical staff of Summa Akron City and St. Thomas Hospitals elects two (2) directors: the President of the Medical Staff and the President-Elect of the Medical Staff. (ii) The Chairs of the medical staff departments elect two (2) department chairs to be directors (iii) The following individuals are directors by designation: (a) President & CEO of Summa Health System; (b) President & COO of Summa Akron City and St. Thomas Hospitals; (c) Chair of Summa Akron City and St. Thomas Hospitals Foundation; and (d) The Presidents of The Women's Board of St. Thomas Hospital and the Women's Board of Summa Health System shall rotate annually to provide a single representative. (iv) Other than as set forth above, Summa Health System is the sole member of Summa Akron City and St. Thomas Hospitals and has the right to elect the Board of Directors of Summa Akron City and St. Thomas Hospitals. Following the adoption of the Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation are to be elected as set forth below: (i) Nine (9) non-physician Directors are to be elected by Summa Health System as the sole member of the Corporation. (ii) Six (6) physician Directors are to be elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals (iii) The Chief Medical Officer of Summa Health System is to be a Special Voting Director Summa Barberton Citizens Hospital: Prior to the adoption of Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation were elected as set forth below: The sole member of Summa Barberton Citizens Hospital is Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. The sole member elects the Board of Directors of Summa Barberton Citizens Hospital subject to the approval of Summa Health System. Following the adoption of the Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation are to be elected as set forth below: (i) Nine (9) non-physician Directors are to be elected by Summa Health System as the sole member of the Corporation. (ii) Six (6) physician Directors are to be elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals (iii) The Chief Medical Officer of Summa Health System is to be a Special Voting Director Summa Wadsworth-Rittman Hospital: Prior to the adoption of Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation were elected as set forth below: The sole member of Summa Wadsworth-Rittman Hospital is Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. The sole member elects the Board of Directors of Summa Wadsworth-Rittman Hospital subject to the approval of Summa Health System. Following the adoption of the Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation are to be elected as set forth below: (i) Nine (9) non-physician Directors are to be elected by Summa Health System as the sole member of the Corporation. (ii) Six (6) physician Directors are to be elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals (iii) The Chief Medical Officer of Summa Health System is to be a Special Voting Director Summa Foundation: In addition to directors elected by the Summa Health System Board as the sole member of Summa Foundation, the President and CEO of Summa Health System serves as a director of Summa Foundation. Summa Physicians, Inc.: Summa Physicians, Inc. is affiliated with Summa Akron City and St. Thomas Hospitals and only persons approved by Summa Akron City and St. Thomas Hospitals or employed by Summa Akron City and St. Thomas Hospitals or an affiliated entity may serve as a director of Summa Physicians, Inc. Cuyahoga Falls General Hospital (merged December 31, 2013): Summa Health System was the sole member of Cuyahoga Falls General Hospital and had the right to elect the Board of Directors of Cuyahoga Falls General Hospital. Form 990, Page 6, Part VI, Line 7b Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizens Hospital, Summa Wadsworth-Rittman Hospital: Summa Health System is the sole member of each of Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizens Hospital, and Summa Wadsworth-Rittman Hospital. As the sole member, Summa Health System has the power and authority to approve or disapprove of each of the following on behalf of each of Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizens Hospital, and Summa Wadsworth-Rittman Hospital: (i) Any modification of the essential nature, purpose, mission or operations of the Corporation; (ii) Adoption of a Code of Regulations, Bylaws or other constitutive document of the Corporation and any and all amendments thereto; (iii) Adoption of any amendments to the Articles of Incorporation or similar charter or organizational document or agreement and/or any other change in the corporate structure or governance of the Corporation; (iv) Establishment of qualifications for the selection of Directors, Directors or Managers of the Corporation; (v) Appointment or election and removal of members of the governing body of the Corporation; (vi) Appointment or election and removal of the President and/or Chief Executive Officer or similar officer(s) of the Corporation; (vii) Adoption of annual operating and capital budgets of the Corporation; (viii) The borrowing of money or other incurring or creating of any indebtedness of the Corporation, including by way of a guaranty of the debt of another, in an amount greater than $1,000,000 or that will increase the amount of indebtedness incurred in the current calendar year, in the aggregate, to more than $3,500,000; (ix) Adoption of the long range plans of the Corporation; (x) Determinations as to the use and occupancy of any building owned or leased by the Corporation; (xi) The sale, encumbrance, lease or disposition of real property of the Corporation other than in the ordinary course of the operations of the Corporation; and (xii) The merger, reorganization, dissolution or other corporate action of a similar nature, including participation in a joint venture, proposed by the Corporation. Summa Foundation: Summa Health System is the sole member ("Member") of Summa Foundation. The following are the matters ("Reserved Powers") which must be submitted to, and receive the approval of both the Board of Directors of Summa Foundation and the Member: (i) Adoption of the Foundation's annual operating and capital budgets; (ii) Expenditures for (a) non budgeted items in excess of certain dollar limits set from time to time by the Member and (b) items which are included in the Foundation's annual budgets but which exceed the budgeted amount by an amount in excess of certain dollar limits set from time to time by the Member; (iii) Incurrence, assumption or guarantee of any indebtedness if following the incurrence, assumption, or guarantee of such indebtedness the aggregate amount of all outstanding indebtedness incurred, assumed or guaranteed by the Foundation which has not been previously approved by the Member exceeds certain dollar limits set from time to time by the Member; (iv) Submission of any certificate of need application with any State or Federal Regulatory Agency; (v) Execution of any contract that calls for the Foundation to expand a sum in excess of certain dollar limits set from time to time by the Member or to provide services with a value in excess of certain dollar limits set from time to time by the Member; (vi) Election of such officers as are required to be elected under this Code of Regulations; (vii) Appointment of the Foundation's auditors and/or accountants; (viii) Adoption of the Foundation's long range plans and management objective, including the execution of any agreement with consortiums, alliances, etc; (ix) Sale, lease or other disposition of any real or personal property of the Foundation with a value in excess of certain dollar limits to be set from time to time by the Member; (x) Sale, release, dissolution, transfer, exchange, or other disposition of any organization (or of all or substantially all of the assets of such organization) controlled by the Foundation if after such sale, release, dissolution, transfer, exchange or other disposition, such organization (or all or substantially all of the assets of such organization) would no longer be controlled by the Foundation; (xi) Adoption or amendment of the Foundation's Code of Regulations or Articles of Incorporation; (xii) Any other matter which may be specified by the Member or by the Board or required by law. Summa Physicians, Inc. - N/A Cuyahoga Falls General Hospital (merged December 31, 2013): Summa Health System was the sole member of Cuyahoga Falls General Hospital. As the sole member, Summa Health System had the power and authority to approve or disapprove of each of the following on behalf of Cuyahoga Falls General Hospital: (i) Any modification of the essential nature, purpose, mission or operations of Cuyahoga Falls General Hospital; (ii) Approval of the Codes of Regulations, Bylaws or other constitutive document of Cuyahoga Falls General Hospital and any corporation or entity controlled by, related to or affiliated with Cuyahoga Falls General Hospital (an "Affiliated Corporation") and any and all amendments thereto; (iii) The 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 Cuyahoga Falls General Hospital or any Affiliated Corporation; (iv) The establishment of qualifications for the selection of Directors, Directors or Managers of Cuyahoga Falls General Hospital; (v) The appointment or election and removal of members of the governing body of Cuyahoga Falls General Hospital; (vi) The appointment or election and removal of the President and/or Chief Executive Officer or similar officer of Cuyahoga Falls General Hospital; (vii) The adoption of annual operating and capital budgets of Cuyahoga Falls General Hospital; (viii) The adoption of the long range plans of Cuyahoga Falls General Hospital; (ix) Determinations as to the use and occupancy of any building owned or leased by Cuyahoga Falls General Hospital; (x) The sale, encumbrance, lease or disposition of real property of Cuyahoga Falls General Hospital other than in the ordinary course of the operations of Cuyahoga Falls General Hospital; and (xi) The merger, reorganization, dissolution or other corporate action of a similar nature undertaken by Cuyahoga Falls General Hospital. Form 990, Page 6, Part VI, Line 11b The return was reviewed in detail by a committee consisting of internal and external legal counsel, financial management, and an external auditor. The review committee included the Senior Vice President, Finance & CFO and the Senior Vice President, Legal Services & General Counsel. This detailed review occurred in September 2013. Following this review and incorporation of changes recommended by this committee, the return was provided to the Summa Health System Committee on Governance prior to its September 2013 meeting for further review. The Committee on Governance is a standing committee appointed by the Summa Health System Board of Directors and includes members of the Board of Directors. Schedule H of the return was also reviewed by the Summa Health System 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, Page 6, Part VI, Line 12c Conflict of Interest Process Summary: A Conflict of Interest Questionnaire is sent annually to all Summa Health System 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 System 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 System Policy on Conflict of Interest as approved by the Summa Health System 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. Disclosure Procedure: Any person with a conflicting interest in any transaction or arrangement is required to disclose the conflicting interest to the Board or committee considering such transaction or arrangement prior to or at the beginning of any meeting at which such transaction or arrangement is under consideration. The person with a conflicting interest is prohibited from using his/her personal influence on the matter but may briefly state his/her position on the transaction or arrangement and answer questions raised by members of the Board or committee. The person with a conflicting interest is prohibited from otherwise participating in the decision and may be required to leave the meeting during the discussion and vote on the transaction or arrangement. In addition, if appropriate, a non-interested person or committee may be appointed to investigate alternatives to the proposed transaction or arrangement. The minutes of Board meetings and committee meetings reflect whether any conflicting interests were disclosed, the nature of the conflicting interests, and the names of persons who were present for discussion and votes relating to the transaction or arrangement. Form 990, Page 6, Part VI, Line 15a & 15b Executive Compensation: The Compensation Committee of the Summa Health System 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 with the exception of one board member who is an independent contractor who recuses himself on voting regarding the CEO evaluation and compensation package. The Compensation Committee engages outside consulting support to provide independent market data, advice and counsel to the Compensation Committee. For the past four years, the Compensation Committee has used Hay Group, a nationally recognized consulting firm, to assist their efforts. The Hay Group provides the following services to the Compensation Committee: (a) education of Committee members regarding executive compensation trends and best practices in healthcare organizations; (b) assessment of the market competitiveness and reasonableness of Summa's executive compensation programs including base salary, incentive compensation, core and executive benefits, as well as their alignment with the mission and future performance expectations; (c) written, detailed evaluation of the market reasonableness of Summa's executive compensation and benefits program; and (d) ongoing support and independent advice to the Compensation Committee on matters related to executive compensation. Each year the Compensation Committee reviews and approves the compensation for the following positions: Summa Health System: President & CEO Senior Vice President, Finance & CFO Senior Vice President, Legal Services & General Counsel Senior Vice President, IT&S & CIO Senior Vice President, Service Lines, Ambulatory & Ancillary Senior Vice President, Planning & Marketing Senior Vice President & Chief Nursing Officer Senior Vice President, Human Resources Senior Vice President, Chief Medical Officer President, SummaCare Summa Akron City and St. Thomas Hospitals: President & COO Summa Foundation: President Summa Barberton Citizens Hospital & Summa Wadsworth-Rittman Hospital: President & COO Summa Physicians, Inc.: President Cuyahoga Falls General Hospital: Note: Cuyahoga Falls General Hospital did not employ a President & COO during 2013 Form 990, Page 6, Part VI, Line 19 Summa Health System makes its Conflicts of Interest policy available upon request. The Articles of Incorporation of Summa Health System and its related entities are available on the website of the Ohio Secretary of State (www.sos.state.oh.us). Summa Health System 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). Form 990, Page 12, Part XI, Line 9 Other Changes in Net Assets or Fund Balances: FASB 106 Post Retirement (44,069) Net Assets released from restriction 128,446 Minimum Pension Liability 26,813,193 Transfers between affiliates 28,050,757 Change in Trust Value 750,749 Other changes in Net Assets (361,400) ----------- Total Changes in Net Assets 55,337,676 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:39878355 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES-AFFILIATE TOTAL FEES:52404016 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN PRACTICE SUPPORT TOTAL FEES:24730957 FORM 990 PART IX LINE 11G DESCRIPTION:NON-MEDICAL PURCHASED SERVICES TOTAL FEES:70707310 FORM 990 PART IX LINE 11G DESCRIPTION:REPAIR & MAINTENANCE TOTAL FEES:13113267 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION SERVICES TOTAL FEES:6947477 FORM 990 PART IX LINE 11G DESCRIPTION:HOSPICE SERVICES TOTAL FEES:3914611 FORM 990 PART IX LINE 11G DESCRIPTION:PERFUSION/BLOOD PROCESSING TOTAL FEES:3726787 FORM 990 PART IX LINE 11G DESCRIPTION:AMBULANCE SERVICE TOTAL FEES:325945 Summa Enterprise Group LLC 525 East Market Street Akron OH 44304 030507853 Consulting OH 2737204 19411709 SACSTH Summa Enterprise Group Properties LLC 525 East Market Street Akron OH 44304 550837372 Real Estate OH 0 0 SEG Akron Endoscopy ASC LLC 525 East Market Street Akron OH 44309 621865245 prof.med.svcs OH 0 0 sacsth St Thomas Medical Center Women's Board 444 North Main Street Akron OH 44310 346576575 Support OH 3 11-I SACSTH false Summa Health System Community 525 East Market Street Akron OH 44304 463018310 Support Org OH Applied for 11 NA true Ohio Sleep Disorders Center 130 West Exchange Street Akron OH 44302 341872278 Office Physic OH SACSTH & SBH related 0 0 false 0 0.66670 Summa Rehab Hospital LLC 4550 Lena Drive Mechanicsburg PA 17055 271952573 Rehab Hospita OH SACSTH related 12567497 4814205 false 0 0.52000 Ohio Health Choice Inc 525 East Market Street Akron OH 443041619 341895396 PPO OH NA C Corp 2575718 2752112 0.80000 true Summa Insurance Company Inc 10 North Main Street Akron OH 44308 341809108 Prop/Cas. Ins OH NA C Corp 219615623 92429484 1.00000 true Summa Health System Corp 525 East Market Street Akron OH 443041619 341515252 Mgmt Services OH NA C Corp 761754 6733783 1.00000 true Wadsworth-Rittman Prof Services Corp 195 Wadsworth Road Wadsworth OH 442819504 010842997 Prof. Med. Sv OH NA C Corp 0 10237 1.00000 true Middlebury Assurance Company PO Box 1051 KY1-1102 Grand Cayman Cayman Islands CJ 980405096 Self Insurance CJ NA Foreign Corp 13635724 65267485 1.00000 true SummaCare Inc 525 East Market Street Akron OH 44309 341726655 Insurance OH NA C Corp 277579780 104838092 1.00000 true Health Care Center Physicians Inc 525 East Market Street Akron OH 443041619 341692767 Inactive OH NA C Corp 0 0 1.00000 true Summa Accountable Care Organization 525 East Market Street Akron OH 44304 273857055 Contracting OH NA C Corp 3595001 2569026 1.00000 true Aris Teleradiology Holdings Inc 5655 Hudson Drive Hudson OH 44236 453697866 Radiology Svc DE SACSTH C Corp 12789339 5337617 0.57900 false Summa Management Services Organization 10 North Main Street Akron OH 44308 461145832 Mgmt Services OH SHS Corp C Corp 35161961 9308891 1.00000 true Summa Integrated Services Organization 10 North Main Street Akron OH 44308 461159251 Mgmt Services OH SHS Corp C Corp 20142570 22047851 1.00000 true true true true false false false false false true true true true false false true false false true Summa Rehab Hospital LLC a 2586679 FMV Summa Akron City and St Thomas Hospital b 212252 FMV Summa Foundation b 845165 FMV Summa Foundation b 100000 FMV Summa Foundation c 212252 FMV Summa Akron City and St Thomas Hospital c 845165 FMV Summa Barberton Citizens Hospital c 100000 FMV Summa Physicians Inc j 3016116 FMV Summa Physicians Inc j 223595 FMV Summa Physicians Inc j 114881 FMV Summa Akron City and St Thomas Hospital k 3016116 FMV Summa Barberton Citizens Hospital k 223595 FMV The Wadsworth-Rittman Area Hospital Assn k 114881 FMV Summa Akron City and St Thomas Hospital l 43810683 cost Summa Barberton Citizens Hospital l 7200473 cost The Wadsworth-Rittman Area Hospital Assn l 1662672 cost Summa Insurance Company Inc l 73527908 FMV Summa Insurance Company Inc l 11086919 FMV Summa Insurance Company Inc l 12783393 FMV Summa Insurance Company Inc l 3750964 FMV Summa Rehab Hospital LLC l 551496 FMV Summa Health System m 1032648 FMV Summa Health System m 103992 FMV Summa Health System m 80208 FMV Summa Health System m 1305530 FMV Summa Physicians Inc m 43810683 cost Summa Physicians Inc m 7200473 cost Summa Physicians Inc m 1662672 cost Middlebury Assurance Company m 7792642 FMV Middlebury Assurance Company m 1985258 FMV Middlebury Assurance Company m 1127246 FMV Middlebury Assurance Company m 290184 FMV Summa Integrated Services Organization m 1495245 FMV SummaCare Inc m 1846658 FMV Summa Health System p 26579941 cost Summa Health System p 5782043 cost Summa Health System p 2142996 cost Summa Health System p 1417884 cost Summa Health System s 5199999 cost Crystal Clinic Orthopaedic Center LLC 3925 Embassy Parkway 250 Akron OH 44333 261130649 Ortho Hospital OH related false 61039993 26652012 false 0 false 0.49650 Summa Western Reserve Hospital LLC 1900 23rd Street Cuyahoga Falls OH 44223 263536780 Hospital OH related false 45982000 10467352 false 0 false 0.40000