2012-11-13T10:00:12-06:00 2011-12-31 ERNST & YOUNG US LLP 111 MONUMENT CIRCLE SUITE 2600 INDIANAPOLIS IN 46204 990 2011-01-01 900640432 Summa Health System Group Return % BRIAN K DERRICK SUMM 3303753196 525 East Market Street Akron OH 44309 Brian K Derrick 2012-11-12 true 3176817000 2011 2016-02-24 21:20:13Z Thomas J Strauss 525 East Market Street Akron OH 44309 1154617292 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. 124 90 8802 898 12826425 4349842 17452932 6053617 1026551028 1061546122 14431945 21938379 10682616 18099365 1069118521 1107637483 9291949 1448421 0 0 485919403 495891252 0 0 1103524 542186906 566499307 1037398258 1063838980 31720263 43798503 1065416547 1136021642 674722922 718039774 390693625 417981868 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 396132115 458901445 Inpatient Services - For 2011, Summa Akron City & St. Thomas Hospitals (SACSTH), Summa Barberton Citizens Hospital (SBH) and The Wadsworth-Rittman Area Hospital Association (WRH) had 856 beds in service, admitted 44,874 adult patients and delivered 3,581 newborns. The adult patients received 213,475 days of care, inpatient surgeries total 7,064, emergency admits totaled 30,856 and the average length of stay was 4.76 days. 478360840 554159768 Outpatient Services - In 2011, Summa Akron City & St. Thomas Hospitals, Summa Barberton Citizens Hospital, The Wadsworth-Rittman Area Hospital Association and Summa Physicians, Inc. provided 1,681,643 occasions of service, including 134,763 emergency room visits, 15,948 surgical operations, and 1,530,932 other outpatient visits. 35267666 12452164 Research/Education Summa Health System has a long, successful 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 graduates from U.S. and international medical schools train in 17 accredited residency training programs. Summa Health System provides clinical learning experiences to more than 2,600 nursing and allied health students. Summa Health System established partnerships with Northeast Ohio Medical University, The University of Akron, Kent State University, Case Western Reserve University, Youngstown State University and a variety of industries in the northeast Ohio region. In addition, Summa Health System is an active partner in the Austen BioInnovation Institute in Akron. 29729752 1495624 36032745 939490373 true true false true 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 true false true true true true false false false true true true true false true true 927 0 true 8802 true true true false false false false true true false false false false false X 124 90 true false true false true true true true true false true true true true true true true false true true true true FL OH X BRIAN K DERRICK 3303753196 525 EAST MARKET STREET Akron OH 44309 X John Adams 2.0 X 0 0 0 Kyle Allen DO 48.0 X 238598 0 41923 Karen Ayers DO 2.0 X 0 0 0 Michael Bage MD 48.0 X 504510 0 10204 Susan Baker 2.0 X 0 0 0 William Bauman MD 48.0 X 594383 0 17581 Julia Bianchi 2.0 X 0 0 0 Michael Bianco MD 2.0 X 56850 0 0 James Biggar 2.0 X 0 0 0 Michelle Blanda MD 2.0 X 0 0 0 Nick Browning 2.0 X 0 0 0 Candace Campbell-Jackson 2.0 X 0 0 0 Cynthia Capers 2.0 X 0 0 0 Dennis Chack 2.0 X 0 0 0 Douglas Chonko DO 2.0 X 0 0 0 Thomas Clark 2.0 X 0 0 0 Jacob Cohen MD 2.0 X 0 0 0 Norman Crocker MD 2.0 X 0 0 0 George Daverio 2.0 X 0 0 0 David Dellinger DO 2.0 X 0 0 0 T Clifford Deveny MD 48.0 X X 273090 0 36532 Dennis Dick 2.0 X X 0 0 0 Vince DiGirolamo 3.0 X X 0 0 0 C Gordon Ewers 2.0 X 0 0 0 Edward Ferris MD 2.0 X 0 0 0 Daniel Figliola 2.0 X 0 0 0 Michael Frank MD 3.0 X X 0 0 0 Jason Fried DO 2.0 X 0 0 0 Steven Gaich MD 48.0 X 327774 0 25474 Mark Goldfarb 2.0 X 0 0 0 Eric Graf 2.0 X 0 0 0 Russell Gregory 2.0 X 0 0 0 Stephen Hailer 2.0 X 0 0 0 Thomas Harnden 3.0 X X 0 0 0 Robert Harrigan 48.0 X X 1002992 0 74559 Robert Hemphill MD 2.0 X 0 0 0 Thomas Hudson 2.0 X 0 0 0 Rodney Ison MD 2.0 X 28390 16500 0 Mary Ann Jackson 2.0 X 0 0 0 Tracy Jensen 2.0 X 0 0 0 Phil Kaufmann 2.0 X 0 0 0 James Kennedy MD 2.0 X 0 0 0 Phillp Khalil DO 2.0 X 0 0 0 A Gus Kious MD 48.0 X X 36704 0 46 Thomas Knoll 40.0 X 222408 0 0 Joseph Koenig MD 48.0 X 653840 0 73258 Rich Kramer 2.0 X 0 0 0 James Kraynak 2.0 X 0 0 0 Dennis Liddle 2.0 X 0 0 0 Dina Lloyd 2.0 X 0 0 0 Anthony Lockhart 2.0 X 0 0 0 Ann Loftus 2.0 X 0 0 0 Anthony Manna 2.0 X 0 0 0 Richard Marsh 3.0 X X 0 0 0 Joseph McShannic MD 48.0 X 436940 0 22188 Walter Mirapaul 2.0 X 0 0 0 Dale Murphy MD 48.0 X 568923 0 42768 Randy Myeroff 2.0 X 0 0 0 Vivian Celeste Neal 2.0 X 0 0 0 Joseph Nienaltowski DO 2.0 X 0 0 0 Thomas O'Neill 48.0 X X 488174 0 67174 Elwood Palmer 2.0 X 0 0 0 Charles Parsons 2.0 X 0 0 0 Jonathon Pavloff 2.0 X 0 0 0 Mark Pluskota MD 2.0 X 0 0 0 William Powel III 48.0 X X 615406 0 89577 Dwight Powers 2.0 X 0 0 0 Ernest Preston 2.0 X 0 0 0 Theresa Proenza 2.0 X 0 0 0 Margaret Ralston Payne 3.0 X X 0 0 0 Kathleen Raynor 2.0 X 0 0 0 Froncie Repetti 2.0 X 0 0 0 Harriett Richman 2.0 X 0 0 0 Ronald Russ DO 2.0 X 0 0 0 Mona Sarkar 2.0 X 0 0 0 Robert Schaal MD 2.0 X 75000 0 0 Steve Schmidt 48.0 X X 320368 0 12539 Diane Schnee 2.0 X 0 0 0 Helen Scott 2.0 X 0 0 0 Anthony Solaro 2.0 X 0 0 0 Martin Spector 2.0 X 0 0 0 Thomas Strauss 48.0 X X 1714943 0 97692 Vicki Sussman 2.0 X 0 0 0 Susan Taft 2.0 X 0 0 0 Terry Taylor 2.0 X 0 0 0 Douglas Trochelman MD 48.0 X 654341 0 17581 Susan Ullman 2.0 X 0 0 0 Sharon VanNostran MD 2.0 X 0 0 0 Joseph Varley MD 48.0 X 327802 0 8492 Norman Wells 2.0 X 0 0 0 Darrell Widmer MD 48.0 X 163848 0 5169 Jay Williamson MD 48.0 X X 277318 0 9596 Stephen Wilt 2.0 X 0 0 0 Joseph Zarconi MD 48.0 X 519285 0 49246 Thomas DeBord 48.0 X 325407 0 24638 Brian Derrick 48.0 X 142749 0 13023 C Michael Rutherford 48.0 X 175364 0 144 Jeffrey Morris MD 48.0 X 313646 0 32887 Charles Alderson 48.0 X 230557 0 17663 Bryan Fredericks 48.0 X 313718 0 21897 Kathleen Jobe 48.0 X 211945 0 17849 Michael Hillman MD 48.0 X 551561 0 54514 Gregory Kall 48.0 X 432141 0 45456 Unhee Kim 48.0 X 546394 0 51157 Kyle Klawitter 48.0 X 431997 0 85029 Patrice Lange 48.0 X 423614 0 39657 Charles Ross MD 48.0 X 435938 0 34480 James Stonkus 48.0 X 209631 0 41551 Kevin Theiss 48.0 X 291432 0 26128 Mary Ward 48.0 X 545282 0 45390 John Zografakis MD 48.0 X 886987 0 25810 Scott Weiner MD 48.0 X 657932 0 24662 Mehool Patel MD 48.0 X 656476 0 6651 Eric Espinal MD 48.0 X 643840 0 20288 Jennifer Restivo MD 48.0 X 646561 0 24566 Kathleen Rice 0.0 X 480992 0 622 Stephen Kaiser DO 0.0 X 120141 0 13009 John Brocketti 0.0 X 104685 0 1394 19880877 16500 1370064 436 true true false Hammond Construction Inc 1278 Park Avenue CANTON OH 44706 Construction 12690000 Professional Anesthesia Services 190 North Union Street AKRON OH 44304 Medical services 7925960 Matrix Management Solutions 5200 Stoneham Road NORTH CANTON OH 44720 Billing Services 4454241 Eclipsys Corporation Three Ravinia Drive ATLANTA GA 30346 IT & EMR Services 4434835 Sodexo Inc 10 Earhart Drive WILLIAMSVILLE NY 14221 Catering Services 4121336 139 245931 479870 1667350 3660466 411228 6053617 NET PATIENT REVENUE 621110 1036605859 1036345013 260846 PROGRAM RELATED INVESTMENTS 900099 11552475 8572245 -97094 3077324 REFERENCE LAB 621500 11266138 11266138 HOUSE CALL PROGRAM 900099 1051482 1051482 RESEARCH REVENUE 541700 946986 946986 123182 123182 1061546122 17362933 17362933 3063605 3063605 0 10150846 1478892 4129721 815091 6021125 663801 6684926 663801 6021125 43413650 9845 41902189 9466 1511461 379 1511841 1511841 72600 245931 123342 -50742 -50742 0 0 CAFETERIA SALES 722210 5034577 487158 4547419 PARKING 812930 1524898 1524898 GIFT/FLOWER SHOP 453220 1007934 1007934 3897772 245576 3652196 11465181 1107637483 1047038908 12826425 41718533 1367325 1367325 81096 81096 0 0 16739332 10737463 6001869 1364125 778448 585677 385409752 342770254 42102986 536512 8642540 7762937 879603 56865178 50057270 6661252 146656 26870325 23645886 3224439 9020758 3006093 6014665 1504486 2614 1501872 670995 221196 449799 145402 145402 0 54151 54151 126132151 108198767 17848349 85035 4370518 1034649 3316479 19390 23001669 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TAX 2596862 0 2596862 0 8363285 3867513 4326102 169670 1063838980 939490373 123245083 1103524 1896696 1450134 123566622 137063192 7068394 4886801 142807314 157350663 9522 3952 0 0 16878270 21027546 10521760 12031830 8678367 9000945 1062544036 626143458 390001352 436400578 247510295 217906778 3843888 4675205 12420773 24403441 2854654 2696636 97358640 107123941 1065416547 1136021642 123988157 157668147 2560350 1915588 2380384 3543430 358138764 356342139 1298070 1164886 0 0 34897978 20536469 0 0 151459219 176869115 674722922 718039774 X 353905299 379626550 20748468 22097706 16039858 16257612 390693625 417981868 1065416547 1136021642 X 43798503 -16510260 X false true true X true true X false false false SUMMA AKRON CITY & ST THOMAS HOSPITALS 340714755 03 true 363361 SUMMA BARBERTON CITIZENS HOSPITAL 261375072 03 true 0 CUYAHOGA FALLS GENERAL HOSPITAL 340718383 09 true 0 THE WADSWORTH-RITTMAN AREA HOSPITAL ASSN 346549371 03 true 0 SUMMA AKRON CITY & ST THOMAS HOSPITALS FOUNDATION 341219001 07 true 0 SUMMA FOUNDATION 320323002 07 true 0 6 363361 6660819 6323558 4540510 6941569 5638036 30104492 6660819 6323558 4540510 6941569 5638036 30104492 1416886 28687606 3713044 2479286 1527282 1494312 1752613 10966537 41071029 3984878 0.69849 0.63443 X 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 Akron City & St Thomas Hospitals Foundation.) Based on the public support test under Part III, the public support percentage for 2011 for CFGH which should be shown in Section C, Line 15, is 94.12%. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true 700 true 19800 true 36670 true 85232 false true 3000 145402 false Part II-B, Line 1 In 2011, Summa Health System volunteers and management interacted with Federal and state leaders to discuss the impact of the Affordable Care Act on local operations and finances. Summa leaders shared their perspective relative to Accountable Care, Sustainable Growth Rate, Graduate Medical Education, Medicare, Medicaid and Insurance Reform with members, staff, and agency leadership at Federal, state and regional levels. Summa leaders also provided education to members and staff to help them understand how deficit and debt decisions impact safety net providers like Summa. 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 15633841 113108 149521 15896470 13145135 2481325 7380 15633840 13311624 -183166 16677 13145135 9445067 3890076 -23519 13311624 1.00000 true false 65111627 65111627 596888858 266268414 330620444 2926994 2385773 541221 366012820 343669378 22343442 31603737 13819893 17783844 436400578 MALPRACTICE FUND 12793819 BONDS ASSURED GUARANTY 4660690 BOND ISSUE COSTS 1713838 BENEFICAL INTEREST IN WRHF 934010 DEFERRED PENSION & COMP 239920 PURCHASE OPTION ASSET 1694014 NON-PERF ASSET AIR RIGHTS 1124370 BENEFICAL INTEREST IN PERP. TR 3772403 DUE FROM RELATED ORGANIZATIONS 75988419 OTHER ACCOUNTS RECEIVABLE 261917 BENEFICAL INTEREST IN PROPERTY 2813463 INVESTMENTS - OTHER 1127078 107123941 0 LEASE ESCALATION LIABILITY 649205 CAPITAL LEASE OBILIGATIONS 45096041 ASSET RETIREMENT OBLIGATION FI 2218218 INTEREST RATE SWAP 13391519 POST RETIREMENT BENEFITS 1652211 CONTINGENT LIABILITIES 4733692 MALPRACTICE LIABILITY 12301079 UNSECURED PAYABLES 67498785 PURCHASE OPTION LIABILITY 27469643 OTHER OBLIGATIONS 1858722 176869115 Part IV, Line 2b Custodial funds held by Summa Akron City & St. Thomas Hospitals 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 Akron City & St. Thomas Hospitals 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, Inc. ("SIC"), together with affiliates of SHS 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 income 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 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 of deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. true South Asia 0 0 Investments 63297 Central America and the Caribbean 0 0 Program Services Self insurance 4702729 0 0 0 0 4766026 4766026 true false true false false false Golf Outing 236200 175772 60428 0 505 0 43533 23182 19251 Men Who Cook 82331 70159 12172 0 4093 6138 13444 0 13196 0 0 0 0 0 0 0 0 0 0 318531 245931 72600 0 4598 6138 56977 23182 32447 123342 -50742 true true X true X true X true true true false true true 16590777 4903628 11687149 0.01100 148466581 120897216 27569365 0.02590 0 0 0 165057358 125800844 39256514 0.03690 1102455 0 1102455 0.00100 30346009 11510458 18835551 0.01770 24984044 0 24984044 0.02340 6421433 1304589 5116844 0.00480 1946473 151028 1795445 0.00170 64800414 12966075 51834339 0.04860 229857772 138766919 91090853 0.08550 21062 21062 10486 10486 15369 15369 4200 4200 262 262 1278 1278 118733 118733 0.00010 87601 87601 0.00010 258991 258991 0.00020 true 22185613 0 362933784 379535818 -16602034 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 Aris Teleradiology Radiology Service 0.65000 0.35000 Digestive Health Ctr Digestive Disease 0.05000 0.44000 Medina-Summit ASC Ambulatory Surgery Center 0.20000 0.70000 6 1 Summa Akron City Hospital

525 East Market Street Akron OH 44304

X X X X X 2 Summa St Thomas Hospital

444 North Main Street Akron OH 44310

X X X X X 3 Summa Barberton Hospital

155 Fifth Street NE Barberton OH 44203

X X X X 4 The Wadsworth-Rittman Area Hospital Assn

195 Wadsworth Road Wadsworth OH 44281

X X X 5 Crystal Clinic Orthopaedic Center LLC

3925 Embassy Parkway 250 Akron OH 44333

X X X 6 Summa Western Reserve Hospital LLC

1900 23rd Street Cuyahoga Falls OH 44223

X X X X Summa Akron City Hospital 1 true true 200. true 400. true X X X X X X false true X X X X X X true false true X false false Summa St Thomas Hospital 2 true true 200. true 400. true X X X X X X false true X X X X X X true false true X false false Summa Barberton Hospital 3 true true 200. true 400. true X X X X X X false true X X X X X X true false true X false false The Wadsworth-Rittman Area Hospital Assn 4 true true 200. true 400. true X X X X X X false true X X X X X X true false true X false false Crystal Clinic Orthopaedic Center LLC 5 true true 200. true 400. true X X X X X X false true X X X X true false false X X false false Summa Western Reserve Hospital LLC 6 true true 200. true 400. true X X X X X X false true X X X X true false true X false false 19 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 Neurosciences at White Pond

750 White Pond Drive Akron OH 44320

Neurology services Summa Sleep Medicine Center

3985 Medina Road Ste 210 Medina OH 44256

Sleep and 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 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 $81,393,136. Part I, Line 7(g) The amount of subsidized health services reported on Line 7(g) attributable to Summa Physicians, Inc. ("SPI") is $21,248,939. Part III, Line 4 A cost-to-charge ratio is used to determine the amount reflected on Line 2. Text of the Audited Financial Statement Footnote: "Summa Health System grants equal access for health services to all members of the community regardless of financial status. Net patient service revenue is reported at the estimated net realizable amounts from patients, third-party payors, public programs or others. It is Summa Health System's policy to bill for, and pursue collection of all services rendered. An estimated provision for doubtful accounts is recorded that results in net patient service revenue being reported at the net amount expected to be received. Summa Health System has determined, based on an assessment at the consolidated level, that patient service revenue is primarily recorded prior to assessing the patient's ability to pay and as such, the entire provision for doubtful accounts related to patient revenue is recorded as a deduction from patient service revenue in the accompanying consolidated statements of operations and changes in net assets. At the point in time that a charge is believed to be uncollectible, the related receivable is written-off as a doubtful account. Allowances are made for estimated doubtful accounts. Estimates of retroactive adjustments under reimbursement agreements with third-party payors are accrued in the period the related services are rendered and adjusted in future periods as adjustments become known or as years are no longer subject to audits, reviews and investigations." An important part of Summa Health System's commitment to providing quality and accessible healthcare includes covering the expense of payments that were expected but not received. While Summa Health System recognizes that the cost of bad debt is part of the cost of doing business, we agree with the Ohio Hospital Association that it is important to report these costs to show the total picture of how much care Summa Health System provides to the community without full reimbursement. Part III, Line 8 Medicare allowable costs are based on information provided on worksheet B, part I, column 26, line 118 from the various hospital's 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 V, Line 13(g) 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. Part VI, Line 2 The health care needs of the community are assessed by a survey conducted collaboratively by Summa Health System, Summit County Health District, Healthy Connections Network, Akron City Health Department, Children's Hospital 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 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 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 (546,000) and accounts for more than 60% of the persons served by Summa. Medina and Portage Counties have similar populations, with Medina being slightly larger. Each accounts for less than 20% of the persons served by Summa. The region and its people are continuing to recover economically. More than 50% of households in Summit and Portage Counties make less than $50,000 dollars annually and 13.2% and 11.9% of households make less than $15,000 dollars annually respectively. Similarly, for the calendar year 2009, the monthly unemployment rates for Medina, Portage, and Summit Counties were 8.2%, 10.7%, and 10.8% 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 Portage and Summit Counties is expected to remain flat, Medina County is projected to see considerable growth: 7% from the 5-year period 2008 to 2013. More importantly, the age groups that demand healthcare services the most (45-64 year olds and age 65 and older) are expected to grow significantly. In Summit County alone, these two groups are expected to increase 3.6% and 7.8% respectively over the five year period. The growth in population for those aged 65 and older is more dramatic in Portage and Medina Counties where this age group will grow 13.4% and 20.1% respectively. These growth rates indicate increasing demand for Summa's services in a concurrently challenging market where citizens are progressively more dependent on Summa's charitable services. 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 (Federally Qualified Health Center, OPEN M, Access to Care Program) 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 2,100 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 are located near downtown Akron, Ohio and have 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 ("SWRH") is a joint venture between Summa Health System 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 ("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. Robinson Memorial Hospital, an affiliate of Summa Health System, is the largest provider of acute medical care in Portage County. This affiliation is charged with the responsibility of providing greater access to healthcare services for the residents of Portage County and the surrounding communities through joint ventures and physician strategies. Established in 1993, SummaCare offers a full line of health plans including PPO plans, HMO plans and Point-of-Service plans and Medicare POS plans plus life, dental and vision plans. 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 and Summa Akron City & St. Thomas Hospitals Foundation are nonprofit organizations 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, these Foundations create and implement innovative partnerships, health policy opportunities and funding strategies to support Summa Health System's education, research and patient care agenda. Summa Health Network 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 (through a joint venture with Summa Health System) 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. Ohio Health Choice 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 more than 275 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 with the Ohio Hospital Association annually. true Austen BioInnovation Institute in Akron 302 Buchtel Common Akron OH 443256220 346002924 501(c)(3) 567867 Founding member contribution American Heart Association 5455 N High Street Columbus OH 43214 135613797 501(c)(3) 94255 Healtcare research & education Open M Summit County Free Clinic 941 Princeton Street Akron OH 44311 341046107 501(c)(3) 21870 Health & Wellness Habitat for Humanity of Summit County 2301 Romig Road Akron OH 44320 341518873 501(c)(3) 5580 Community support University of Akron 198 Fir Hill Akron OH 44325 346002924 501(c)(3) 25500 Research & education Valor HomeFamily And Community Services 705 Oakwood Street Ste 106 Ravenna OH 44266 341902451 501(c)(3) 8000 Social Services The Ohio University Foundation PO Box 869 Athens OH 45701 316402113 501(c)(3) 6000 Academic & Research Wick Poetry Center Kent State University 301C Satterfield Hall Kent OH 44242 316402079 501(c)(3) 9000 Education Susan G Komen Northeast Ohio 26210 Emery Rd Ste 307 Cleveland OH 44128 751835298 501(c)(3) 7500 Cancer research Akron Urban League 440 Vernon Odom Blvd Akron OH 44307 340714520 501(c)(3) 11180 Education American Cancer Society 525 North Broad St Canfield OH 444069274 251798733 501(c)(3) 20000 Healthcare research & education Friends of 913 65 Steiner Ave Akron OH 44301 264312124 501(c)(3) 9000 Community support Akron Symphony 17 N Broadway Akron OH 44308 346003828 501(c)(3) 10000 Funds & Inkind Svcs Conservancy for CVNP 403 W Hines Rd Peninsula OH 44264 341917257 501(c)(3) 5400 Economic Development Greater Akron Chamber 1 Cascade Plaza 17th Floor Akron OH 44308 341156576 501(c)(6) 6640 Education WD 15 1 Dental Clinic Fund 48 15084 Book NA Ophthalmology Cataract Surgery 65 47996 Book NA SummaShares 17 12699 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 providing the services. 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 true true X X X X true true false false false true true false false Kyle Allen DO 237003 0 0 0 1595 0 7060 0 34863 0 280521 0 0 0 Michael Bage MD 400876 0 103034 0 600 0 0 0 10204 0 514714 0 0 0 William Bauman MD 558175 0 34828 0 1380 0 7350 0 10231 0 611964 0 0 0 Thomas DeBord 232748 0 81279 0 11380 0 10818 0 13820 0 350045 0 0 0 Brian Derrick 52292 0 90167 0 290 0 0 0 13023 0 155772 0 0 0 T Clifford Deveny MD 123150 0 85236 0 64704 0 5589 0 30943 0 309622 0 0 0 Steven Gaich MD 279745 0 48029 0 0 0 7350 0 18124 0 353248 0 0 0 Robert Harrigan 555736 0 445636 0 1620 0 63374 0 11185 0 1077551 0 59456 0 Thomas Knoll 222408 0 0 0 0 0 0 0 0 0 222408 0 0 0 Joseph Koenig MD 540159 0 113681 0 0 0 27476 0 45782 0 727098 0 25061 0 Joseph McShannic MD 436840 0 100 0 0 0 0 0 22188 0 459128 0 0 0 Dale Murphy MD 361977 0 198066 0 8880 0 32298 0 10470 0 611691 0 31632 0 Thomas O'Neill 250502 0 228792 0 8880 0 25002 0 42172 0 555348 0 18072 0 William Powel III 347908 0 256118 0 11380 0 44368 0 45209 0 704983 0 39594 0 C Michael Rutherford 18301 0 129714 0 27349 0 0 0 144 0 175508 0 0 0 Steve Schmidt 226812 0 87776 0 5780 0 7350 0 5189 0 332907 0 0 0 Thomas Strauss 773567 0 940536 0 840 0 86712 0 10980 0 1812635 0 84223 0 Douglas Trochelman MD 585669 0 68672 0 0 0 7350 0 10231 0 671922 0 0 0 Joseph Varley MD 269869 0 57153 0 780 0 7350 0 1142 0 336294 0 0 0 Darrell Widmer MD 147916 0 15932 0 0 0 4515 0 654 0 169017 0 0 0 Jay Williamson MD 190184 0 85394 0 1740 0 0 0 9596 0 286914 0 0 0 Joseph Zarconi MD 302519 0 206766 0 10000 0 38932 0 10314 0 568531 0 36106 0 Jeffrey Morris MD 227635 0 79391 0 6620 0 7783 0 25104 0 346533 0 0 0 Charles Alderson 166189 0 57748 0 6620 0 6301 0 11362 0 248220 0 0 0 Bryan Fredericks 236415 0 70923 0 6380 0 7800 0 14097 0 335615 0 0 0 Kathleen Jobe 152308 0 53257 0 6380 0 6525 0 11324 0 229794 0 0 0 Michael Hillman MD 369424 0 180757 0 1380 0 24736 0 29778 0 606075 0 0 0 Gregory Kall 260439 0 160285 0 11417 0 35307 0 10149 0 477597 0 25902 0 Unhee Kim 324132 0 210808 0 11454 0 39112 0 12045 0 597551 0 31053 0 Kyle Klawitter 239729 0 96153 0 96115 0 32983 0 52046 0 517026 0 23741 0 Patrice Lange 238859 0 172913 0 11842 0 34414 0 5243 0 463271 0 27071 0 Charles Ross MD 251026 0 176032 0 8880 0 24652 0 9828 0 470418 0 18224 0 James Stonkus 150162 0 53089 0 6380 0 5495 0 36056 0 251182 0 0 0 Kevin Theiss 175527 0 105885 0 10020 0 12544 0 13584 0 317560 0 7309 0 Mary Ward 312149 0 221753 0 11380 0 39704 0 5686 0 590672 0 23263 0 John Zografakis MD 462219 0 423028 0 1740 0 7350 0 18460 0 912797 0 0 0 Scott Weiner MD 477514 0 178798 0 1620 0 7350 0 17312 0 682594 0 0 0 Mehool Patel MD 538191 0 118254 0 31 0 1226 0 5425 0 663127 0 0 0 Eric Espinal MD 379844 0 262616 0 1380 0 0 0 20288 0 664128 0 0 0 Jennifer Restivo MD 534061 0 112469 0 31 0 8367 0 16199 0 671127 0 0 0 Kathleen Rice 6989 0 410156 0 63847 0 125 0 497 0 481614 0 0 0 Stephen Kaiser DO 114311 0 5830 0 0 0 3751 0 9258 0 133150 0 0 0 John Brocketti 1409 0 34431 0 68845 0 1137 0 257 0 106079 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, and tax preparation services were paid on behalf of certain officers. The personal use is reflected as wages. Part I, Line 4a In 2011, Kathleen Rice received $481,614 in severance and benefits. John Brocketti received $106,079 in severance and benefits. 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 2011: Thomas J. Strauss $79,632, Robert Harrigan $56,024, Mary Ward $32,354, Kyle Klawitter $25,160, Greg Kall $27,434, William A. Powel, III $37,018, Joseph Zarconi, MD $31,582, Patrice Lange $24,934, Unhee Kim $33,404, Thomas P. O'Neill $17,532, Charles Ross, MD $17,302, Dale Murphy, MD $24,948, Joseph Koenig, MD $20,126, Michael Hillman, MD $17,386, Kevin Theiss $12,544 and Thomas DeBord $4,116. Part I, Line 6 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. Akron Bath Copley Jt Twp Hosp Dist 341448680 009730LT7 2004-06-10 160904918 See Schedule O, Rider 2 false false false Summit County Port Authority 341765940 86605VAE9 2006-10-31 15405000 See Schedule 0, Rider 6 false false false Ohio Higher Educational Facility Comm 346849674 67756AY89 2010-05-11 180125341 See Schedule O, Rider 10 false false false 15055000 0 164278376 3107915 2238718 0 2285007 3930806 0 89411463 59931009 0 2006 true true true true 620000 0 15405000 0 867000 0 308100 153159 0 14076741 0 0 2008 false false true true 0 0 180125341 18190573 3004911 0 0 4929857 0 99408811 0 54591189 true false false true false true true false false 0.18370 0.00090 0.18460 true true true false false 0.03000 0.02500 0.05500 true false true true true false 0.04100 0.00380 0.04480 true false true false 0 true See Rider 3 3.1 true false false false true true See Rider 7 30. false false false 0 false true false false false 0 true See Rider 11 2.2 true false true Steven Gaich MD Salary advance X 25000 3952 false true true 3952 Kelly Bianco Family Member 24048 See Part V false Brian Bauman MD Family Member 434704 See Part V false Denise Angerstien Family Member 48646 See Part V false Deanne Kvach Family Member 56109 See Part V false Vincent Allen Family Member 46893 See Part V false Deborah Rutherford Family Member 34277 See Part V false Professional Anesthesia Service In See Part V 7925960 See Part V false Summa Emergency Associates See Part V 1543378 See Part V false Inpatient Medical Services Inc See Part V 173850 See Part V false Primary Care Physicians See Part V 2378025 See Part V false Ritzman Pharmacies Inc See Part V 2195345 See Part V false Predevelopment Limited See Part V 109770 See Part V false Park West One LLC See Part V 294603 See Part V false Schedule L, Part IV Business Transactions Involving Interested Persons Kelly Bianco is a family member of Michael Bianco, M.D., director of WRH. Kelly Bianco was paid reasonable compensation as an employee of WRH. Brian Bauman, M.D. is a family member of William Bauman, M.D., director of Summa Physicians Inc. Brian Bauman was paid reasonable compensation as an employee of Summa Physicians Inc. Denise Angerstien is a family member of Dennis Chack, director of SACSTH. Denise Angerstien was paid reasonable compensation as an employee of SACSTH. Deanne Kvach is a family member of Kyle Klawitter, System VP of Human Resources. Deanne Kvach was paid reasonable compensation as an employee of SACSTH. Vincent Allen is a family member of Unhee Kim, VP of Clinical Services. Vincent Allen was paid reasonable compensation as an employee of SACSTH. Deborah Rutherford is a family member of C. Michael Rutherford, Director & System CFO. Deborah Rutherford was paid reasonable compensation as an employee of SBH. Jacob Cohen, M.D., Director of SACSTH, is an officer of Professional Anesthesia Services, Inc. Compensation represents fees paid for services performed by Professional Anesthesia Services, Inc. Michelle Blanda, M.D., director of SACSTH, is an officer of Summa Emergency Associates, Inc. Compensation represents fees paid for services performed by Summa Emergency Services, Inc. Robert Schaal, M.D., director of SACSTH, is an officer of Inpatient Medical Services, Inc. Compensation represents fees paid for services performed by Inpatient Medical Services, Inc. Sharon VanNostran, D.O., director of SACSTH, is an officer of Primary Care Physicians. Compensation represents fees paid for services performed by Primary Care Physicians. Eric Graf, Director of WRH, is part owner of Ritzman Pharmacies, Inc. Thomas Knoll, Director of WRH, is on the board of Ritzman Pharmacies, Inc. Compensation represents fees for goods & services to Ritzman Pharmacies, Inc. T. Clifford Deveny, M.D., director & President of SPI, is part owner Predevelopment Limited and Park West One, LLC. Compensation represents lease payments to Predevelopment Limited and Park West One, LLC. X 9 113056 FMV X 5 279947 FMV X Events 53 18225 Comparable Prices false true false 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 22 11 Hospitals (SACSTH) Summa Akron City & St. Thomas 29 25 Hospitals Foundation (SACSTHF) Summa Foundation (SF) 28 24 Summa Physicians, Inc. (SPI) 7 0 Summa Barberton Citizens 12 10 Hospital (SBH) The Wadsworth-Rittman Area 13 9 Hospital Assn (WRH) Cuyahoga Falls General 13 11 Hospital (CFGH) Form 990, Page 6, Part III, Line 4d Other Programs Services included the Physician House Calls program, a collaboration between Summa Health System and SummaCare. This program helps meet the needs of those patients in our community who have difficulty going to their physician's office for the care of their acute and chronic health problems. This program is designed to provide ongoing access to care in the patient's home 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 6, Part VI, Line 1a Summa Akron City and St. Thomas Hospitals: N/A Summa Akron City and St. Thomas Hospitals Foundation: Summa Akron City and St. Thomas Hospitals Foundation has an Executive Committee comprised of the Chair, President, Secretary, Treasurer, and the Special Voting Directors of the Summa Akron City and St. Thomas Hospitals Foundation. The Special Voting Directors are the Chair, Summa Akron City and St. Thomas Hospitals Board of Directors; Chair, Summa System Board of Directors; President of Summa Health System; President, Medical Staff, Summa Akron City and St. Thomas Hospitals; and the Vice President, Medical Education and Research, Summa Akron City and St. Thomas Hospitals. All members of the Executive Committee are Directors of Summa Akron City and St. Thomas Hospitals 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 Akron City and St. Thomas Hospitals 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 Akron City and St. Thomas Hospitals Foundation. Summa Foundation: Summa Foundation has an Executive Committee. The Executive Committee is appointed by the Board of Directors and may include up to eleven (11) Directors including the Chair, President, Secretary, Treasurer, and the Special Voting Directors. The Special Voting Directors are (i) Chair, Summa Health System Board of Directors; (ii) President & CEO, Summa Health System; (iii) System Vice President, Medical Education & Research, (iv) System Director, Research; and (v) President, Summa Foundation. All members of the Executive Committee are Directors of Summa Akron City and St. Thomas Hospitals 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. Summa Barberton Citizens Hospital: N/A The Wadsworth-Rittman Area Hospital Assn: The Wadsworth-Rittman Area Hospital Assn has 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 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 Wadsworth-Rittman Area Hospital Assn 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 Wadsworth-Rittman Area Hospital Assn. Cuyahoga Falls General Hospital: Cuyahoga Falls General Hospital has an Executive Committee comprised of three (3) physician directors, three (3) community directors, and (1) director selected by Summa Health System, the sole member of Cuyahoga Falls General Hospital. All members of the Executive Committee are Directors of Cuyahoga Falls General Hospital. The Executive Committee nominates the Community Directors to the Board of Directors and serves an advisory function to bring issues of importance to the board of directors of the Member, Summa Health System. Additionally, the Executive Committee has 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: Michael Bage, M.D., Douglas Trochelman, M.D., and Willam A. Powel, III have business relationships through Summa Physicians, Inc.: Michael Bage, M.D. and Douglas Trochelman, M.D. are employed by Summa Physicans, Inc.; William A. Powel, III is a Director of Summa Physicians, Inc. Dennis Chack and Anthony Lockhart have a business relationship through First Energy: Dennis Chack is employed as an officer of First Energy and Anthony Lockhart is a retired officer of First Energy. Thomas Strauss and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: both are Directors of Summa Western Reserve Hospital. Greg Kall, Thomas O'Neill, and Unhee Kim have a business relationship through ARIS Teleradiology, LLC: all are Directors of ARIS Teleradiology, LLC. Summa Akron City and St. Thomas Hospitals Foundation: Anthony Lockhart and Richard Marsh have a business relationship through First Energy: both are retired officers of First Energy. Summa Foundation: Anthony Lockhart and Richard Marsh have a business relationship through First Energy: both are retired officers of First Energy. Summa Physicians, Inc.: Joseph Koenig, M.D., William Bauman, M.D., Dale Murphy, M.D., and Steven Gaich, M.D. are employed by Summa Physicians, Inc. and A. Gus Kious, M.D. is the President and a Director of Summa Physicians, Inc. William A. Powel, III and Thomas O'Neill are all employed by Summa Akron City and St. Thomas Hospitals. Summa Barberton Citizens Hospital: N/A The Wadsworth-Rittman Area Hospital Association: 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 Strauss and Thomas Knoll have a business relationship through Summa Western Reserve Hospital: both are Directors of Summa Western Reserve Hospital. Cuyahoga Falls General Hospital: Stephen Hailer and C. Michael Rutherford have a business relationship through North Akron Savings Bank. Stephen Hailer is President of North Akron Savings Bank and C. Michael Rutherford is a Director of North Akron Savings Bank. Stephen Hailer, Thomas Strauss and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: all are Directors of Summa Western Reserve Hospital. Douglas Chonko, D.O. and Ronald Russ, D.O. have a business relationship through Kent Management Group: each is employed by Kent Management Group. Form 990, Page 6, Part VI, Line 4 Summa Foundation Summa Foundation merged with Summa Akron City and St. Thomas Hospitals Foundation effective June 1, 2012. Summa Akron City and St. Thomas Hospitals Foundation was the surviving corporation and effective on the merger date, the surviving corporation changed its name to Summa Foundation. Summa Akron City and St. Thomas Hospitals Foundation Summa Akron City and St. Thomas Hospitals Foundation merged with Summa Foundation effective June 1, 2012. Summa Akron City and St. Thomas Hospitals Foundation was the surviving corporation and effective on the merger date, the surviving corporation changed its name to Summa Foundation. The following changes have been made to the Code of Regulations since the filing of the 2010 990: (i) Changed the name of the corporation from "Summa Akron City and St. Thomas Hospitals Foundation" to "Summa Foundation"; (ii) Changed the Member from Summa Akron City and St. Thomas Hospitals to Summa Health System; (iii) Changed the voting requirements for the sole Member to reject an elected director from 60% of Member's Board of Directors to a simple majority; (iv) Changed the maximum number of Directors from 49 to 30 with not less than 25; (v) Changed the quorum definition from 40% to 50%; (vi) Added a requirement that a majority of the Directors be independent; (vii) Reduced the number of Special Voting Directors from 5 to 1; only the President & CEO of Summa Health System will be a Special Voting Director. (viii) The following Special Voting Directors were deleted: (1) Chair, Summa Akron City and St. Thomas Hospitals; (2) Chair, Summa Health System; (3) President, Medical Staff, Summa Akron City and St. Thomas Hospitals; and (4) System Vice President, Medical Education and Research; (ix) Reduced the size of the Executive Committee from up to 11 to 5; (x) Specified that the Executive Committee is to be appointed at the annual meeting; members will consist of the Chair, Vice Chair, Secretary, Treasurer and one director named by the Chair; (xi) Specified that the Executive and Finance Committees shall be the standing committees; the Development Committee was deleted as a standing committee; (xii) Added a Vice Chair and a Chief Development Officer to the list of officers; (xiii) Changed the single President & COO position to two individual positions. 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 Akron City and St. Thomas Hospitals Foundation: Summa Akron City and St. Thomas Hospitals is the sole member of Summa Akron City and St. Thomas Hospitals Foundation. Summa Foundation: Summa Health System is the sole member of Summa Foundation. Summa Barberton Citizens Hospital: The sole member of Summa Barberton Citizens Hospital is Summa Barberton Wadworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. The Wadsworth-Rittman Area Hospital Association: The sole member of The Wadsworth-Rittman Area Hospital Assn is Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. 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: Summa Health System is the sole member of Cuyahoga Falls General Hospital. Form 990, Page 6, Part VI, Line 7a Summa Akron City and St. Thomas Hospitals: (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. Summa Akron City and St. Thomas Hospitals Foundation: In addition to directors elected by the Summa Akron City and St. Thomas Hospitals Foundation Board as the sole member of Summa Akron City and St. Thomas Hospitals Foundation, subject to approval by Summa Health System, the individuals holding the following offices serve as directors of Summa Akron City and St. Thomas Hospitals Foundation for so long as they serve in their respective capacities: (i) Chair, Summa Akron City and St. Thomas Hospitals Board of Directors; (ii) Chair, Summa Health System Board of Directors; (iii) President of Summa Health System; (iv) President, Medical Staff, Summa Akron City and St. Thomas Hospitals; and (v) Vice President, Medical Education and Research, Summa Akron City and St. Thomas Hospitals. Summa Foundation: In addition to directors elected by the Summa Health System Board as the sole member of Summa Foundation, the individuals holding the following offices serve as directors of Summa Foundation for so long as they serve in their respective capacities: (i) Chair, Summa Health System Board of Directors; (ii) President & CEO, Summa Health System; (iii) System Vice President, Medical Education & Research, (iv) System Director, Research; and (v) President, 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. Summa Barberton Citizens Hospital: 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. The Wadsworth-Rittman Area Hospital Assn: The sole member of The Wadsworth-Rittman Area Hospital Assn 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 The Wadsworth-Rittman Area Hospital Assn subject to the approval of Summa Health System. Cuyahoga Falls General Hospital: Summa Health System is the sole member of Cuyahoga Falls General Hospital and has 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 Health System is the sole member of Summa Akron City and St. Thomas Hospitals. As the sole member, Summa Health System has the power and authority to approve or disapprove of each of the following on behalf of Summa Akron City and St. Thomas Hospitals: (i) Any modifications of the essential nature, purpose, mission or operations of Summa Akron City and St. Thomas Hospitals; (ii) Approval of the Code of Regulations, Bylaws or other constitutive document of Summa Akron City and St. Thomas Hospitals and any corporation or entity controlled by, related or affiliated with Summa Akron City and St. Thomas Hospitals (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 Summa Akron City and St. Thomas Hospitals or any Affiliated Corporation; (iv) The establishment of qualifications for the selection of Directors, Directors or Managers of Summa Akron City and St. Thomas Hospitals; (v) The appointment or election and removal of members of the governing body of Summa Akron City and St. Thomas Hospitals; (vi)The appointment or election and removal of the President and/or Chief Executive Officer or similar officer of Summa Akron City and St. Thomas Hospitals; (vii) The adoption of annual operating and capital budgets of Summa Akron City and St. Thomas Hospitals; (viii) The adoption of the long range plans of Summa Akron City and St. Thomas Hospitals; (ix) Determinations as to the use and occupancy of any building owned or leased by Summa Akron City and St. Thomas Hospitals; (x) The sale, encumbrance, lease or disposition of real property of Summa Akron City and St. Thomas Hospitals other than in the ordinary course of the operations of Summa Akron City and St. Thomas Hospitals; and (xi) The merger, reorganization, dissolution or other corporate action of a similar nature, including participation in a joint venture, undertaken by Summa Akron City and St. Thomas Hospitals. Summa Akron City and St. Thomas Hospitals Foundation: Summa Akron City and St. Thomas Hospitals is the sole member ("Member") of Summa Akron City and St. Thomas Hospitals 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 Akron City and St. Thomas Hospitals 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 inclurred, 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. Form 990, Page 6, Part VI, Line 7b cont. 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 and the Member: (i) Any modification of the essential nature, purpose, mission or operations of the Corporation; (ii) Adoption of a Code of Regulations 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 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 Chief Operating Officer ("President & COO") or similar officer(s) of the Corporation; (vii) Adoption of annual operating and capital budgets of the Corporation; (viii) 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 Corporation'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; (ix) 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 Corporation which has not been previously approved by the Member exceeds certain dollar limits set from time to time by the Member; (x) Execution of any contract that calls for the Corporation to expend a sum in excess of certain dollar limits set from time to time by the Member or to provide services with a value in excess of certain dollar limits set from time to time by the Member; (xi) Adoption of the long range plans of the Corporation; (xii) Determinations as to the use and occupancy of any building owned or leased by the Corporation; (xiii) The purchase, sale, encumbrance, lease or disposition of real property of the Corporation other than in the ordinary course of the operations of the Corporation; and (xiv) The merger, reorganization, dissolution or other corporate action of a similar nature proposed by the Corporation. Summa Physicians, Inc.: N/A Summa Barberton Citizens Hospital: Summa Health System is the sole member of Summa Barberton Wadsworth-Rittman Hospitals, LLC which, in turn, is the sole member of Summa Barberton Citizens Hospital. Summa Health System has the power and authority to approve or disapprove of each of the following on behalf of Summa Barberton Citizens Hospital: (i) Any modification of the essential nature, purpose, mission or operations of Summa Barberton Citizens Hospital; (ii)Approval of the Codes of Regulations, Bylaws or other constitutive document of Summa Barberton Citizens Hospital and any corporation or entity controlled by, related to or affiliated with Summa Barberton Citizens Hospital (an "Affiliated Corporation") and any and all admendments 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 Summa Barberton Citizens Hospital or any Affiliated Corporation; (iv) The establishment of qualifications for the selection of Directors, Directors or Managers of Summa Barberton Citizens Hospital; (v) The appointment or election and removal of members of the governing body of Summa Barberton Citizens Hospital; (vi) The appointment or election and removal of the President and/or Chief Executive Officer or similar officer of Summa Barberton Citizens Hospital; (vii) The adoption of annual operating and capital budgets of Summa Barberton Citizens Hospital; (viii) The adoption of the long range plans of Summa Barberton Citizens Hospital; (ix) Determinations as to the use and occupancy of any building owned or leased by Summa Barberton Citizens Hospital; (x) The sale, encumbrance, lease or disposition of real property of Summa Barberton Citizens Hospital other than in the ordinanry course of the operations of Summa Barberton Citizens Hospital; and (xi) The merger, reorganization, dissolution or other corporate action of a similar nature undertaken by Summa Barberton Citizens Hospital. The Wadsworth-Rittman Area Hospital Association: Summa Health System is the sole member of Summa Barberton Wadsworth-Rittman Hospitals, LLC which, in turn, is the sole member of The Wadsworth-Rittman Area Hospital Assn. Summa Health System has the power and authority to approve or disapprove of each of the following on behalf of The Wadsworth-Rittman Area Hospital Assn: (i) Any modification of the essential nature, purpose, mission or operations of The Wadsworth-Rittman Area Hospital Assn; (ii)Approval of the Codes of Regulations, Bylaws or other constitutive document of The Wadsworth-Rittman Area Hospital Assn and any corporation or entity controlled by, related to or affiliated with The Wadsworth-Rittman Area Hospital Assn (an "Affiliated Corporation") and any and all admendments 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 The Wadsworth-Rittman Area Hospital Assn or any Affiliated Corporation; (iv) The establishment of qualifications for the selection of Directors, Directors or Managers of The Wadsworth-Rittman Area Hospital Assn; (v) The appointment or election and removal of members of the governing body of The Wadsworth-Rittman Area Hospital Assn; (vi) The appointment or election and removal of the President and/or Chief Executive Officer or similar officer of The Wadsworth-Rittman Area Hospital Assn; (vii) The adoption of annual operating and capital budgets of The Wadsworth-Rittman Area Hospital Assn; (viii) The adoption of the long range plans of The Wadsworth-Rittman Area Hospital Assn; (ix) Determinations as to the use and occupancy of any building owned or leased by The Wadsworth-Rittman Area Hospital Assn; (x) The sale, encumbrance, lease or disposition of real property of The Wadsworth-Rittman Area Hospital Assn other than in the ordinary course of the operations of The Wadsworth-Rittman Area Hospital Assn; and (xi) The merger, reorganization, dissolution or other corporate action of a similar nature undertaken by The Wadsworth-Rittman Area Hospital Assn. Cuyahoga Falls General Hospital: Summa Health System is the sole member of Cuyahoga Falls General 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 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 System Vice President, Finance and CFO and the System Vice President, Legal Services and General Counsel. This detailed review occurred in October 2012. 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 October 2012 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 15 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. The Compensation Committee engages outside consulting support to provide independent market data, advice and counsel to the Compensation Committee. For the past two years, the Compensation Committee has used The 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; System Vice President; Finance & CFO; System Vice President, Legal Services & General Counsel; System Vice President, IT&S & CIO; System Vice President, Service Lines, Ambulatory & Ancillary; System Vice President, Planning & Marketing; System Vice President & Chief Nursing Officer; System Vice President, Human Resources; System Vices President, Quality & Medical Affairs; Summa Akron City and St. Thomas Hospitals: President & COO Summa Akron City and St. Thomas Hospitals Foundation: President Summa Barberton Citizens Hospital & The Wadsworth-Rittman Area Hospital Assn: President & COO Summa Physicians, Inc: President SummaCare: President Form 990, Page 6, Part VI, Line 18 The Forms 990 are available on Summa Health System's website: www.summahealth.org. The Forms 990-T and group exemption application are available upon request. Form 990, Page 6, Part VI, Line 19 Summa Health System makes its Conflicts of Interest policy available on its website (www.summahealth.org). 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). The financial statements are available through Electronic Municipal Market Access (www.emma.msrb.org). Form 990, Page 12, Part XI, Line 5 Other Changes in Net Assets or Fund Balances Accrued Interest 310,232 Prior Year Net Asset Transfer 13,839,077 FASB 106 Post Retirement ( 227,540) Affiliate Liabilities (2,545,000) Write-down on sale of ARIS LLC (3,150,201) Unrealized Losses (5,483,336) Minimum Pension Liability (19,206,878) Other change in Net Assets ( 46,614) ----------- Total change in Net Assets (16,510,260) 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 2,100 registered, inpatient beds on the campuses of Summa Akron City and St. Thomas Hospitals, Summa Barberton Hospital, Summa Wadsworth-Rittman Hospital, Summa Western Reserve Hospital*, Crystal Clinic Orthopaedic Center*, and Robinson Memorial Hospital, an affiliate of Summa Health System.** In addition, outpatient care is provided in more than 16 community health centers and Emergency Departments (EDs), some integrated in the healthcare facilities and some are free standing. *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 below. ** Robinson Memorial Hospital, an affiliate of Summa Health System, is a county hospital. It is referenced in this document only for the purpose of identifying all entities affiliated with Summa Health System. 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. In 2011, Summa Akron City and St. Thomas Hospitals successfully met all requirements outlined by the Joint Commission, resulting in a three-year accreditation. Summa Akron City and St. Thomas Hospitals was also named #1 hospital in the Akron, Ohio, metropolitan area, and considered "high-performing" in eight specialties by U.S. News and World Report. During this period, patient satisfaction improved to the highest level in the history of both hospitals. Combined, Summa Akron City and St. Thomas Hospitals employs more than 5,300 individuals and has a medical staff of more than 1,000 professionals. Together, Summa Akron City and St. Thomas Hospitals has 1,027 registered beds and 69 licensed bassinets. All told, the buildings and facilities on both campuses total 1.7 million square feet. Summa Akron City Hospital: Summa Akron City Hospital offers general medical, surgical, cancer, 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, including the Heart & Lung Center/Specialty Health Center, the Jean and Milton Cooper Cancer Center and the Ann and David Brennan Critical Care Center. In 2011, in collaboration with the Akron Area YMCA, Summa successfully opened the University Park YMCA on the campus of Summa Akron City Hospital. Summa St. Thomas Hospital: Summa St. Thomas Hospital offers general medical, surgical, and critical care services. 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 Barberton Hospital: Summa Barberton Hospital is a 500,000 square foot acute care teaching hospital located on nearly 16 acres. The Summa Barberton Hospital campus is located approximately 10 miles southwest of Akron, Ohio. Summa Barberton Hospital employs more than 1,300 employees and approximately 400 medical staff. It has 311 registered adult beds and 16 available bassinets and in 2011, successfully completed triennial accreditation activities with the Joint Commission Survey, resulting in three-year accreditation. Summa Barberton Hospital also broke ground on a new $17.3 million expansion that involves a new emergency department, new dining area and a conference center. 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. An acute care facility and winner of The Joint Commission's Gold Seal of Approval, The Wadsworth-Rittman Area Hospital Association is located approximately 20 miles west of Akron, Ohio. The Wadsworth-Rittman Area Hospital Association has 98 registered beds, employs more than 450 employees, and has a medical staff of more than 320 professionals. In 2011, it successfully completed triennial accreditation activities with the Joint Commission Survey, resulting in three-year accreditation. The Wadsworth-Rittman Area Hospital Association doubled the size of their ICU to eight beds and moved the unit to a new, larger location. In surgical services they have added three new operating room suites, which became operational in November 2011. CHARITY CARE: In 2011, Summa Health System provided charity care at an estimated net cost of nearly $11.7 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 2011, the charity care program (including Hospital Care Assurance Program) benefitted nearly 83,000 patient encounters. Medicaid Shortfall: Ohio Medicaid reimbursements historically 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 $27.5 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 2011, the cost for providing care written off as bad debt was nearly $22.2 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 2011, Summa Health System provided approximately $1.1 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, Developing Options for Violent Emergencies (DOVE) program for crisis services and diabetes education are offered, even though they are not profitable. Income from other services is used to cover these costs. In 2011, the cost for subsidized services was more than $24.9 million. Form 990, Page 2, Part III, 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, Alzheimer's Association, the American Heart Association and Relay for Life, 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 2011, these contributions exceeded $1.7 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 2011. 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. Approximately $3.9 million in research funding was awarded during the year. In 2011, 400 clinical research protocols were conducted at Summa Health System, with a growing research agenda in patient-centered outcomes research. Inventions by Summa employees have led to six provisional patents being processed for filing, and three pending utility patents. 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 our region and beyond. Nursing education is also offered in collaboration with our local university partners. In 2011, 246 residents and fellows trained at Summa's three main hospitals. On average, more than 40% of these residents remain in our local and surrounding communities. Summa's 2011 investment in health professions education totaled more than $18.8 million. The work of Summa's internal medicine residency program, directed at improving the quality and safety of patient care as part of the ACGME's Educational Innovation Project, was presented at two national meetings and published in the Journal of Graduate Medical Education. In addition, Summa has expanded the size and scope of the medical simulation center in support of Summa's commitment to quality and safety, and approved the development of two new fellowship training programs, one in medical simulation and one in emergency medical services. 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. Health System Services: Following is a description of Summa Health System's notable accomplishments by primary service lines in 2011: Behavioral Health: The Summa Center for Behavioral Health offers a wide range of psychiatric and medical treatment services and provides a full continuum of care for patients with behavioral health needs. In 2011, Summa Akron City and St. Thomas Hospitals became a community Medicaid provider for ambulatory chemical dependency services to retain patients within Summa Health System for treatment. Behavioral Health established an on-call psychiatrist at Summa Barberton Hospital. Ambulatory chemical dependency services were relocated to Stark County to work more collaboratively with Aultman Hospital and AultCare as a provider of chemical dependency services for their patients. Cancer Care: Summa Health System holds one of the highest ratings by the American College of Surgeons Commission on Cancer, having received in 2011 a three-year accreditation with "Commendation". The Cancer Center has successfully coordinated a non-insured patient drug replacement program, eRecovery, between pharmacy and oncology services and has yielded System drug savings of more than $400,000 and a patient savings of more than $1.4 million (at hospital charges) in 2011. Cardiovascular: Summa Cardiovascular Institute at Summa Health System provides testing and treatment for cardiovascular issues affecting the heart and vascular systems. In 2011, Summa opened the Heart Failure Clinic on the campus of Summa Akron City Hospital and Summa Anticoagulation Management Services (SAMS), in collaboration with the pharmacy. Emergency Services: Summa Akron City Hospital has been verified a Level I trauma center since 1998 and Robinson Memorial Hospital, an affiliate of Summa Health System, has been verified a Level III trauma center since 2003. During 2011, the services available were expanded with the addition of the new emergency department at Summa Health Center at Lake Medina. Further progress was attained in the construction of the new emergency departments at Summa Akron City Hospital and Summa Health Center at Green (both opening in 2012.) Orthopaedics: In 2011, Summa Health System, through its joint venture Crystal Clinic Orthopaedic Center, increased its market share to 48.1 percent from 46.6 percent in nine regional market areas. Financial performance was improved through system-wide implant cost containment, uniform vendor contracts, and system-wide uniform payer contract renewals. Post Acute and Senior Services: Summa Health System's The Bridge to Home transitional RN model expanded in 2011 to cover six System hospitals and Mercy Medical Center. "It's My Health", a nursing model combining patient centered care and transitional care, received the Magnet "Best New Knowledge Innovations Award" at the ANCC National Magnet Conference in 2011. Women's Health: Summa Health System provides patient-centered care for women through unique programs include the Pelvic Pain Specialty Center and urogynecological/ incontinence care from the Institute for Minimally Invasive Therapeutics. During 2011, Women's Health achieved or exceeded the benchmarks set in the Ohio Hospital Compare core measures. 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 2011, Summa Health System provided charity care to the indigent (including unreimbursed Medicaid) at the net cost of more than $39.2 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. Form 990, Page 2, Part III continued Summa Physicians Inc. (SPI): Summa Physicians Inc. (SPI) is a Summa Health System entity comprised of multi-specialty physicians and practices. SPI employs more than 275 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 2011, Summa Physicians Inc. hired 32 physicians. SPI has made significant improvement in health risk assessments, and a total of 1,262 have been completed in 2011, leading to better documentation of care provided to Medicare patients and enhanced reimbursement. SPI implemented the electronic medical record system across 132 providers and 51 practice sites. A total of 63 physicians attested for "Meaningful Use" achieving an average incentive of $14,444 each, which aids in care coordination and integration. Summa Akron City & St. Thomas Hospitals Foundation and Summa Foundation: Through philanthropy, Summa Akron City & St. Thomas Hospitals Foundation and Summa Foundation support medical education, research, technology, and clinical innovation. Encompassing fundraising, resource development, community benefit, diversity and government relations, Summa Akron City & Summa St. Thomas Hospitals Foundation and Summa Foundation work 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 Foundations' 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. Contributions to the Summa Akron City & St. Thomas Hospitals Foundation in 2011 exceeded $4.2M, including private and public sector support and the value of partnerships and collaborative efforts. 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. The Office of Government Relations worked with the Ohio Hospital Association to advocate for a revised Franchise Fee formula. As a result, Summa gained $4.5 million over the next biennium period. Form 990, Schedule K, Part V Rider 1 (for Series 2004 Bonds): Part I, Line A(c)-CUSIP number of Series 2004 Bonds The CUSIP number assigned to the final maturity of the Series 2004A Bonds is 009730 LT7. The CUSIP number assigned to the final maturity of the Series 2004B Bonds is 009730 LU4. Note: The Series 2004A Bonds and the Series 2004B Bonds are treated as a single issue of bonds for federal tax purposes. Rider 2 (for Series 2004 Bonds): Part I, Line A(f)-Description of purpose of Series 2004 Bonds 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, 1994, 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) construct and equip other hospital facilities, (3) refund prior issues with the following issue dates: (a) December 22, 1992 and (b) June 10, 1993, (4) pay the initial costs of a liquidity facility, and (5) pay issuance costs. Note: The Series 2004A Bonds and the Series 2004B Bonds are treated as a single issue of bonds for federal tax purposes. Rider 3 (for Series 2004 Bonds): Part IV, Column A, Line 4b-Name of Provider of GIC for the Series 2004 Bonds Series 2004A Bonds Project Fund GIC - Financial Security Assurance Debt Service Reserve Fund GIC - Merrill Lynch Capital Services, Inc. Series 2004B Bonds Aegon/Transamerica Rider 4 (for Series 2004 Bonds): Part IV, Column A, Line 4c-Term of GIC for the Series 2004 Bonds Series 2004A Bonds Project Fund GIC - 3.1 years Debt Service Reserve Fund GIC - 30.4 years Series 2004B Bonds 3.1 years Rider 5 (for Series 2006 Bonds): Part I, Line B(c)-CUSIP number of the Series 2006 Bonds The CUSIP number assigned to the final maturity of the Series 2006 Bonds is 86605 VAE9. Rider 6 (for Series 2006 Bonds): Part I, Line B(f)-Description of purpose of the Series 2006 Bonds 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. Rider 7 (for Series 2006 Bonds): Part IV, Column B, Line 3b-Name of Provider of Hedge for the Series 2006 Bonds Huntington National Bank Rider 8 (for Series 2006 Bonds): Part IV, Column B, Line 3c-Term of Hedge for the Series 2006 Bonds 30 years Rider 9 (for Series 2010 Bonds): Part I, Line C(c)-CUSIP number of the Series 2010 Bonds The CUSIP number assigned to the final maturity of the Series 2010 Bonds is 67756A Y89. Rider 10 (for Series 2010 Bonds): Part I, Line C(f)-Description of purpose of the Series 2010 Bonds The purposes of the Series 2010 Bonds were to (1) currently refund a taxable loan to Summa Barberton citizens Hospital under a line of credit, the proceeds of which were used to acquire hospital facilities, (2) currently refund a taxable loan to Summa Akron City and St. Thomas Hospitals, the proceeds of which were used for certain capital expenditures, (3) construct and equip hospital facilities, (4) acquire, construct, and equip parking facilities, nursing facilities, administrative facilities, ambulatory care facilities, and medical equipment, and (5) pay issuance costs. Rider 11 (for Series 2010 Bonds): Part IV, Column C, Line 4b-Name of Provider of GIC for the Series 2010 Bonds Morgan Stanley & Company Incorporated Rider 12 (for Series 2010 Bonds): Part IV, Column C, Line 4c-Term of GIC for the Series 2010 Bonds 2.2 years Summa Enterprise Group LLC 525 East Market Street Akron OH 44304 030507853 Consulting OH 2405075 12548583 SACSTH Summa Enterprise Group Properties LLC 525 East Market Street Akron OH 44304 550837372 Real Estate OH 445782 122495 SEG Akron Endoscopy ASC LLC 525 East Market Street Akron OH 44309 621865245 prof.med.svcs OH 0 20000 sacsth St Thomas Medical Center Women's Board 444 North Main Street Akron OH 44310 346576575 Support OH 3 11-I SACSTH false Ohio Sleep Disorders Center 130 West Exchange Street Akron OH 44302 341872278 Office Physic OH SACSTH & SBH related 0 25000 false 0 true 0.66670 Summa Rehab Hospital LLC 4550 Lena Drive Mechanicsburg PA 17055 271952573 Rehab Hospita OH SACSTH Related 0 0 false 0 true 0.52000 Aris Teleradiology LLC 5655 Hudson Drive Hudson OH 44236 412233156 Radiology Svcs OH SACSTH Unrelated 8920259 0 false 49521 true 0.65000 Ohio Health Choice Inc 525 East Market Street Akron OH 443041619 341895396 PPO OH NA C Corp Summa Insurance Company Inc 10 North Main Street Akron OH 44308 341809108 Prop/Cas. 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