Summa Health Group Return

“Summa Health System (fka Summa Akron City and St. Thomas Hospitals): N/A Summa Foundation : Summa Foundation has an Executive Committee comprised of the Chair, Vice Chair, Secretary, Treasurer, and one additional Director of the Summa Foundation. All members of the Executive Committee are Directors of Summa Foundation. The Executive Committee is authorized to exercise the powers of the Board at such time as the Board is not in session, subject to restrictions imposed by previous decisions of the Board and to the provisions of the Summa Foundation Code of Regulations. All interim actions by the Executive Committee are reported at the Board's next meeting succeeding such action. The Executive Committee prepares and makes such recommendations to the Board as are pertinent to the welfare of the Summa Foundation. Summa Physicians, Inc.: The Code of Regulations provides for an Executive Committee to be comprised of three (3) directors. The Executive Committee may make governance decisions between Board meetings. Summa Barberton Citizens Hospital: N/A Summa Wadsworth-Rittman Hospital (merged July 1, 2014): N/A”

“Thomas J. Strauss, Brian Derrick and William A. Powel, III - Business relationship, Thomas J. Strauss and Thomas Malone, M.D. - Business relationship, William Bauman, M.D., Robert Debski, M.D., Scott Weiner, M.D., Thomas P. O'Neill, Robert A. Gerberry, and William A. Powel, III - Business relationship, Erik Steele, D.O. and Thomas P. O'Neill - Business relationship, Thomas Knoll, William A. Powel, III, Brian Derrick, Erik Steele, D.O., and Thomas J. Strauss - Business relationship, Samir Gibara and Scott Honnold - Business relationship, George Daverio, Jr. and C. Gordon Ewers - Business relationship, Jason Butterworth and Mark Krohn - Business relationship, Dale Murphy, M.D. and William A. Powel, III - Business relationship”

“Summa Wadsworth-Rittman Hospital merged with Summa Barberton Citizens Hospital effective as of July 1, 2014. Summa Barberton Citizens Hospital was the surviving entity. Additionally, Summa Akron City and St. Thomas Hospitals changed its name to Summa Health System.”

“Summa Health System (fka Summa Akron City and St. Thomas Hospitals) Summa Health is the sole member of Summa Health System. Summa Foundation Summa Health is the sole member of Summa Foundation Summa Barberton Citizens Hospital Summa Health is the sole member of Summa Barberton Citizens Hospital. Summa Wadsworth-Rittman Hospital Prior to the merger of Summa Wadsworth-Rittman Hospital, effective as of July 1, 2014, Summa Health was the sole member of Summa Wadsworth-Rittman Hospital. Summa Physicians, Inc. Summa Physicians, Inc. has stockholders; the stock is held in trust for the benefit of Summa Health.”

“Summa Health System (fka Summa Akron City and St. Thomas Hospitals) The Directors of the Corporation are elected as set forth below: * Nine (9) non-physician Directors are elected by Summa Health as the sole member of the Corporation. * Six (6) physician Directors are elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals * The Chief Medical Officer of Summa Health is a Special Voting Director Summa Barberton Citizens Hospital The Directors of the Corporation are elected as set forth below: * Nine (9) non-physician Directors are elected by Summa Health as the sole member of the Corporation. * Six (6) physician Directors are elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals * The Chief Medical Officer of Summa Health System is a Special Voting Director Summa Foundation In addition to directors elected by the Summa Health Board as the sole member of Summa Foundation, the President and CEO of Summa Health serves as a director of Summa Foundation. Summa Physicians, Inc. Summa Physicians, Inc. is affiliated with Summa Health System and only persons approved by Summa Health System or employed by Summa Health system or an affiliated entity may serve as a director of Summa Physicians, Inc.”

“Summa Health System (fka Summa Akron City and St. Thomas Hospitals) Summa Barberton Citizens Hospital Summa Wadsworth-Rittman Hospital Summa Health is the sole member of each of Summa Health System, Summa Barberton Citizens Hospital, and Summa Wadsworth-Rittman Hospital. As the sole member, Summa Health has the power and authority to approve or disapprove of each of the following on behalf of each of Summa Health System, Summa Barberton Citizens Hospital, and Summa Wadsworth-Rittman Hospital: (i) Any modification of the essential nature, purpose, mission or operations of the Corporation; (ii) Adoption of a Code of Regulations, Bylaws or other constitutive document of the Corporation and any and all amendments thereto; (iii) Adoption of any amendments to the Articles of Incorporation or similar charter or organizational document or agreement and/or any other change in the corporate structure or governance of the Corporation; (iv) Establishment of qualifications for the selection of Directors, Directors or Managers of the Corporation; (v) Appointment or election and removal of members of the governing body of the Corporation; (vi) Appointment or election and removal of the President and/or Chief Executive Officer or similar officer(s) of the Corporation; (vii) Adoption of annual operating and capital budgets of the Corporation; (viii) The borrowing of money or other incurring or creating of any indebtedness of the Corporation, including by way of a guaranty of the debt of another, in an amount greater than $1,000,000 or that will increase the amount of indebtedness incurred in the current calendar year, in the aggregate, to more than $3,500,000; (ix) Adoption of the long range plans of the Corporation; (x) Determinations as to the use and occupancy of any building owned or leased by the Corporation; (xi) The sale, encumbrance, lease or disposition of real property of the Corporation other than in the ordinary course of the operations of the Corporation; and (xii) The merger, reorganization, dissolution or other corporate action of a similar nature, including participation in a joint venture, proposed by the Corporation. Summa Foundation Summa Health is the sole member ("Member") of Summa Foundation. The following are the matters ("Reserved Powers") which must be submitted to, and receive the approval of both the Board of Directors of Summa Foundation and the Member: (i) Adoption of the Foundation's annual operating and capital budgets; (ii) Expenditures for (a) non budgeted items in excess of certain dollar limits set from time to time by the Member and (b) items which are included in the Foundation's annual budgets but which exceed the budgeted amount by an amount in excess of certain dollar limits set from time to time by the Member; (iii) Incurrence, assumption or guarantee of any indebtedness if following the incurrence, assumption, or guarantee of such indebtedness the aggregate amount of all outstanding indebtedness incurred, assumed or guaranteed by the Foundation which has not been previously approved by the Member exceeds certain dollar limits set from time to time by the Member; (iv) Submission of any certificate of need application with any State or Federal Regulatory Agency; (v) Execution of any contract that calls for the Foundation to expand a sum in excess of certain dollar limits set from time to time by the Member or to provide services with a value in excess of certain dollar limits set from time to time by the Member; (vi) Election of such officers as are required to be elected under this Code of Regulations; (vii) Appointment of the Foundation's auditors and/or accountants; (viii) Adoption of the Foundation's long range plans and management objective, including the execution of any agreement with consortiums, alliances, etc; (ix) Sale, lease or other disposition of any real or personal property of the Foundation with a value in excess of certain dollar limits to be set from time to time by the Member; (x) Sal”

“The return was reviewed in detail by a committee consisting of internal legal counsel, financial management, and an external auditor. The review committee included the Senior Vice President, Finance & CFO and the Senior Vice President, Legal Services & General Counsel. This detailed review occurred in October 2015. Following this review and incorporation of changes recommended by this committee, the return was provided to the Summa Health Committee on Governance prior to its October 2015 meeting for further review. The Committee on Governance is a standing committee appointed by the Summa Health Board of Directors and includes members of the Board of Directors. Schedule H of the return was also reviewed by the Summa Health Community Benefits Committee. After these reviews by the Committee on Governance and the Community Benefits Committee, and prior to filing with the IRS, an email was sent to each voting member of the Boards of Directors. This email included instructions and a link to a password-protected web site on which the entire Form 990 was available for viewing.”

“A conflict of interest questionnaire is sent annually to all Summa Health entities' boards of directors, key employees, senior managers, medical directors, employed physicians, contracted physicians, administrative directors, executive directors, department heads, managers, supervisors, and members of purchasing committees for completion. Responses are individually reviewed for determination of potential conflicts. Those responses deemed to present potential conflicts are then presented to the governance committee (sub-committee of the Summa Health board of directors). The governance committee reviews each response that presents a potential conflict and determines whether additional action is required to eliminate or mitigate the potential conflict. This annual conflict of interest questionnaire process is managed by the corporate compliance department pursuant to the Summa Health policy on conflict of interest as approved by the Summa Health Board of Directors. In addition to the annual conflict of interest questionnaire, the conflict of interest policy imposes a duty to disclose conflicting interests on an ongoing basis. Disclosure Procedure: any person with a conflicting interest in a 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.”

“Executive Compensation: The Compensation Committee of the Summa Health Board of Directors meets at least twice each year to review and approve base compensation and total remuneration for executive staff. Each voting member of the Compensation Committee is an independent director and is not affiliated with management with the exception of one board member who is an independent contractor who recuses himself on voting regarding the CEO evaluation and compensation package. The Compensation Committee engages outside consulting support to provide independent market data, advice and counsel to the Compensation Committee. For the past five years, the Compensation Committee has used Hay Group, a nationally recognized consulting firm, to assist their efforts. The Hay Group provides the following services to the Compensation Committee: (a) education of Committee members regarding executive compensation trends and best practices in healthcare organizations; (b) assessment of the market competitiveness and reasonableness of Summa's executive compensation programs including base salary, incentive compensation, core and executive benefits, as well as their alignment with the mission and future performance expectations; (c) written, detailed evaluation of the market reasonableness of Summa's executive compensation and benefits program; and (d) ongoing support and independent advice to the Compensation Committee on matters related to executive compensation. Each year the Compensation Committee reviews and approves the compensation for the following positions: Summa Health * President & CEO * Senior Vice President, Finance & CFO * Senior Vice President, Legal Services & General Counsel * Senior Vice President, IT&S & CIO * Senior Vice President, Service Lines, Ambulatory & Ancillary * Senior Vice President, Planning & Marketing * Senior Vice President & Chief Nursing Officer * Senior Vice President, Human Resources * Senior Vice President, Chief Medical Officer * Chief Operating Officer Summa Health System (fka Summa Akron City and St. Thomas Hospitals) * President Summa Foundation * President Summa Barberton Citizens Hospital & Summa Wadsworth-Rittman Hospital * Sr. Vice President, Hospital Operations/Site Administrator Summa Physicians, Inc. * President”

“See response to Part VI, Line 15a”

“Summa Health makes its Conflicts of Interest policy available upon request. The Articles of Incorporation of Summa Health and its related entities are available on the website of the Ohio Secretary of State (www.sos.state.oh.us). Summa Health makes its financial statements available on its website (www.summahealth.org). The financial statements are also available through the Electronic Municipal Market Access (www.emma.msrb.org) and on Summa's website (www.summahealth.org).”

“Beginning with the 2014 tax year all independent contractors were paid by Summa Health (EIN 34-1887844) which is the parent organization of the filing organization.”

“Registration Fees - Total Revenue: 1593021, Related or Exempt Function Revenue: 1593021, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Research Grants - Total Revenue: 1202041, Related or Exempt Function Revenue: 1202041, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Medical Education - Total Revenue: 758614, Related or Exempt Function Revenue: 758614, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;”

“Gift/Flower Shop - Total Revenue: 150419, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 150419;”

“The director count information is presented in the following format: Entity name - Number of Voting Members - Number of independent voting members Summa Health System ("SHS") - 13 - 6 Summa Foundation ("SF") - 22 -21 Summa Barberton Citizens Hospital ("SBH") - 13 - 6 Summa Physicians, Inc. ("SPI") - 6 - 0 Totals for Group return - 54 - 33 All of the organizations listed above are subordinates under the control of Summa Health ("SH"). As of December 31, 2014, SH had 15 voting directors, 10 of whom were independent voting directors.”

“Summa Wadsworth Hospital was merged into Summa Barberton Citizens Hospital on July 13, 2014.”

“(Expenses $ 11,825,302 including grants of $ 354,193)(Revenue $ 16,839,420) SUMMA HEALTH IS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT PROVIDES COORDINATED, VALUE-BASED CARE ACROSS THE CONTINUUM FOR THE PEOPLE AND POPULATIONS WE SERVE. WE HOLD OURSELVES CLINICALLY AND FINANCIALLY ACCOUNTABLE FOR HEALTH OUTCOMES IN OUR COMMUNITIES. SUMMA HEALTH SERVES MORE THAN ONE MILLION PATIENTS EACH YEAR IN COMPREHENSIVE EMERGENCY, ACUTE, CRITICAL, OUTPATIENT AND LONG-TERM/HOMECARE SETTINGS AND REPRESENTS MORE THAN 1,700 REGISTERED, INPATIENT BEDS ON THE CAMPUSES OF SUMMA HEALTH SYSTEM, SUMMA BARBERTON CITIZEN'S HOSPITAL, THE WADSWORTH-RITTMAN AREA HOSPITAL ASSOCIATION, SUMMA REHAB HOSPITAL*, WESTERN RESERVE HOSPITAL*, AND CRYSTAL CLINIC ORTHOPAEDIC CENTER*. IN ADDITION, OUTPATIENT CARE IS PROVIDED IN MORE THAN 16 COMMUNITY HEALTH CENTERS AND EMERGENCY DEPARTMENTS (EDS), SOME INTEGRATED IN THE HEALTHCARE FACILITIES, OTHERS ARE FREE-STANDING. *SUMMA REHAB HOSPITAL, * WESTERN RESERVE HOSPITAL AND *CRYSTAL CLINIC ORTHOPAEDIC CENTER ARE JOINT VENTURES IN WHICH SUMMA HEALTH HAS AN INTEREST, AND ARE REFERENCED IN THIS DOCUMENT FOR THE PURPOSE OF IDENTIFYING ALL ENTITIES AFFILIATED WITH SUMMA HEALTH. SUMMA'S PROPORTIONATE INTEREST OF THESE JOINT VENTURES' CHARITY CARE AND OTHER COMMUNITY BENEFITS ARE INCLUDED ON SCHEDULE H OF SUMMA HEALTH'S IRS FORM 990 GROUP RETURN. PROVIDING SUPERIOR, MULTI-SPECIALTY PATIENT CARE, MEDICAL RESEARCH AND CONTINUING MEDICAL EDUCATION, SUMMA HEALTH RANKS AS A HIGHLY RECOGNIZED HEALTHCARE PROVIDER IN SEVERAL DISCIPLINES INCLUDING: BARIATRIC SURGERY, CARDIOVASCULAR, EMERGENCY, ONCOLOGY, ORTHOPAEDIC SURGERY, PRIMARY CARE SPORTS MEDICINE, STROKE AND NURSING BY PRESTIGIOUS ORGANIZATIONS SUCH AS: THE SOCIETY OF CHEST PAIN CENTERS AMERICAN COLLEGE OF SURGEONS AMERICAN HEART ASSOCIATION AMERICAN STROKE ASSOCIATION NATIONAL ACCREDITATION PROGRAM OF BREAST CENTERS AMERICAN NURSING CREDENTIALING CENTER PREMIER HEALTHCARE ALLIANCE OHIO PATIENT SAFETY INSTITUTE US NEWS AND WORLD REPORT CONQUER CANCER FOUNDATION AMERICAN SOCIETY OF CLNICAL ONCOLOGY AMERICAN COLLEGE OF RADIATION AMERICAN COLLEGE OF SURGEONS: COMMISSION ON CANCER NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY: CENTER OF EXCELLENCE CARECHEX METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM THE JOINT COMMISSION SUMMA HEALTH IS SUMMIT COUNTY'S LARGEST EMPLOYER AND A LEADING ECONOMIC ENGINE FOR THE REGION. SUMMA HEALTH INCLUDES THE FOLLOWING: SUMMA HEALTH SYSTEM: SUMMA HEALTH SYSTEM IS A SINGLE LEGAL ENTITY THAT INCLUDES TWO HOSPITAL CAMPUSES AND SEVERAL OFF-SITE LOCATIONS. SUMMA HEALTH SYSTEM OPERATES BOTH HOSPITAL LOCATIONS AS WELL AS THE HOSPITAL-BASED OFF-SITE LOCATIONS UNDER THE SAME MEDICARE PROVIDER NUMBER. SUMMA HEALTH SYSTEM EMPLOYS MORE THAN 9,000 INDIVIDUALS WITH SUMMA HEALTH SYSTEM ACCOUNTING FOR APPROXIMATELY 7,000 OF THESE EMPLOYEES. SUMMA HEALTH SYSTEM HAS A MEDICAL STAFF OF MORE THAN 1,000 PROFESSIONALS WORKING ON ITS CAMPUSES. SUMMA HEALTH SYTSEM HAS 946 REGISTERED BEDS AND 46 LICENSED BASSINETS. THE BUILDINGS AND FACILITIES ON BOTH CAMPUSES TOTAL APPROXIMATELY 1.7 MILLION SQUARE FEET. SUMMA HEALTH SYSTEM OFFERS GENERAL MEDICAL, SURGICAL, OBSTETRICAL, TRAUMA, AND CRITICAL CARE SERVICES. SUMMA AKRON CITY HOSPITAL PROVIDES ACUTE CARE SERVICES ON A CAMPUS OF APPROXIMATELY 60 ACRES. THE CAMPUS IS HOME TO SPECIALTY HEALTH CENTERS OFFERING A WIDE RANGE OF OUTPATIENT SERVICES. SUMMA HEALTH SYSTEM RECEIVED THE FOLLOWING RECOGNITION IN 2014: SUMMA AKRON CITY & ST. THOMAS HOSPITALS RANKED SIXTH BEST HOSPITAL IN OHIO BY U.S. NEWS & WORLD REPORT. IT IS RANKED NATIONALLY IN 2 SPECIALTIES OF ENDOCRINOLOGY (DIABETES CARE) AND GASTROENTEREOLOGY; AND AS HIGH PERFORMING IN 9 OTHER ADULT SPECIALTIES: CARDIOLOGY & HEART SURGERY; EAR, NOSE & THROAT; GERIATRICS; GYNECOLOGY; NEPHROLOGY; NEUROLOGY & NEUROSURGERY; ORTHOPEDICS; PULMONOLOGY; AND UROLOGY. SUMMA BECAME ONE OF EIGHT COMMUNITY ONCOLOGY”

“(Expenses $ 0 including grants of $ 0)(Revenue $ 0) Part III Line 4D - Other Program Services - continued: MEDICAID SHORTFALL HISTORICALLY, OHIO MEDICAID REIMBURSEMENTS HAVE NOT COVERED THE COST OF PROVIDING THE CARE TO PROGRAM BENEFICIARIES, CREATING A BUDGETARY SHORTFALL. AS ONE OF NORTHEAST OHIO'S TOP PROVIDERS OF HOSPITAL CARE FOR MEDICAID PATIENTS, SUMMA HEALTH'S UNPAID COSTS FOR MEDICAID TOTALED MORE THAN $6.8 MILLION. BAD DEBT SUMMA HEALTH IS COMMITED TO PROVIDING QUALITY AND ACCESSIBLE HEALTHCARE. THIS INCLUDES COVERING THE EXPENSE OF PAYMENTS THAT WERE EXPECTED BUT NOT RECEIVED. WHILE SUMMA HEALTH RECOGNIZES BAD DEBT IS PART OF DOING BUSINESS, IT AGREES WITH THE OHIO HOSPITAL ASSOCIATION THAT IT IS IMPORTANT TO REPORT THESE COSTS TO SHOW THE TOTAL PICTURE OF CARE SUMMA HEALTH PROVIDES TO THE COMMUNITY WITHOUT FULL REIMBURSEMENT. IN 2014, THE COST FOR PROVIDING CARE WRITTEN OFF AS A BAD DEBT EXPENSE WAS APPROXIMATELY $24 MILLION. COMMUNITY HEALTH IMPROVEMENT SERVICES AN IMPORTANT PART OF SUMMA HEALTH'S MISSION IS OFFERING A PREVENTION AND WELLNESS PROGRAM TO BUILD A HEALTHIER COMMUNITY. IN 2014, SUMMA HEALTH PROVIDED MORE THAN $1.2 MILLION TO HELP FUND HEALTH IMPROVEMENT ACTIVITIES SUCH AS FREE AND LOW-COST HEALTH SCREENING, HEALTH EDUCATION SERVICES AND WELLNESS PROGRAMMING. SUBSIDIZED HEALTH SERVICES SUMMA HEALTH IS COMMITTED TO PROVIDING SUBSIDIZED HEALTH SERVICES - CLINICIAL SERVICES THAT MEET AN IDENTIFIED COMMUNITY NEED AND ARE PROVIDED DESPITE FINANCIAL LOSS. VITAL SERVICES SUCH AS THE CENTER FOR SENIOR HEALTH, CARE CENTER FOR PATIENTS WITH HIV OR AIDS, AND DIABETES EDUCATION ARE OFFERED, EVEN THOUGH THEY ARE NOT PROFITABLE. INCOME FROM OTHER SERVICES IS USED TO COVER THESE COSTS. IN 2014, THE COST FOR SUBSIDIZED SERVICES WAS APPROXIMATELY $24 MILLION. FINANCIAL AND IN-KIND DONATIONS ANNUALLY, SUMMA HEALTH CONTRIBUTES FINANCIAL ASSISTANCE AND IN-KIND SERVICES TO SUPPORT COMMUNITY ORGANIZATIONS THAT PROMOTE HEALTH, WELLNESS, AND AN IMPROVED QUALITY OF LIFE. FROM THE LOCAL CHAPTERS OF NATIONAL GROUPS SUCH AS UNITED WAY, THE AMERICAN HEART ASSOCIATION AND THE AMERICAN CANCER SOCIETY, TO AKRON COMMUNITY HEALTH RESOURCES (AKRON'S ONLY FEDERALLY-FUNDED HEALTH CENTER) SUMMA HEALTH PARTICIPATES IN NUMEROUS COMMUNITY PROGRAMS AND HELPS OTHER NONPROFITS FULFILL THEIR MISSIONS. IN 2014, THESE CONTRIBUTIONS WERE MORE THAN $1 MILLION. RESEARCH SUMMA HEALTH'S QUALITY MEDICAL CARE IS DERIVED IN PART FROM ITS ABILITY TO TRANSLATE RESULTS FROM CAREFULLY PLANNED AND EXECUTED RESEARCH INTO EFFECTIVE PATIENT CARE STRATEGIES. RESEARCH AND INNOVATION IS AN INTEGRAL FOCUS OF THE ACADEMIC AND CLINICAL ENVIRONMENT AT SUMMA HEALTH AND HELPS SET THE HIGHEST STANDARDS FOR MEDICAL CARE IN THE COMMUNITY. SUMMA HEALTH'S REPUTATION FOR EXCELLENCE IN SUCH CRITICAL SPECIALITIES AS CARDIOLOGY, DIABETES, EMERGENCY SERVICES, ORTHOPAEDICS, ONCOLOGY, SENIOR HEALTH, SURGERY, AND WOMEN'S HEALTH CONTINUES TO GROW THROUGH RESEARCH AND INNOVATION. SUMMA HEALTH INVESTED MORE THAN $6.4 MILLION IN RESEARCH IN 2014. IN ADDITION TO SUPPORT FROM SUMMA FOUNDATION, MAJOR RESEARCH PROGRAMS ARE SUPPORTED BY GRANTS FROM THE NATIONAL INSTITUTES OF HEALTH, THE DEPARTMENT OF DEFENSE AND INDUSTRY SPONSORS. EDUCATION SUMMA HEALTH SUPPORTS THE EDUCATION OF PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS. SUMMA HEALTH SYSTEM IS THE LARGEST OF THE MAJOR TEACHING AFFILIATES OF THE NORTHEST OHIO MEDICAL UNIVERSITY (NEOMED, A CONSORTIUM OF THE UNIVERSITY OF AKRON, KENT STATE UNIVERSITY AND YOUNGSTOWN STATE UNIVERSITY, AND OFFERS EDUCATION TO NEOMED'S COLLEGES OF MEDICINE AND PHARMACY STUDENTS, AS WELL AS TO MEDICAL STUDENTS FROM SCHOOLS AROUND THE COUNTRY. IN ADDITION, SUMMA HEALTH OFFERS 17 ACCREDITED RESIDENCY TRAINING PROGRAMS IN NUMEROUS SPECIALTIES, TRAINING THE NEXT GENERATION OF PRIMARY CARE AND SPECIALTY PHYSICIANS FOR THE REGION AND BEYOND. NURSING EDUCATION ALSO IS OFFERED IN COLLABORATION WITH OUR LOCAL UNIVERSITY PARTNERS. IN 2014, APPROXIMATELY 230 RESIDENTS AND FEL”

“(Expenses $ 0 including grants of $ 0)(Revenue $ 0) Part III Line 4D - Other Program Services - Final Section: SUMMARY ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF SUMMA HEALTH, NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. SUMMA HEALTH PROVIDED SERVICES TO ALL PATIENTS ON A NON-DISCRIMINATORY BASIS AND WITHOUT REGARD TO ANY PATIENT'S ABILITY TO PAY FOR SUCH SERVICES OR THE INDIVIDUAL'S PARTICIPATION IN A GOVERNMENT-SPONSORED OR SUBSIDIZED HEALTHCARE SYSTEM. PATIENTS WERE ENCOURAGED TO APPLY FOR UNCOMPENSATED CARE AND, DEPENDING ON THEIR LEVEL OF INCOME AND NUMBER OF DEPENDENTS, ALL (OR A PORTION) OF THEIR BILL WAS REDUCED. GROSS ANNUAL FAMILY INCOME WAS COMPARED USING A SLIDING SCALE BASED ON THE FEDERAL POVERTY INCOME GUIDELINES TO DETERMINE ITHE CHARITY DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. IN 2014, SUMMA HEALTH PROVIDED CHARITY CARE TO THE INDIGENT (INCLUDING UNREIMBURSED MEDICAID) AT THE COST OF APPROXIMATELY $14.2 MILLION. THIS AMOUNT DOES NOT INCLUDE SERVICES PROVIDED WRITTEN OFF AS BAD DEBT. IN ADDITON TO UNCOMPENSATED MEDICAL CARE, SUMMA HEALTH PROVIDED WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND MEDICALLY UNDERSERVED. SUMMA HEALTH ALSO OPERATED A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THESE PROGRAMS WERE OFFERED AT A REDUCED PRICE OR PROVIDED TO THE COMMUNITY FREE OF CHARGE. SUMMA HEALTH OPERATES ITS FACILITIES IN A MANNER CONSISTENT WITH THE COMMUNITY BENEFIT REQUIREMENTS OF REV. RULE 69-545 AND SUBSEQUENT CASE LAW AND IRS GUIDELINES. SUMMA HEALTH'S HOSPITALS PROVIDE EMERGENCY SERVICES WHICH ARE OPEN AND AVAILABLE TO ALL PERSONS OF THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. THE BOARD OF DIRECTORS CONSISTED OF PERSONS WHO ARE BROADLY REPRESENTATIVE OF THE COMMUNITY AND MEDICAL STAFF. SUMMA PHYSICIANS INC. - PROGRAM SERVICE ACCOMPLISHMENTS SUMMA PHYSICIANS INC. (SPI) IS A SUMMA HEALTH ENTITY COMPRISED OF MULTI-SPECIALTY PHYSICIANS AND PRACTICES. IN TOTAL, SPI EMPLOYS NEARLY 300 PHYSICIANS AND MORE THAN 700 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 2014, SPI CONTINUED ITS DEVELOPMENT OF PRIMARY CARE PODS AND THE MEDICAL HOME MODEL OF CARE, TO FURTHER ENHANCE THE FOCUSED PATIENT CARE MODEL, BETTER COMMUNICATE QUALITY INITIATIVES AND ENHANCE PHYSICIAN RECRUITMENT. SUMMA FOUNDATION - PROGRAM SERVICE ACCOMPLISHMENTS THROUGH PHILANTHROPY, SUMMA FOUNDATION SUPPORTS MEDICAL EDUCATION, RESEARCH, TECHNOLOGY, AND CLINICAL INNOVATION. ENCOMPASSING FUNDRAISING, RESOURCE DEVELOPMENT, COMMUNITY BENEFIT, DIVERSITY AND GOVERNMENT RELATIONS, SUMMA FOUNDATION WORKS TO DEVELOP NEW, DIVERSIFIED AND INCREASED RESOURCES AND BUILD RELATIONSHIPS THAT INFLUENCE HEALTH POLICY TO ADVANCE THE REGIONAL PRIORITIES OF SUMMA HEALTH. DEVELOPMENT THE FOUNDATION'S DEVELOPMENT DEPARTMENT OFFERS A SPECTRUM OF PHILANTHROPIC OPTIONS FOR DONORS DESIGNED TO CREATE A POSITIVE IMPACT ON SUMMA HEALTH'S OPERATIONS, PROGRAMS, PROJECTS AND PERCEPTIONS AND TO AFFECT POSITIVE CHANGE IN THE COMMUNITIES SUMMA HEALTH SERVES. DEVELOPMENT HOUSES THE GRANT AND PROPOSAL DEVELOPMENT OFFICES CREATED TO IDENTIFY THE RESOURCES AND EXPERTISE OF EXTERNAL AND INTERNAL PARTNERS TO GENERATE FUNDING OR RESEARCH, EDUCATION AND CLINICAL AND SYSTEM PROJECTS. PHILANTHROPIC COMMITMENTS TO THE SUMMA FOUNDATION IN 2014 TOTALED $9.1 MILLION. COMMUNITY BENEFIT AND DIVERSITY THIS DEPARTMENT LEADS EFFORTS TO ADDRESS HEALTH DISPARITIES AND OTHER IMPORTANT COMMUNITY NEEDS AND RAISE AWARENESS OF HEALTH AND HEALTHCARE ISSUES AFFECTING THE COMMUNITIES SERVED BY SUMMA HEALTH. COMMUNITY BENEFIT AND DIVERSITY PROVIDE WELLNESS AND EDUCATIONAL TOOLS, FACILITATE ECONOMIC DEVELOPMENT PROGRAMS, DEVELOP COMMUNITY PARTNERSHIPS, COMMUNICATE SUMMA HEALTH'S BENEFIT TO THE COMMUNITY AND ENGAGE THE”

“Purchased Medical Services - Total Expense: 41246618, Program Service Expense: 41246618, Management and General Expenses: , Fundraising Expenses: ; Purchased Non-Medical Services - Total Expense: XXX-XX-XXXX, Program Service Expense: , Management and General Expenses: XXX-XX-XXXX, Fundraising Expenses: 76230; Perfusion/Blood - Total Expense: 3330728, Program Service Expense: 3330728, Management and General Expenses: , Fundraising Expenses: ; Ambulance Services - Total Expense: 313155, Program Service Expense: 313155, Management and General Expenses: , Fundraising Expenses: ; Hospice Services - Total Expense: 3459000, Program Service Expense: 3459000, Management and General Expenses: , Fundraising Expenses: ; Physician Practice Support - Total Expense: 21797987, Program Service Expense: 21797987, Management and General Expenses: , Fundraising Expenses: ; Physician Services - Affiliates - Total Expense: 53691482, Program Service Expense: 53691482, Management and General Expenses: , Fundraising Expenses: ; Collections - Total Expense: 6324710, Program Service Expense: 5306432, Management and General Expenses: 1018278, Fundraising Expenses: ; Repair/Maintenance - Total Expense: 13449277, Program Service Expense: 11283943, Management and General Expenses: 2165334, Fundraising Expenses: ;”

“Net Assets Released from Restrictions - 2714000; Change in Net Assets - 7318893; Pension Liability Adjustment - -39362000; Post Retirement Benefit Adjustment - -300000; Transfers Between Affiliates - -XXX-XX-XXXX; Other Changes in Net Assets - -3790700;”