Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 01-01-2013 , 2013, and ending 12-31-2013
BCheck if applicable:
CName of organization
Summa Health System Group Return
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
525 East Market Street
Suite
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Akron, OH443041619
D Employer identification number

90-0640432
E Telephone number

G Gross receipts $ 1,326,232,013
F Name and address of principal officer:
Thomas J Strauss
525 East Market Street
Akron,OH44304
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.summahealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5864
K Form of organization:
 
L Year of formation:  
M State of legal domicile:
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: 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.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 78
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 44
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 8,712
6 Total number of volunteers (estimate if necessary) ............. 6 807
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 10,060,672
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 3,918,418
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 6,541,029 8,800,411
9 Program service revenue (Part VIII, line 2g) ......... 1,107,704,787 1,101,296,459
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 21,233,432 13,934,346
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 14,763,435 19,701,542
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,150,242,683 1,143,732,758
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 286,406 260,359
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 513,798,749 488,396,107
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,788,976    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 593,269,146 600,542,226
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,107,354,301 1,089,198,692
19 Revenue less expenses. Subtract line 18 from line 12....... 42,888,382 54,534,066
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,193,991,987 1,221,959,811
21 Total liabilities (Part X, line 26)............. 727,643,905 636,147,164
22 Net assets or fund balances. Subtract line 21 from line 20..... 466,348,082 585,812,647
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: SUMMA HEALTH SYSTEM'S MISSION IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE TO PATIENTS AND MEMBERS AND CONTRIBUTE TO A HEALTHIER COMMUNITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 346,049,828 including grants of $ 0 ) (Revenue $ 437,836,567 )
Inpatient Services - For 2013, Summa Akron City & St. Thomas Hospitals (SACSTH), Summa Barberton Citizens Hospital (SBH) and The Wadsworth-Rittman Area Hospital Association (WRH) had 790 beds in service, admitted 42,187 adult patients and delivered 3,771 newborns. The adult patients received 201,431 days of care, inpatient surgeries total 7,233, emergency admits totaled 30,232 and the average length of stay was 4.77 days.
4b (Code:   ) (Expenses $ 478,704,295 including grants of $ 0 ) (Revenue $ 605,676,490 )
Outpatient Services - In 2013, Summa Akron City & St. Thomas Hospitals, Summa Barberton Citizens Hospital, The Wadsworth-Rittman Area Hospital Association and Summa Physicians, Inc. provided 1,541,061 occasions of service, including 145,671 emergency room visits, 16,228 surgical operations, and 1,379,162 other outpatient visits.
4c (Code:   ) (Expenses $ 38,983,039 including grants of $ 0 ) (Revenue $ 13,581,713 )
Research/Education - Summa Health System has a history of sponsoring and supporting basic and clinical research to understand diseases and treatment. Centers, programs and labs facilitate research in a number of medical fields. Summa Health System fosters a learning environment for the next generation of caregivers. At three of Summa Health System's hospitals, over 200 medical schools graduates train in 17 accredited residency training programs. Summa Health System provides clinical learning experiences to more than 250 nursing and allied health students.
4d Other program services (Describe in Schedule O.)
(Expenses $ 34,935,380 including grants of $ 260,359 ) (Revenue $ 44,201,689 )
4e Total program service expensesMediumBullet898,672,542
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions).... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I........................... Click to see attachment
31
Yes
 
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...................... Click to see attachment
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
Yes
 
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
768
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
8,712
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
78
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
44
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
FL , OH
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletBRIAN K DERRICK525 EAST MARKET STREETAkronOH44304 (330) 375-3196
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) John Adams........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(2) Karen Ayers DO........................................................................
Director SBH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(3) Michael Bage MD........................................................................
Director SACSTH (end 9/13)
 48.0
.......................2.0 		X           502,517 0 15,755
(4) Susan Baker........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................0.0 		X           0 0 0
(5) Danielle Barran........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(6) William Bauman MD........................................................................
Director SACSTH, SBH, WRH, SPI
 50.0
.......................0.0 		X           615,922 0 15,856
(7) Julia Bianchi........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(8) Michael Bianco MD........................................................................
Director WRH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(9) James Biggar........................................................................
Dir/Treas SACSTH (end 9/13)
 2.0
.......................0.0 		X   X       0 0 0
(10) Michelle Blanda MD........................................................................
Director SACSTH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(11) Nicholas Browning........................................................................
Director SACSTH (end 9/13)
 2.0
.......................2.0 		X           0 0 0
(12) Jason Butterworth........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(13) Candace Campbell-Jackson........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................0.0 		X           0 0 0
(14) Dennis Chack........................................................................
Director SACSTH (end 1/13)
 2.0
.......................0.0 		X           0 0 0
(15) Douglas Chonko DO........................................................................
Director CFGH (end 12/13)
 2.0
.......................0.0 		X           0 0 0
(16) Thomas Clark........................................................................
Director/Chair SF
 4.0
.......................0.0 		X   X       0 0 0
(17) Jacob Cohen MD........................................................................
Director SACSTH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Norman Crocker MD........................................................................
Director WRH (end 9/13)
 2.0
.......................0.0 		X           2,400 0 0
(19) George Daverio........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(20) Robert Debski MD........................................................................
Director SACSTH, SBH, WRH
 50.0
.......................0.0 		X           275,450 0 8,969
(21) David Dellinger DO........................................................................
Director CFGH (end 12/13)
 2.0
.......................0.0 		X           0 0 0
(22) Dennis Dick........................................................................
Dir/Treas CFGH (end 12/13)
 2.0
.......................0.0 		X   X       0 0 0
(23) Vince DiGirolamo........................................................................
Dir SACSTH, Dir/Treas SF (9/13
 4.0
.......................2.0 		X           0 0 0
(24) R James Dom Dera MD........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................12.0 		X           2,700 53,000 0
(25) C Gordon Ewers........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(26) Edward Ferris MD........................................................................
Director SACSTH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(27) Daniel Figliola........................................................................
Director CFGH (end 12/13)
 2.0
.......................0.0 		X           0 0 0
(28) Daniel Finelli MD........................................................................
Dir/Vice Chr SACSTH, SBH, WRH
 4.0
.......................2.0 		X   X       0 0 0
(29) Jason Fried DO........................................................................
Director CFGH (end 12/13)
 2.0
.......................0.0 		X           0 0 0
(30) Steven Gaich MD........................................................................
Director SPI
 50.0
.......................0.0 		X           323,915 0 10,260
(31) Samir Gibara........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(32) Mark Goldfarb........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(33) Eric Graf........................................................................
Dir/Secty/Treas WRH (end 9/13)
 2.0
.......................0.0 		X   X       0 0 0
(34) Russell Gregory........................................................................
Dir/Vice Chr SACSTH, SBH, WRH
 2.0
.......................2.0 		X   X       0 0 0
(35) Stephen Hailer........................................................................
Director/Chair CFGH (end 12/13
 4.0
.......................2.0 		X   X       0 0 0
(36) Thomas Harnden........................................................................
Director/Chair SBH (9/13)
 4.0
.......................2.0 		X   X       0 0 0
(37) Robert Harrigan........................................................................
Dir SACSTH & COO (end 9/13)
 46.0
.......................4.0 		X   X       0 1,050,809 83,645
(38) Iris Harvey........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(39) Robert Hemphill MD........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(40) Scott Honnold........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(41) Thomas Hudson........................................................................
Director WRH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(42) Rodney Ison MD........................................................................
Director SBH (end 9/13)
 2.0
.......................0.0 		X           18,830 18,000 0
(43) Mary Ann Jackson........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(44) Philip Kaufmann........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(45) James Kennedy MD........................................................................
Director SBH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(46) Phillip Khalil DO........................................................................
Director CFGH (end 12/13)
 2.0
.......................0.0 		X           0 0 0
(47) A Gus Kious MD........................................................................
Director/Pres SPI (end 12/13)
 50.0
.......................0.0 		X   X       331,767 0 17,006
(48) Thomas Knoll........................................................................
Dir/Chair SACSTH, SBH, WRH
 4.0
.......................46.0 		X   X       0 123,662 0
(49) Joseph Koenig MD........................................................................
Director SPI
 50.0
.......................0.0 		X           771,014 0 17,405
(50) James Kraynak........................................................................
Dir/Vice Chr CFGH (end 12/13)
 2.0
.......................0.0 		X   X       0 0 0
(51) Mark Krohn........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(52) Dennis Liddle........................................................................
Dir/Secty/Treas SBH (end 9/13)
 2.0
.......................0.0 		X   X       0 0 0
(53) David Lieberth........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................2.0 		X           0 0 0
(54) Dina Lloyd........................................................................
Dir/Vice Chr SBH (end 9/13)
 2.0
.......................0.0 		X   X       0 0 0
(55) Anthony Lockhart........................................................................
Dir/Chair SACSTH (end 9/13)
 4.0
.......................4.0 		X   X       0 0 0
(56) Hitesh Makkar MD........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................0.0 		X           40,678 0 0
(57) Joseph McShannic MD........................................................................
Director SACSTH (end 9/13)
 50.0
.......................0.0 		X           532,139 0 21,232
(58) Dale Murphy MD........................................................................
Director SPI
 46.0
.......................4.0 		X           0 478,498 40,145
(59) Vivian Celeste Neal........................................................................
Dir SACSTH, SBH, WRH, SF
 2.0
.......................0.0 		X           0 0 0
(60) Joseph Nienaltowski DO........................................................................
Director CFGH (end 12/13)
 2.0
.......................2.0 		X           0 0 0
(61) Thomas ONeill........................................................................
Director SPI, CFO SACSTH
 46.0
.......................4.0 		X   X       0 409,249 34,443
(62) Charles Parsons........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................0.0 		X           0 0 0
(63) Martin Paul........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................0.0 		X           0 0 0
(64) Jonathon Pavloff........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(65) Mark Pluskota MD........................................................................
Director SBH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(66) William Powel III........................................................................
Director SPI, System Secty
 4.0
.......................46.0 		X   X       0 575,932 61,741
(67) Dwight Powers........................................................................
Director WRH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(68) Kathleen Raynor........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(69) Froncie Repetti........................................................................
Director SACSTH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(70) Ronald Russ DO........................................................................
Director CFGH (end 12/13)
 2.0
.......................0.0 		X           0 0 0
(71) Mona Sarkar........................................................................
Director/Secty SF
 2.0
.......................0.0 		X   X       0 0 0
(72) Robert Schaal MD........................................................................
Director SACSTH (end 9/13)
 2.0
.......................2.0 		X           0 0 0
(73) Anthony Solaro........................................................................
Director WRH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(74) Erik Steele DO........................................................................
Director SACSTH, SBH, WRH
 46.0
.......................4.0 		X           0 349,981 2,606
(75) Thomas Strauss........................................................................
Dir SF, System Pres/CEO
 4.0
.......................46.0 		X   X       0 1,273,746 108,510
(76) George Strickler........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(77) Vicki Sussman........................................................................
Director WRH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(78) Susan Taft........................................................................
Director SACSTH, SBH, WRH
 2.0
.......................0.0 		X           0 0 0
(79) Terry Taylor........................................................................
Director SBH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(80) Paul Testa........................................................................
Director SF
 2.0
.......................0.0 		X           0 0 0
(81) Douglas Trochelman MD........................................................................
Director SACSTH (end 9/13)
 46.0
.......................4.0 		X           766,450 0 16,124
(82) Susan Ullman........................................................................
Dir/Vice Chr WRH (end 9/13)
 2.0
.......................0.0 		X   X       0 0 0
(83) Sharon VanNostran DO........................................................................
Director SACSTH (end 9/13)
 2.0
.......................0.0 		X           0 0 0
(84) Joseph Varley MD........................................................................
Director SACSTH (end 9/13)
 50.0
.......................0.0 		X           363,845 0 19,233
(85) Norman Wells........................................................................
Director CFGH (end 12/13)
 2.0
.......................4.0 		X           0 0 0
(86) Scott Weiner MD........................................................................
Director SACSTH, SBH, WRH
 50.0
.......................0.0 		X           891,150 0 18,228
(87) Darrell Widmer MD........................................................................
Director WRH (end 9/13)
 50.0
.......................0.0 		X           200,641 0 7,202
(88) Stephen Wilt........................................................................
Director/Vice Chr SF
 2.0
.......................0.0 		X   X       0 0 0
(89) Charles Alderson........................................................................
CFO, SBH & WRH
 50.0
.......................0.0 		    X       205,935 0 11,072
(90) Thomas DeBord........................................................................
President SBH & WRH
 50.0
.......................0.0 		    X       316,075 0 39,646
(91) Brian Derrick........................................................................
System CFO
 4.0
.......................46.0 		    X       0 797,298 40,264
(92) Phylis Ferrara........................................................................
President/CDO, SF
 50.0
.......................0.0 		    X       198,223 0 1,101
(93) Bryan Fredericks........................................................................
COO, SPI
 50.0
.......................0.0 		    X       280,819 0 12,648
(94) Kathleen Jobe........................................................................
Chief Nursing Officer, SBH
 50.0
.......................0.0 		    X       196,356 0 10,098
(95) Thomas Malone MD........................................................................
President SACSTH
 46.0
.......................4.0 		    X       0 166,020 812
(96) Steve Schmidt........................................................................
COO, SF
 50.0
.......................0.0 		    X       259,262 0 34,616
(97) Shane Seymour........................................................................
CDO, SF (end 6/13)
 50.0
.......................0.0 		    X       0 168,598 4,089
(98) Adrian Dan MD........................................................................
HCE - Bariatric Surgery
 50.0
.......................0.0 		        X   849,180 0 16,209
(99) John Zografakis MD........................................................................
HCE - Bariatric Surgery
 50.0
.......................0.0 		        X   806,782 0 18,040
(100) Joel Porter MD........................................................................
HCE - Colorectal Surgery
 50.0
.......................0.0 		        X   799,610 0 11,284
(101) Eric Miller MD........................................................................
HCE - Orthopaedic Surgery
 50.0
.......................0.0 		        X   764,460 0 9,225
(102) Mehool Patel MD........................................................................
HCE - Oncology, Hematology
 50.0
.......................0.0 		        X   709,135 0 6,649
(103) Jay Williamson MD........................................................................
Former President, SPI
 50.0
.......................0.0 		          X 219,314 0 10,961
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 11,244,569 5,464,793 725,074
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet420
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Professional Anesthesia Service, 190 North Union StreetAKRONOH44304 Medical services 8,725,263
Siemens Medical Solutions, 51 Valley Stream ParkwayMALVERNPA19355 Contract services 5,767,737
Sodexo Inc Affiliates, 10 Earhart DriveWILLIAMSVILLENY14221 Catering services 5,034,256
Allscripts Healthcare LLC, Three Ravinia DriveATLANTAGA30346 IT & EMR Services 4,976,234
Akron Radiology Inc, 525 East Market StreetAKRONOH44304 Medical Services 3,309,425
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet45
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 1,052,375
d Related organizations...1d 212,252
e Government grants (contributions)1e 1,102,000
f All other contributions, gifts, grants, and
similar amounts not included above1f 		6,433,784
g Noncash contributions included in lines
1a-1f:$ 		104,909
h Total. Add lines 1a-1f.......MediumBullet 8,800,411
Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 621110 1,044,128,075 1,044,024,191 103,884  
b PROGRAM RELATED INVESTMENTS 900099 22,241,190 21,884,264 356,926  
c MEDICAL EDUCATION 611600 12,188,317 12,188,317    
d REFERENCE LAB 621500 8,766,906   8,766,906  
e ARRA MEANINGFUL USE 900099 7,925,431 7,925,431    
f All other program service revenue . 6,046,540 5,778,641 267,899  
g Total. Add lines 2a–2f........MediumBullet 1,101,296,459
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 9,352,825   30,985 9,321,840
4 Income from investment of tax-exempt bond proceeds..MediumBullet 26,717     26,717
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 12,507,565 308,103
b Less: rental expenses 7,758,858 64,340
c Rental income or (loss) 4,748,707 243,763
d Net rental income or (loss).......MediumBullet 4,992,470   -29,494 5,021,964
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 177,106,901 1,608,802
b Less: cost or other basis and sales expenses 172,947,391 1,213,508
c Gain or (loss) 4,159,510 395,294
d Net gain or (loss)..........MediumBullet 4,554,804   331,926 4,222,878
8a Gross income from fundraising events (not including
$ 1,052,375
of contributions reported on line 1c). See Part IV, line 18 ..
a 156,431
b Less: direct expenses ...b 515,158
c Net income or (loss) from fundraising events..MediumBullet -358,727   -358,727
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a CAFETERIA SALES 721210 5,558,245   231,640 5,326,605
b PARKING 812930 1,587,215     1,587,215
c GIFT/FLOWER SHOP 453220 1,010,216     1,010,216
d All other revenue .... 6,912,123     6,912,123
e Total. Add lines 11a–11d ...... MediumBullet 15,067,799
12 Total revenue. See Instructions......MediumBullet 1,143,732,758 1,091,800,844 10,060,672 33,070,831
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 228,377 228,377
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 31,982 31,982
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 7,602,813 6,542,854 1,059,959  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 526,079 526,079 0  
7 Other salaries and wages 393,389,512 329,124,429 63,157,370 1,107,713
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 5,545,783 4,652,912 892,871  
9 Other employee benefits ....... 55,882,280 46,669,864 8,955,719 256,697
10 Payroll taxes ........... 25,449,640 21,352,248 4,097,392  
11 Fees for services (non-employees):        
a Management ...... 2,880,484 2,416,726 463,758  
b Legal ......... 91,036 0 91,036  
c Accounting ........... 338,457 0 338,457  
d Lobbying ........... 252,047 0 252,047  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 16,188 0 16,188  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 215,748,725 141,831,697 73,736,717 180,311
12 Advertising and promotion .... 593,051 481,147 92,330 19,574
13 Office expenses ....... 30,465,580 25,458,927 4,885,443 121,210
14 Information technology ...... 19,856,803 16,629,286 3,191,080 36,437
15 Royalties .. 0      
16 Occupancy ........... 19,674,079 16,506,553 3,167,526  
17 Travel ............ 1,469,111 1,210,152 232,222 26,737
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 2,162,591 1,808,616 347,065 6,910
20 Interest ........... 13,493,340   13,493,340  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 40,900,564 34,315,573 6,584,991  
23 Insurance .............. 8,404,586 7,051,448 1,353,138  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 134,872,984 134,872,984    
b BAD DEBT PROVISION 89,167,141 89,167,141    
c STATE FRANCHISE FEE 12,039,765 12,039,765    
d TAX EXPENSE 1,224,403   1,224,403  
e All other expenses 6,891,291 5,753,782 1,104,122 33,387
25 Total functional expenses. Add lines 1 through 24e 1,089,198,692 898,672,542 188,737,174 1,788,976
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 1,802,242 1 60,183
2 Savings and temporary cash investments ......... 170,463,959 2 190,532,021
3 Pledges and grants receivable, net ........... 5,664,789 3 6,995,713
4 Accounts receivable, net ............. 162,255,507 4 175,269,983
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 23,595,042 7 24,277,038
8 Inventories for sale or use .............. 13,552,762 8 10,793,973
9 Prepaid expenses and deferred charges .......... 10,389,016 9 9,388,108
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,117,235,348
b Less: accumulated depreciation ..... 10b 690,351,299 455,914,691 10c 426,884,049
11 Investments—publicly traded securities .......... 203,858,864 11 270,068,608
12 Investments—other securities. See Part IV, line 11 ..... 5,214,254 12 9,386,412
13 Investments—program-related. See Part IV, line 11 ..... 20,436,783 13 30,770,383
14 Intangible assets ............... 2,579,662 14 2,462,688
15 Other assets. See Part IV, line 11 ........... 118,264,416 15 65,070,652
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,193,991,987 16 1,221,959,811
Liabilities 17 Accounts payable and accrued expenses ......... 171,468,917 17 79,128,980
18 Grants payable ................. 919,847 18 0
19 Deferred revenue ................ 2,615,753 19 2,374,731
20 Tax-exempt bond liabilities ............. 350,982,844 20 343,097,418
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 4,614 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 18,985,571 23 17,859,615
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 182,666,359 25 193,686,420
26 Total liabilities. Add lines 17 through 25......... 727,643,905 26 636,147,164
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 426,876,312 27 538,731,106
28 Temporarily restricted net assets ........... 22,365,155 28 29,111,026
29 Permanently restricted net assets ........... 17,106,615 29 17,970,515
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 466,348,082 33 585,812,647
34 Total liabilities and net assets/fund balances ........ 1,193,991,987 34 1,221,959,811
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,143,732,758
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,089,198,692
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
54,534,066
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
466,348,082
5
Net unrealized gains (losses) on investments ...............
5
9,592,823
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
55,337,676
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
585,812,647
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
No
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
(A) SUMMA AKRON CITY AND ST THOMAS HOSPITALS
  		340714755 03 Yes           845,165
(B) SUMMA BARBERTON CITIZENS HOSPITAL
  		261375072 03 Yes           100,000
(C) CUYAHOGA FALLS GENERAL HOSPITAL
  		340718383 09 Yes           0
(D) THE WADSWORTH-RITTMAN AREA HOSPITAL ASSN
  		346549371 03 Yes           0
Total 945,165

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... 4,540,510 6,941,569 5,638,036 5,122,826 7,808,474 30,051,415
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......           0
3 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
4 Total. Add lines 1 through 3 4,540,510 6,941,569 5,638,036 5,122,826 7,808,474 30,051,415
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. 754,159
6 Public support. Subtract line 5 from line 4. 29,297,256
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
7 Amounts from line 4.. 4,540,510 6,941,569 5,638,036 5,122,826 7,808,474 30,051,415
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... 1,527,282 1,494,312 1,752,613 1,814,584 1,047,164 7,635,955
9 Net income from unrelated business activities, whether or not the business is regularly carried on..           0
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..           0
11 Total support (Add lines 7 through 10). 37,687,370
12
12
7,669,714
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
77.738 %
15
15
75.437 %
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
Summa Health System Group Return
  		Employer identification number

90-0640432
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

   
RESTRICTED
RESTRICTED
RESTRICTED, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
Summa Health System Group Return
  		Employer identification number

90-0640432
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
Summa Health System Group Return
  		Employer identification number

90-0640432
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
Yes
 
12,340
d
Mailings to members, legislators, or the public? .........................
Yes
 
80
e
Publications, or published or broadcast statements? .......................
Yes
 
500
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
24,800
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
211,827
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
2,500
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
252,047
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1 In 2013, Summa Health System board members, management, physicians and staff interacted with public sector leadership to influence select health policy and funding priorities. On a federal level, Summa leadership partnered with federal delegation members and staff on issues pertaining to the sustainable growth rate, graduate medical education, Medicare payments, and insurance reform. Summa also devoted a greater percentage of its advocacy resources to advance the Medicaid expansion issue within Ohio. Summa staff also interacted with state legislators and staff on issues related to insurance reform, workforce development, Medicaid payments and reform, and the Ohio capital bill.
Part II-B, Line 1(f) The amount on Line 1(f) represents the portion of annual dues to organizations such as AHA and OHA allocable to lobbying activities.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 16,730,854 15,896,470 15,633,841 13,145,135 13,311,624
b Contributions ........ 70,706 347,618 113,108 2,481,325 -183,166
c Net investment earnings, gains, and losses 762,707 486,766 149,521 7,380 16,677
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ...... 17,564,267 16,730,854 15,896,470 15,633,840 13,145,135
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   68,801,142 68,801,142
b Buildings ................   602,732,665 367,376,640 235,356,025
c Leasehold improvements ............   3,792,595 1,677,673 2,114,922
d Equipment ................   414,956,421 304,727,591 110,228,830
e Other .................   26,952,525 16,569,395 10,383,130
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 426,884,049
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) MALPRACTICE FUND 14,612,401
(2) BONDS ASSURED GUARANTY 4,331,974
(3) BOND ISSUE COSTS 1,861,929
(4) BENEFICAL INTEREST IN WRHF 934,010
(5) DEFERRED PENSION & COMP 273,152
(6) NON-PERF ASSET AIR RIGHTS 1,124,370
(7) BENEFICAL INTEREST IN PERP. TR 5,002,300
(8) DUE FROM RELATED ORGANIZATIONS 33,919,214
(9) OTHER ACCOUNTS RECEIVABLE 108,536
(10) BENEFICAL INTEREST IN PROPERTY 2,902,766
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 65,070,652
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
LEASE ESCALATION LIABILITY 628,566
CAPITAL LEASE OBILIGATIONS 58,100,778
ASSET RETIREMENT OBLIGATION FI 2,408,284
INTEREST RATE SWAP 5,819,572
POST RETIREMENT BENEFITS 1,293,340
CONTINGENT LIABILITIES 2,583,856
MALPRACTICE LIABILITY 14,411,030
UNSECURED PAYABLES 101,975,263
PURCHASE OPTION LIABILITY 4,698,787
OTHER OBLIGATIONS 1,766,944
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 193,686,420
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Part IV, Line 2B Custodial funds held by Summa Foundation on behalf of Cuyahoga Falls General Hospital Foundation.
Part V, Line 4 Endowment funds provide income to be used to fulfill the tax-exempt purposes of Summa Foundation.
Part X, Line 2, FIN 48 Footnote: The System and most of its subsidiaries are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (Code) and are exempt from federal income taxes pursuant to Section 501(a) of the Code. The System also has certain subsidiaries that are taxable for federal income tax purposes. Summa Insurance Company ("SIC"), together with affiliates of Summa Health System Corporation ("SHSC"), file a consolidated federal income tax return in accordance with a tax-sharing agreement dated January 1, 2010. The entities utilize a consolidated approach to the allocation of federal income taxes, whereas SHSC's tax-sharing agreement with its subsidiaries allows it to make certain code elections in its consolidated federal tax return. In the event such code elections are made, any benefit or liability is the responsibility of SHSC and is accrued and paid by the participating subsidiaries. SIC is not subject to state income taxes as it is licensed as a health insurance company under Chapter 1751 of the Ohio Revised Code. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and the respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The System recognizes interest income, interest expense, and penalties related to uncertain tax positions with the provision for income tax.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ...............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Central America and the Caribbean     Program Services Self Insurance 11,195,331
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     11,195,331
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     11,195,331
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
Part I, Line 3(1), Col. F Insurance premiums paid $11,195,331
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


Software ID:  
Software Version:  



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

Sapphire Ball
(event type) 		(b) Event #2

Golf Outing
(event type) 		(c) Other events

1
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 895,740 240,400 72,666 1,208,806
2 Less: Contributions . . 780,430 206,410 65,535 1,052,375
3 Gross income (line 1
minus line 2) . . . 		115,310 33,990 7,131 156,431
VerticalDirectExpenses 4 Cash prizes . . . 0 0 0 0
5 Noncash prizes . . 0 4,524 0 4,524
6 Rent/facility costs . . 145,795 48,435 7,734 201,964
7 Food and beverages . 114,172 23,427 1,715 139,314
8 Entertainment . . . 98,572 4,900 0 103,472
9 Other direct expenses . 49,544 9,966 6,374 65,884
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 515,158
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow -358,727
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2013
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    22,673,393 7,074,188 15,599,205 1.430 %
b Medicaid (from Worksheet 3,
column a) .... 		    129,094,267 105,829,555 23,264,712 2.130 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    151,767,660 112,903,743 38,863,917 3.560 %
Other Benefits
     1,253,825 10,400 1,243,425 0.110 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		    33,020,952 13,915,467 19,105,485 1.750 %
g Subsidized health services
(from Worksheet 6) .. 		    26,414,921 0 26,414,921 2.420 %
h Research (from Worksheet 7)     6,502,710 1,393,396 5,109,314 0.470 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		    2,318,996 0 2,318,996 0.210 %
j Total. Other Benefits ..     69,511,404 15,319,263 54,192,141 4.960 %
k Total. Add lines 7d and 7j .     221,279,064 128,223,006 93,056,058 8.520 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support     7,380 0 7,380  
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy     8,491 0 8,491  
8 Workforce development     57,940 0 57,940 0.010 %
9 Other            
10 Total     73,811 0 73,811 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
22,326,352
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
406,906,959
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
394,190,262
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
12,716,697
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1Crystal Clinic Ortho
  		Orthopaedic Service 49.650 %   50.350 %
2Summa Western Reserv
  		General Hospital 40.000 %   60.000 %
3Ohio Sleep Disorders
  		Sleep Medicine 66.670 %   33.330 %
4Digestive Health Ctr
  		Digestive Disease 5.000 %   44.000 %
5Medina-Summit ASC
  		Ambulatory Surgery Center 20.000 %   70.000 %
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?6
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Summa Akron City & St Thomas Hospital
525 East Market Street
Akron,OH44304
www.summahealth.org 		X X   X   X X     1
2 Summa Barberton Citizens Hospital
155 Fifth Street NE
Barberton,OH44203
www.summahealth.org 		X X   X   X X     1
3 The Wadsworth-Rittman Area Hospital
195 Wadsworth Road
Wadsworth,OH44281
www.summahealth.org 		X X   X     X     1
4 Summa Western Reserve Hospital LLC
1900 23rd Street
Cuyahoga Falls,OH44223
www.westernreservehospital.org 		X X   X     X     1
5 Crystal Clinic Orthopaedic Center LLC
444 North Main Street
Akron,OH44310
www.crystalclinic.com 		X X   X           2
6 Summa Rehab Hospital LLC
29 North Adams Street
Akron,OH44304
www.summarehabhospital.com 		X     X         Rehabilitation 2
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Group 1
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		 
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13   No
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Group 2
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		 
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13   No
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19   No
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
Part V, Section B, Line 3 (GROUPS 1 & 2) In conducting its 2013 Community Health Needs Assessment, the facilities took into account input from persons who represent the community by interviewing community leaders, including those with specialized knowledge in the area of public health, and by conducting focus groups with residents in the community to solicit their views of the significant health needs of the community. A list of the persons interviewed, by organization and title, can be found on page 13 of the CHNA report available at the URL http://www.summahealth.org/about-us/about-summa/community-benefit-and-dive rsity/communityneedsassessment2013.
Part V, Section B, Line 4 (GROUPS 1 & 2) Summa Health System conducted the CHNA on behalf of each of its six hospital facilities listed in Part V, Section A. In addition, Summa Health System collaborated with Akron General Health System and Akron Children's Hospital in conducting the CHNA.
Part V, Section B, Line 7 (GROUPS 1 & 2) Most of the health needs identified in the CHNA report are addressed in the various implementation strategies by one or more of the hospital facilities listed in Part V, Section A. Not all facilities are addressing all of the needs. A specific list of the needs being addressed by each hospital on a facility-by-facility basis is available in Summa Health System's Implementation Strategy available on at the URL http://www.summahealth.org/about-us/about-summa/community-benefit-and-dive rsity/communityneedsassessment2013. Needs identified in the CHNA but not addressed by any of the hospital facilities listed in Part V, Section A include: obtaining healthy foods, childhood chronic disease, child development, child lifestyle risk factors, child mental health and substance abuse, child safety, child access to care, and child environmental risk factors. Obtaining healthy foods was not addressed by the hospital facilities due to the other community resources available, including the Akron Canton Regional Food Bank. Similarly, due to other community resources available to assist children, specifically Akron Children's Hospital, the aforementioned health needs relating to children were not addressed by the hospital facilities.
Part V, Section B, Line 14(g) (GROUP 1) In addition to the measures indicated, Summa's hospitals also provide a description of the Financial Assistance Policy in the Patient Handbook, which is provided to all patients upon admission into the hospital facility. Also see Schedule H, Part VI, Line 3 for more information.
Part V, Section B, Line 19 (GROUP 2) The hospital facilities in reporting Group 2 are specialty hospital facilities and do not have emergency departments. Each facility is located in close proximity to the hospital facilities in reporting Group 1 where emergency patients are treated.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?20
Name and address Type of Facility (describe)
1 Summa Health Center at Lake Medina
3780 Medina Road
Medina,OH44256 		Lab, imaging, therapy, sleep medicine, radiation oncology & outpatient surgery
2 Summa Health Center at Green
3838 Massillon Road
Green,OH44685 		Lab, imaging, rehabilitation, therapy & other health service
3 Summa Health Center at White Pond
1 Park West Suite 130
Akron,OH44320 		Lab, imaging, and other specialty health programs
4 Summa Health Center at Western Reserve
5655 Hudson Drive
Hudson,OH44236 		Lab, imaging, rehabilitation, wound care & sports medicine
5 Summa Health Center at Lake Anna
500 West Hopocan Avenue
Barberton,OH44203 		Therapy, rehabilitation and sports medicine
6 Summa Health Center at Anna Dean
28 Conservatory Drive
Barberton,OH44203 		Outpatient rehab and therapy
7 Summa Health Center at Cuyahoga Falls
1860 State Road
Cuyahoga Falls,OH44223 		Lab and imaging services
8 Summa Wellness Institute
5625 Hudson Drive
Hudson,OH44236 		Medical-based fitness programs rehabilitation & therapy
9 Summa Services - Wadsworth Community Ctr
621 School Drive
Wadsworth,OH44281 		Imaging, rehabilitation and orthopaedic sports medicine
10 Summa Neurosciences at White Pond
750 White Pond Drive
Akron,OH44320 		Neurology services
11 Summa Sleep Medicine Center - Green
1700 Boettler Road Ste 215
Uniontown,OH44685 		Sleep and neurology services
12 Summa Rehabilitation Svcs at White Pond
750 White Pond Drive
Akron,OH44320 		Occupational & rehab services
13 Natatorium Rehabilitation and Wellness
2345 4th Street
Cuyahoga Falls,OH44223 		Orthopaedic & sports therapy
14 Summa Rehab at Tallmadge Rec Center
46 North Munroe
Tallmadge,OH44278 		Physical therapy and sports health
15 Summa Urgent Care & Corporate Health
2875 West Market Street
Fairlawn,OH44333 		Urgent care & corporate health
16 Summa Urgent Care at Stow
3913 Darrow Road Ste 100
Stow,OH44224 		Urgent care & occupational health services
17 Cedar Pines
185 West Cedar Street Ste 100
Akron,OH44307 		Cardiology & stress tests
18 Ignatia Hall South
3730 Whipple Avenue Ste 5
Canton,OH44718 		Outpatient addiction medicine
19 Summa Home Infusion
2743 Gilchrist Road Ste 200
Akron,OH44305 		Home care & infusion services
20 Summa Ctr for Health Equity-New Seasons
1493 S Hawkins Avenue
Akron,OH44320 		Chronic disease management, health, nutrition, exercise & education services
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Part V, Section B, Line 3 (GROUPS 1 & 2) In conducting its 2013 Community Health Needs Assessment, the facilities took into account input from persons who represent the community by interviewing community leaders, including those with specialized knowledge in the area of public health, and by conducting focus groups with residents in the community to solicit their views of the significant health needs of the community. A list of the persons interviewed, by organization and title, can be found on page 13 of the CHNA report available at the URL http://www.summahealth.org/about-us/about-summa/community-benefit-and-dive rsity/communityneedsassessment2013.
Part V, Section B, Line 4 (GROUPS 1 & 2) Summa Health System conducted the CHNA on behalf of each of its six hospital facilities listed in Part V, Section A. In addition, Summa Health System collaborated with Akron General Health System and Akron Children's Hospital in conducting the CHNA.
Part V, Section B, Line 7 (GROUPS 1 & 2) Most of the health needs identified in the CHNA report are addressed in the various implementation strategies by one or more of the hospital facilities listed in Part V, Section A. Not all facilities are addressing all of the needs. A specific list of the needs being addressed by each hospital on a facility-by-facility basis is available in Summa Health System's Implementation Strategy available on at the URL http://www.summahealth.org/about-us/about-summa/community-benefit-and-dive rsity/communityneedsassessment2013. Needs identified in the CHNA but not addressed by any of the hospital facilities listed in Part V, Section A include: obtaining healthy foods, childhood chronic disease, child development, child lifestyle risk factors, child mental health and substance abuse, child safety, child access to care, and child environmental risk factors. Obtaining healthy foods was not addressed by the hospital facilities due to the other community resources available, including the Akron Canton Regional Food Bank. Similarly, due to other community resources available to assist children, specifically Akron Children's Hospital, the aforementioned health needs relating to children were not addressed by the hospital facilities.
Part V, Section B, Line 14(g) (GROUP 1) In addition to the measures indicated, Summa's hospitals also provide a description of the Financial Assistance Policy in the Patient Handbook, which is provided to all patients upon admission into the hospital facility. Also see Schedule H, Part VI, Line 3 for more information.
Part V, Section B, Line 19 (GROUP 2) The hospital facilities in reporting Group 2 are specialty hospital facilities and do not have emergency departments. Each facility is located in close proximity to the hospital facilities in reporting Group 1 where emergency patients are treated.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number
90-0640432
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) American Heart Association
5455 N High Street
Columbus,OH43214 		13-5613797 501(c)(3) 100,000       Research/education
(2) Open M Summit County Free Clinic
941 Princeton Street
Akron,OH44311 		34-1046107 501(c)(3) 19,500       Health & Wellness
(3) Habitat for Humanity of Summit County
2301 Romig Road
Akron,OH44320 		34-1518873 501(c)(3) 12,500       Community support
(4) University of Akron
198 Fir Hill
Akron,OH44325 		34-6002924 Governmental 26,350       Research & education
(5) Susan G Komen Northeast Ohio
26210 Emery Rd Ste 307
Cleveland,OH44128 		75-1835298 501(c)(3) 20,000       Cancer research
(6) Greater Akron Chamber
1 Cascade Plaza 17th Floor
Akron,OH44308 		34-1156576 501(c)(6) 8,600       Education WD












2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
5
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) Dental Clinic Fund 29 7,954   Book NA
(2) Ophthalmology Cataract Surgery 13 13,838   Book NA
(3) SummaShares 15 10,190   Book NA








Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Part I, Line 2, General Information on Grants and Assistance The procedures for monitoring the use of grant funds is based on the criteria established prior to awarding the grant or assistance. Once the criteria is met a payment will be made to the University or agency utilizing the funds.
Part II, Line 1(2) For furtherance of Summa Akron City and St. Thomas Hospitals charitable purposes including providing medical education and healthcare services to the surrounding community.
Schedule I (Form 990) 2013


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Michael Bage MDDirector SACSTH (end 9/13) (i)
(ii)		 410,711
0 		91,156
0 		650
0 		7,650
0 		8,105
0 		518,272
0 		0
0
(2)William Bauman MDDirector SACSTH, SBH, WRH, SPI (i)
(ii)		 593,820
0 		20,802
0 		1,300
0 		7,650
0 		8,206
0 		631,778
0 		0
0
(3)Robert Debski MDDirector SACSTH, SBH, WRH (i)
(ii)		 275,450
0 		0
0 		0
0 		0
0 		8,969
0 		284,419
0 		0
0
(4)Steven Gaich MDDirector SPI (i)
(ii)		 316,013
0 		7,902
0 		0
0 		7,650
0 		2,610
0 		334,175
0 		0
0
(5)Robert HarriganDir SACSTH & COO (end 9/13) (i)
(ii)		 0
438,797 		0
195,934 		0
416,078 		0
77,637 		0
6,008 		0
1,134,454 		0
60,441
(6)A Gus Kious MDDirector/Pres SPI (end 12/13) (i)
(ii)		 260,537
0 		6,395
0 		64,835
0 		15,325
0 		1,681
0 		348,773
0 		0
0
(7)Joseph Koenig MDDirector SPI (i)
(ii)		 571,411
0 		199,108
0 		495
0 		8,925
0 		8,480
0 		788,419
0 		0
0
(8)Joseph McShannic MDDirector SACSTH (end 9/13) (i)
(ii)		 459,379
0 		72,760
0 		0
0 		6,375
0 		14,857
0 		553,371
0 		0
0
(9)Dale Murphy MDDirector SPI (i)
(ii)		 0
183,477 		0
45,629 		0
249,392 		0
36,014 		0
4,131 		0
518,643 		0
30,317
(10)Thomas ONeillDirector SPI, CFO SACSTH (i)
(ii)		 0
250,655 		0
62,719 		0
95,875 		0
30,445 		0
3,998 		0
443,692 		0
26,959
(11)William Powel IIIDirector SPI, System Secty (i)
(ii)		 0
350,982 		0
102,721 		0
122,229 		0
54,327 		0
7,414 		0
637,673 		0
39,937
(12)Erik Steele DODirector SACSTH, SBH, WRH (i)
(ii)		 0
228,256 		0
50,000 		0
71,725 		0
0 		0
2,606 		0
352,587 		0
0
(13)Thomas StraussDir SF, System Pres/CEO (i)
(ii)		 0
763,884 		0
194,287 		0
315,575 		0
102,035 		0
6,475 		0
1,382,256 		0
85,619
(14)Douglas Trochelman MDDirector SACSTH (end 9/13) (i)
(ii)		 626,005
0 		138,845
0 		1,600
0 		8,925
0 		7,199
0 		782,574
0 		0
0
(15)Joseph Varley MDDirector SACSTH (end 9/13) (i)
(ii)		 356,031
0 		6,514
0 		1,300
0 		7,650
0 		11,583
0 		383,078
0 		0
0
(16)Scott Weiner MDDirector SACSTH, SBH, WRH (i)
(ii)		 870,092
0 		19,558
0 		1,500
0 		8,925
0 		9,303
0 		909,378
0 		0
0
(17)Darrell Widmer MDDirector WRH (end 9/13) (i)
(ii)		 196,777
0 		2,564
0 		1,300
0 		5,679
0 		1,523
0 		207,843
0 		0
0
(18)Charles AldersonCFO, SBH & WRH (i)
(ii)		 167,625
0 		0
0 		38,310
0 		5,972
0 		5,100
0 		217,007
0 		0
0
(19)Thomas DeBordPresident SBH & WRH (i)
(ii)		 232,239
0 		23,266
0 		60,570
0 		34,017
0 		5,629
0 		355,721
0 		10,496
0
(20)Brian DerrickSystem CFO (i)
(ii)		 0
464,776 		0
202,792 		0
129,730 		0
31,054 		0
9,210 		0
837,562 		0
0
(21)Phylis FerraraPresident/CDO, SF (i)
(ii)		 96,977
0 		75,000
0 		26,246
0 		0
0 		1,101
0 		199,324
0 		0
0
(22)Bryan FredericksCOO, SPI (i)
(ii)		 237,250
0 		0
0 		43,569
0 		8,077
0 		4,571
0 		293,467
0 		0
0
(23)Kathleen JobeChief Nursing Officer, SBH (i)
(ii)		 159,597
0 		0
0 		36,759
0 		5,656
0 		4,442
0 		206,454
0 		0
0
(24)Thomas Malone MDPresident SACSTH (i)
(ii)		 0
80,705 		0
50,000 		0
35,315 		0
0 		0
812 		0
166,832 		0
0
(25)Steve SchmidtCOO, SF (i)
(ii)		 190,743
0 		26,670
0 		41,849
0 		31,883
0 		2,733
0 		293,878
0 		13,987
0
(26)Shane SeymourCDO, SF (end 6/13) (i)
(ii)		 0
102,296 		0
2,781 		0
63,521 		0
0 		0
4,089 		0
172,687 		0
0
(27)Adrian Dan MDHCE - Bariatric Surgery (i)
(ii)		 710,561
0 		137,669
0 		950
0 		7,656
0 		8,553
0 		865,389
0 		0
0
(28)John Zografakis MDHCE - Bariatric Surgery (i)
(ii)		 730,297
0 		74,885
0 		1,600
0 		8,925
0 		9,115
0 		824,822
0 		0
0
(29)Joel Porter MDHCE - Colorectal Surgery (i)
(ii)		 575,444
0 		224,166
0 		0
0 		8,925
0 		2,359
0 		810,894
0 		0
0
(30)Eric Miller MDHCE - Orthopaedic Surgery (i)
(ii)		 710,261
0 		52,699
0 		1,500
0 		2,550
0 		6,675
0 		773,685
0 		0
0
(31)Mehool Patel MDHCE - Oncology, Hematology (i)
(ii)		 531,383
0 		177,602
0 		150
0 		1,225
0 		5,424
0 		715,784
0 		0
0
(32)Jay Williamson MDFormer President, SPI (i)
(ii)		 194,329
0 		0
0 		24,985
0 		6,650
0 		4,311
0 		230,275
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Part I, Line 1a Summa Health System grossed-up taxes for supplemental executive retirement programs paid to certain officers, key employees and the highly compensated. Health and social club dues, tax preparation services and housing allowances were paid on behalf of certain officers. The personal use is reflected as wages.
Part I, Line 3 Compensation of the President & CEO is established by Summa Health System ("SHS"), the related parent organization for all members in the Summa Health System Group Return. SHS has a compensation committee which uses an independent compensation consultant, market surveys, and an annual review process to establish compensation for the position of President & CEO.
Part I, Line 4a In 2013, Robert Harrigan received $148,922 in severance and benefits from a related organization.
Part I, Line 4b Summa Health System has a 457(f) program for the executive staff which rewards certain officers, directors and key employees for meeting key long-term strategic objectives of the organization. Amounts paid in 2013: Thomas J. Strauss $97,336, Robert Harrigan $68,712, William A. Powel, III $45,402, Brian K. Derrick $23,404, Joseph Zarconi, MD $38,735, Thomas P. O'Neill $21,520, A. Gus Kious $12,789, Dale P. Murphy, MD $30,624, Steve Schmidt $25,366, and Thomas DeBord $25,242.
Part I, Line 7 Summa Health System management incentive program was designed to reward employees for meeting quality performance and financial targets. These include clinical quality, patient satisfaction, employee/physician satisfaction, net operating income, and strengthening of the balance sheet. Payment is based on a factor of base compensation and is subject to review and approval by Summa's Compensation Committee.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number
90-0640432
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A Akron Bath Copley Jt Twp Hosp Dist
  		34-1448680 009730LT7 06-10-2004 160,904,918 See Schedule K, Part VI, Rider 2   X   X   X
B Summit County Port Authority
  		34-1765940 86605VAE9 10-31-2006 15,405,000 See Schedule K, Part VI, Rider 6   X   X   X
C Ohio Higher Educational Facility Comm
  		34-6849674 67756AY89 05-11-2010 180,125,341 See Schedule K, Part VI, Rider 8   X   X   X
D Akron Bath Copley JT TWP Hosp Dist
  		34-1448680   07-01-2012 32,509,635 See Schedule K, Part VI, Rider 11   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 23,865,000 1,460,000 0 4,654,253
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 164,278,376 15,405,000 180,152,058 32,509,635
4 Gross proceeds in reserve funds . . . . . . . . . . . . 3,107,915 0 18,190,573 0
5 Capitalized interest from proceeds . . . . . . . . . . . 2,238,718 867,000 3,004,911 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 2,285,007 308,100 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 3,930,806 153,159 4,929,857 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 89,411,463 14,076,741 144,468,307 0
11 Other spent proceeds . . . . . . . . . . . . . . 59,931,009 0 0 32,509,635
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 9,558,410 0
13 Year of substantial completion . . . . . . . . . . . . 2006 2008 2012 2012
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . . . X     X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X     X X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X X     X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X      
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X     X X      
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X       X      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X     X X      
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X       X      
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 15.560 % 1.060 % 1.820 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0.060 % 2.870 % 0.140 %  
6 Total of lines 4 and 5 . . . . . . . . . . . . . 15.620 % 3.930 % 1.960 %  
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .                
b Exception to rebate? . . . . . . . . X   X          
c No rebate due? . . . . . . . . X       X   X  
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X     X X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X X     X X  
b Name of provider . . . . . . . . . 0
  		see rider 7
  		0
  		 
 
c Term of hedge . . . . . . . . . . 30. 30.   12.
d Was the hedge superintegrated? . . . .   X   X       X
e Was the hedge terminated? . . . . . .   X   X       X
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X     X X     X
b Name of provider . . . . . . . . . see rider 5
  		0
  		see rider 10
  		0
 
c Term of GIC . . . . . . . . . . 3.1   2.2  
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X       X      
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Form 990, Schedule K, Part I, Line A, Col.(c) The CUSIP number assigned to the final maturity of the Series 2004A Bonds is 009730LT7. The CUSIP number assigned to the final maturity of the Series 2004B Bonds is 009730LU4. (Note: The Series 2004A Bonds and the Series 2004B Bonds are treated as a single issue of bonds for federal tax purposes).
Form 990, Schedule K, Part I, Line A, Col.(f) The purposes of the Series 2004A Bonds were to (1) construct and equip a critical care pavilion, (2) construct and equip other hospital facilities, (3) refund prior issues with the following issue dates: (a) July 1, 1999, (b) July 28, 2000 and (c) March 12, 2002, (4)fund a debt service reserve for the issue, and (5) pay issuance costs. The purposes of the Series 2004B Bonds were to (1) construct and equip a critical care pavilion, (2) contruct and equip other hospital facilities, (3) refund prior issues with the following issue dates: (a) December 22, 1992 and (b) June 10, 1993, (4) pay the initial costs of a liquidity facility, and (5) pay issuance costs. (Note: The Series 2004A Bonds and the Series 2004B Bonds are treated as a single bond issue for federal tax purposes).
Form 990, Schedule K, Part III, Col. A, Line 6 The private business use percentage on Schedule K, Part III, Col. A, Line 6 is projected to be less than 5% over the life of the bonds due to the expected termination of certain lease arrangements.
Form 990, Schedule K, Part IV, Col. A, Line 2c Series 2004A Bonds Date arbitrage rebate computation performed was June 10, 2013. Series 2004B Bonds Date arbitrage rebate computation performed was June 10, 2013.
Form 990, Schedule K, Part IV, Col. A, Line 5b Series 2004A Bonds Project Fund GIC - Financial Security Assurance Debt Service Reserve Fund GIC - Merrill Lynch Capital Services, Inc. Series 2004B Bonds Aegon/Transamerica
Form 990, Schedule K, Part I, Line B, Col.(f) The purposes of the Series 2006 Bonds were to (1) acquire a project site for and construct and equip a wellness institute, and (2) pay issuance costs.
Form 990, Schedule K, Part IV, Col. B, Line 4b Huntington National Bank
Form 990, Schedule K, Part I, Line C, Col.(f) The purposes of the Series 2010 Bonds were to (1) currently refund a taxable loan to Summa Barberton Citizens Hospital under a line of credit, the proceeds of which were used to acquire hospital facilities, (2) currently refund a taxable loan to Summa Akron City and St. Thomas Hospitals, the proceeds of which were used for certain capital expenditures, (3) construct and equip hospital facilities, (4) acquire, construct, and equip parking facilities, nursing facilities, administrative facilities, ambulatory care facilities, and medical equipment, and (5) pay issuance costs.
Form 990, Schedule K, Part IV, Col. C, Line 2c Date arbitrage rebate computation performed was May 11, 2013.
Form 990, Schedule K, Part IV, Col. C, Line 5b Morgan Stanley & Company Incorporated
Form 990, Schedule K, Part I, Line D, Col. (f) The purposes of the Series 2012 Bonds were to (1) refund the Hospital Facilities Revenue Bonds, Series 1998A issued on December 23, 1998 in the original amount of $50,000,000, and (2) to pay the costs of issuance of the Bonds.
Form 990, Schedule K, Part IV, Col. D, Line 2c Date arbitrage rebate computation performed was July 25, 2013.
Form 990, Schedule K, Part IV, Col. D, Line 4b RBS Citizens Bank
Schedule K (Form 990) 2013

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Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Kelly Bianco Family member 22,153 See Part V   No
(2) Brian Bauman MD Family member 443,041 See Part V   No
(3) Cynthia Browning Family member 60,885 See Part V   No
(4) Akron Radiology Inc See Part V 3,309,425 See Part V   No
(5) Inpatient Medical Services Inc See Part V 790,679 See Part V   No
(6) Paragon Health Associates LLC See Part V 1,096,558 See Part V   No
(7) Primary Care Physicians See Part V 2,370,183 See Part V   No
(8) Professional Anesthesia Service Inc See Part V 8,725,263 See Part V   No
(9) Ritzman Pharmacies Inc See Part V 1,174,609 See Part V   No
(10) Summa Emergency Associates Inc See Part V 1,480,786 See Part V   No
(11) Summit County Internists See Part V 605,938 See Part V   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L, Part IV, Business Transactions Kelly Bianco is a family member of Michael Bianco, MD, Director of WRH. Kelly Bianco was paid reasonable compensation as an employee of WRH. Brian Bauman, MD is a family member of William Bauman, MD, Director of SPI. Brian Bauman, MD was paid reasonable compensation as an employee of SPI. Cynthia Browning is a family member of Nicholas Browning, Director of SACSTH. Cynthia Browning was paid reasonable compensation as an employee of SACSTH. Daniel Finelli, MD, Director of SACSTH, SBH & WRH, is a director of Akron Radiology, Inc. Amount paid represents fees for services performed by Akron Radiology, Inc. Robert Schaal, MD, Director of SACSTH, is an officer of Inpatient Medical Services, Inc. Amount paid represents fees for services performed by Inpatient Medical Services, Inc. Edward Ferris, MD, Director of SACSTH, is part owner of Paragon Health Associates, LLC. Amount paid represents fees for services performed by Paragon Health Associates, LLC. Sharon VanNostran, DO, Director of SACSTH, is an officer of Primary Care Physicians. Amount paid represents fees for services performed by Primary Care Physicians. Jacob Cohen, MD, Director of SACSTH, is an officer of Professional Anesthesia Service, Inc. Amount paid represents fees for services performed by Professional Anesthesia Service, Inc. Thomas Knoll, Director of SACSTH, SBH & WRH, is a director of Ritzman Pharmacies, Inc. Amount paid represents fees for goods and services from Ritzman Pharmacies, Inc. Michelle Blanda, MD, Director of SACSTH, is an officer of Summa Emergency Associates, Inc. Amount paid represents fees for services performed by Summa Emergency Associates, Inc. Dale Murphy, MD, Director of SPI, is an officer of Summit County Internists. Amount paid represents fees for services performed by Summit County Internists.
Schedule L (Form 990 or 990-EZ) 2013

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SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 7 79,785 FMV
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies . X 44 16,625 FMV
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( Events ) X 4 8,500 Comparable Prices
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2013)
Schedule M (Form 990) (2013)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
Schedule M (Form 990) (2013)
Additional Data


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SCHEDULE N
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution, or Significant Disposition of Assets
bullet Complete if the organization answered "Yes" to Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
bullet Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet Attach to Form 990 or 990-EZ.
bulletInformation about Schedule N (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number
90-0640432
Part I
Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated if additional space is needed.Click to see list of attachments
1(a)Description of asset(s)
distributed or transaction
expenses paid		 (b)Date of
distribution		 (c)Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d)Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e)EIN of recipient (f)Name and address of recipient (g)IRC section
of recipient(s) (if
tax-exempt) or type
of entity
CFGH Fixed assets (net), A/R and other 12-31-2013 43,556,851 book value 34-0714755 Summa Akron City and St Thomas Hosp
525 East Market Street
Akron,OH44304 		501(c)(3)




















Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
No
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . .
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? . . . . .
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) (2013)

Schedule N (Form 990 or 990-EZ) (2013)
Page 2
Part I
Liquidation, Termination, or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III . . . . . . . . . . .
3
Yes
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? . . . . . .
4a
Yes
 
b
If "Yes," did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .
4b
Yes
 
5
Did the organization discharge or pay all of its liabilities in accordance with state laws? . . . . . . . . . . . . . . . . .
5
Yes
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? . . . . . . . . . . . . . . . . . . . .
6a
Yes
 
b
Did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws? .
6b
 
No
c
If "Yes" to line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No," explain in Part III.

Part II
Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid		 (b) Date of
distribution		 (c) Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d) Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
















Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
No
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2c
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? . . . . . . .
2d
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet
Schedule N(Form 990 or 990-EZ) (2013)

Schedule N (Form 990 or 990-EZ) (2013)
Page 3
Part III
Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.
Return Reference Explanation
Form 990, Schedule N, Part I, Line 2e The following individual was a director of both Cuyahoga Falls General Hospital and Summa Akron City and St Thomas Hospitals at the time of the merger, and remained a director of the Summa Akron City and St Thomas Hospitals: Candace Campbell-Jackson, director.
Form 990, Schedule N, Part I, Line 6b The tax-exempt bond liabilities associated with CFGH were transferred to SACSTH.
Schedule N (Form 990 or 990-EZ) (2013)


Additional Data


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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Return Reference Explanation
Form 990, Page 1, Part I, Lines 3 & 4 Form 990, Page 6, Part VI, Lines 1a & 1b Entity Name Number of Voting Number of Independent Directors Voting Directors Summa Akron City & St. Thomas 16 8 Hospitals ("SACSTH") Summa Foundation ("SF") 23 20 Summa Physicians, Inc. ("SPI") 7 0 Summa Barberton Citizens 16 8 Hospital ("SBH") The Wadsworth-Rittman Area 16 8 Hospital Assn ("WRH") All of the organizations listed above are subordinates under the control of Summa Health System ("SHS"). As of December 31, 2013, SHS had 15 voting directors, 9 of whom are independent voting directors.
Form 990, Page 2, Part III, Line 4d Other Programs Services included: (a) Program-related investments in the following joint venture hospitals: Summa Western Reserve Hospital, LLC, Crystal Clinic Orthopaedic Center, LLC, and Summa Rehab Hospital, LLC. (b) Payments received under the American Reinvestment and Recovery Act for "Meaningful Use" due to successful implementation of electronic medical records. (c) Registration fees, including membership fees to Summa Wellness Institute ("SWI"). SWI is a medically supervised fitness facility blending fitness, wellness and rehabilitation in a clean, service-oriented environment. SWI features professional expertise and programming necessary to safely and effectively assist all people, regardless of current health status, to develop, initiate and maintain an active lifestyle that minimizes risk and promotes health and wellness and is one more step in Summa Health System's mission to provide the highest quality care to our patients and members and contribute to a healthier community.
Form 990, Page 2, Part III, Program Service Accomplishments Summa Health System is an integrated healthcare delivery system that provides coordinated, value-based care across the continuum for the people and populations we serve. We hold ourselves clinically and financially accountable for health outcomes in our communities. Summa Health System serves more than one million patients each year in comprehensive emergency, acute, critical, outpatient and long-term/homecare settings and represents more than 1,700 registered, inpatient beds on the campuses of Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizen's Hospital, The Wadsworth-Rittman Area Hospital Association, Summa Rehab Hospital*, Summa Western Reserve Hospital*, and Crystal Clinic Orthopaedic Center*. In addition, outpatient care is provided in more than 16 community health centers and Emergency Departments (EDs), some integrated in the healthcare facilities, others are free-standing. *Summa Rehab Hospital, *Summa Western Reserve Hospital and *Crystal Clinic Orthopaedic Center are joint ventures in which Summa Health System has an interest, and are referenced in this document for the purpose of indentifying all entities affiliated with Summa Health System. Summa's proportionate interest of these joint ventures' charity care and other community benefits are included on Schedule H of Summa Health System's IRS Form 990 Group Return. Providing superior, multi-specialty patient care, medical research and continuing medical education, Summa Health System ranks as a highly recognized healthcare provider in several disciplines including: cardiovascular, emergency, oncology, stroke and nursing by prestigious organizations such as: The Society of Chest Pain Centers American College of Surgeons American Heart Association American Stroke Association National Accreditation Program of Breast Centers American Nurses Credentialing Center Premier Healthcare Alliance The Joint Commission Summa Health System is Summit County's largest employer and a leading economic engine for the region. Summa Health System includes the following: Summa Akron City and St. Thomas Hospitals: Summa Akron City and St. Thomas Hospitals is a single legal entity that includes two hospital campuses and several off-site locations. Summa Akron City and St. Thomas Hospitals operates both hospital locations as well as the hospital-based off-site locations under the same Medicare provider number. Summa Akron City and St. Thomas Hospitals has more than 5,800 individuals and has a medical staff of more than 1,000 professionals working on its campuses. Summa Akron City and St. Thomas Hospitals has 979 registered beds and 46 licensed bassinets. The buildings and facilities on both campuses total 1.7 million square feet. Summa Akron City Hospital offers general medical, surgical, obstetrical, trauma, and critical care services. Summa Akron City Hospital provides acute care services on a campus of approximately 60 acres. The campus is home to specialty health centers offering a wide range of outpatient services. In 2013, Summa Akron City Hospital opened a new Geriatric Unit in the Emergency Department. Summa Akron City Hospital received the following recognition in 2013: The Pallative Care Program was granted "Advanced Certification in Pallative Care" by The Joint Commission, its highest level of achievement. The program is the only one in Ohio to earn this recognition. Also, Women's Services received the Ohio Patient Safety Institute Acute Care Best Practice Award for the reduction of maternal morbidity and mortality related to hemorrhage. Summa St. Thomas Hospital provides acute care services along with behavioral health and substance abuse care. Summa St. Thomas Hospital was one of the first in the country to recognize the medical aspects of alcoholism as a disease and is the founding location of Alcoholics Anonymous. The hospital opened the nation's first alcoholism treatment ward and continues its longstanding dedication to this program today. Summa Akron City and St. Thomas Hospitals serves as a major teaching affiliate for Northeast Ohio Medical University (NEOMED), sponsoring and/or co-sponsoring 17 residencies and fellowships along with providing educational rotations for medical students. Summa Barberton Citizen's Hospital: Summa Barberton Citizen's Hospital is a 500,000 square foot acute care teaching hospital located on nearly 16 acres, located approximately 10 miles southwest of Akron, Ohio. The hospital has more than 1,400 employees and has approximately 400 medical staff. It has 235 registered adult beds and 14 available bassinets. Summa Barberton Citizen's Hospital opened its new Emergency Department in March 2013. This was followed by the implementation of an ICU/CCU Intensivist Program in August and a 24/7 STEMI Program in October. The Wadsworth-Rittman Area Hospital Association: The Wadsworth-Rittman Area Hospital Association is a 200,000 square foot acute care community hospital located on approximately 38 acres. Located approximately 20 miles west of Akron, Ohio, the Wadsworth-Rittman Area Hospital Association has 101 registered beds, more than 360 employees, and has a medical staff of more than 200 professionals. In 2013, Summa Center at Wadsworth opened to consolidate outpatient PT/OT/speech services at the Center, which also houses outpatient radiology and sports medicine. Charity Care In 2013, Summa Health System provided charity care at an estimated net cost of nearly $15.6 million. This amount represented the net cost associated with providing the care and does not include bad debt. Patients with incomes up to 200% of the federal poverty income guidelines or who have a hospital bill that exceeds 25% of their gross annual family income are eligible to apply for charity care assistance. In addition, there is a sliding scale discount program for those with incomes between 200% and 400% of the federal poverty income guidelines. In 2013, the charity care program (including Hospital Care Assurance Program) benefitted approximately 39,000 patient encounters. Medicaid Shortfall Historically, Ohio Medicaid reimbursements have not covered the cost of providing the care to program beneficiaries, creating a budgetary shortfall. As one of northeast Ohio's top providers of hospital care for Medicaid patients, Summa Health System's unpaid costs for Medicaid totaled more than $23.2 million. Bad Debt Summa Health System is committed to providing quality and accessible healthcare. This includes covering the expenses of payments that were expected but not received. While Summa Health System recognizes bad debt is part of the cost of doing business, it agrees with the Ohio Hospital Association that it is important to report these costs to show the total picture of care Summa Health System provides to the community without full reimbursement. In 2013, the cost for providing care written off as bad debt was approximately $22.3 million. Community Health Improvement Services An important part of Summa Health System's mission is offering a prevention and wellness program to build a healthier community. In 2013, Summa Health System provided more than $1.2 million to help fund health improvement activities such as free and low-cost health screenings, health education services and wellness programming. Subsidized Health Services Summa Health System is committed to providing subsidized health services - clinical services that meet an identified community need and are provided despite financial loss. Vital services such as The Center for Senior Health, Care Center for patients with HIV or AIDS, and diabetes education are offered, even though they are not profitable. Income from other services is used to cover these costs. In 2013, the cost for subsidized services was approximately $26.4 million.
Part III program services (continued) Financial and In-kind Donations Annually, Summa Health System contributes financial assistance and in-kind services to support community organizations that promote health, wellness, and an improved quality of life. From the local chapters of national groups such as United Way, the American Heart Association and the American Cancer Society, to Akron Community Health Resources (Akron's only federally-funded health center) Summa Health System participates in numerous community programs and helps other nonprofits fulfill their missions. In 2013, these contributions exceeded $2.3 million. Research Summa Health System's quality medical care is derived in part from its ability to translate results from carefully planned and executed research into effective patient care strategies. Research and innovation is an integral focus of the academic and clinical environment at Summa Health System and helps set the highest standards for medical care in the community. Summa Health System's reputation for excellence in such critical specialties as cardiology, diabetes, emergency services, orthopaedics, oncology, senior health, surgery, and women's health continues to grow through research and innovation. Summa Health System invested more than $5.1 million in research in 2013. In addition to support from Summa Foundation, major research programs are supported by grants from the National Institutes of Health, the Department of Defense and industry sponsors. Education Summa Health System supports the education of physicians and other healthcare professionals. Summa Akron City and St. Thomas Hospitals is the largest of the major teaching affiliates of the Northeast Ohio Medical University (NEOMED), a consortium of The University of Akron, Kent State University and Youngstown State University, and offers education to NEOMED's colleges of medicine and pharmacy students, as well as to medical students from schools around the country. In addition, Summa offers 17 accredited residency training programs in numerous specialties, training the next generation of primary care and specialty physicians for the region and beyond. Nursing education also is offered in collaboration with our local university partners. In 2013, 245 residents and fellows trained at Summa's three main hospitals. On average, approximately 40% of these residents remain in our local and surrounding communities. Summa's 2013 investment in health professions education totaled $19.1 million. Summa Health System is one of five founding medical and educational institutions responsible for the creation of the Austen BioInnovation Institute in Akron (ABIA), a unique collaboration that expands upon the region's rich legacy in industrial and materials science to pioneer the next generation of life enhancing and life saving innovations. Summa Health System Services: Following is a description of Summa Health System's notable accomplishments by primary service lines in 2013: Behavioral Health - The Center for the Treatment and Study of Traumatic Stress developed and implemented on of Ohio's only intensive outpatient programs designed specifically to deal with the symptoms of post traumatic stress disorder. Cardiovascular - An upgraded Heart Rhythm Services (HRS) Lab opened in January on the campus of Summa Akron City Hospital. Summa's Cardiovascular Institute applied for, and was accepted to, the Centers for Medicare and Medicaid Innovation's Bundled Payments for Care Initiative Program. Emergency/Trauma Services - EMS developed and implemented EMS direct activation of the cardiac catheterization lab for chest pain patients, resulting in an overall decrease time of ten minutes. This resulted in recognition by the American Heart Association's Platinum Achievement Award. Neuroscience - In addition to The Joint Commission's stroke recertification, the "Target Stroke Award" and "Get with the Guidelines Gold Plus Award" were received from AHA. Oncology - Summa Health System approved the VERO Linear Accelerator to expand the radiosurgery program, making Summa Akron City Hospital the first community hospital in the country to have this specialized technology. Respiratory - Expanded its smoking cessation program across the system, and implemented a screening chest scan (CT) program for lung cancer. Seniors, Post Acute and Transitional Care - In addition to the Pallative Care recognition by The Joint Commission, Summa's hospitals achieved NICHE (Nurses Improving Care for Health System Elders) designation for the upcoming year. Women's Services - Met or exceeded the Ohio hospital averages in six perinatal measures, leading to the OHA's Patient Safety Institute's Best Practice Award noted above. Also successfully implemented a large informatics upgrade to the obstetrical electronic documentation and fetal surveillance system to improve safety and reporting reliability. Summary Although reimbursement for services rendered is critical to the operations and stability of Summa Health System, not all individuals possess the ability to purchase essential medical services. Summa Health System provided services to all patients on a non-discriminatory basis and without regard to any patient's ability to pay for such services or the individual's participation in a government-sponsored or subsidized healthcare program. Patients were encouraged to apply for uncompensated care and, depending on their level of income and number of dependents, all (or a portion) of their bill was reduced. Gross annual family income was compared using a sliding scale based on the federal poverty income guidelines to determine the charity discount for which the patient may be eligible. In 2013, Summa Health System provided charity care to the indigent (including unreimbursed Medicaid) at the net cost of more than $38.8 million. This amount does not include services provided and written off as bad debt. In addition to uncompensated medical care, Summa Health System provided wellness programs, community education programs and special programs for the elderly, handicapped, and medically underserved. Summa Health System also operated a variety of broad community support activities. Many of these programs were offered at a reduced price or provided to the community free of charge. Summa Health System operates its facilities in a manner consistent with the community benefit requirements of Rev. Rule 69-545 and subsequent case law and IRS guidelines. Summa Health System's hospitals provide emergency services which are open and available to all persons of the community, regardless of their ability to pay. The board of directors consisted of persons who are broadly representative of the community and medical staff.
Part III program services (cont.) Summa Physicians Inc. - Program Service Accomplishments Summa Physicians Inc. (SPI) is a Summa Health System entity comprised of multi-specialty physicians and practices. In 2013, SPI added 35 physicians in various specialties including cardiology and oncology. In total, SPI employs nearly 300 physicians and 730 support staff in more than 30 specialties and sub-specialties. SPI promotes strong affiliation and employment of physicians to ensure community and hospital needs for physician services are met. In 2013, SPI developed primary care pods to better communicate quality initiatives and enhance physician recruitment. Summa Foundation - Program Service Accomplishments Through philanthropy, Summa Foundation supports medical education, research, technology, and clinical innovation. Encompassing fundraising, resource development, community benefit, diversity and government relations, Summa Foundation works to develop new, diversified and increased resources and build relationships that influence health policy to advance the regional priorities of Summa Health System. Development The Foundation's development department offers a spectrum of philanthropic options for donors designed to create a positive impact on Summa Health System's operations, programs, projects and perceptions and to affect positive change in the communities Summa Health System serves. Development houses the grant and proposal development offices created to identify the resources and expertise of external and internal partners to generate funding for research, education and clinical and system projects. Philanthropic commitments to the Summa Foundation in 2013 were nearly $10 million, including a $4 million gift designated for Summa's Cardiovascular Institute to support the creation of a hybrid operating room. Community Benefit and Diversity This department leads efforts to address health disparities and other important community needs and raise awareness of health and healthcare issues affecting the communities served by Summa Health System. Community benefit and diversity provide wellness and educational tools, facilitate economic development programs, develop community partnerships, communicate Summa Health System's benefit to the community and engage the community and its workforce within the system and throughout the region. Government Relations This department is dedicated to elevating Summa Health System as a credible leader and partner in the health policy planning process. This department collaborates with the system development team to best position Summa education, research and clinical innovation priorities with public sector funding opportunities.
Form 990, Page 5, Part V, Lines 1a & 2a In 2013, Summa Health System, the parent organization, acted as the corporate services operating entity for the system. Operational changes implemented for the system included the centralized payroll management and accounts payable disbursements now transacted by the parent. For more information, see the IRS Form 990 for Summa Health System (parent), EIN 34-1887844.
Form 990, Page 6, Part VI, Line 1a Summa Akron City and St. Thomas Hospitals: N/A Summa Barberton Citizens Hospital: N/A Summa Wadsworth-Rittman Hospital: Prior to adopting an Amended and Restated Code of Regulations in October 2013, Summa Wadsworth-Rittman Hospital had an Executive Committee comprised of the Board Chair, President, Vice Chair, Treasurer, Secretary, and others as elected by the Board of Directors. All members of the Executive Committee are members of the Board of Directors. The Executive Committee was authorized to exercise the powers of the Board at such time as the Board is not in session, subject to restrictions imposed by previous decisions of the Board and to the provisions of the Summa Wadsworth-Rittman Hospital Code of Regulations. All interim actions by the Executive Committee were reported at the Board's next meeting succeeding such action. The Executive Committee prepared and made such recommendations to the Board as are pertinent to the welfare of the Summa Wadsworth-Rittman Hospital. The Amended and Restated Code of Regulations for Summa Wadsworth-Rittman Hospital, adopted in October 2013, did not include a provision for an Executive Committee. Summa Foundation: Summa Foundation has an Executive Committee comprised of the Chair, Vice Chair, Secretary, Treasurer, and one additional Director of the Summa Foundation. All members of the Executive Committee are Directors of Summa Foundation. The Executive Committee is authorized to exercise the powers of the Board at such time as the Board is not in session, subject to restrictions imposed by previous decisions of the Board and to the provisions of the Summa Foundation Code of Regulations. All interim actions by the Executive Committee are reported at the Board's next meeting succeeding such action. The Executive Committee prepares and makes such recommendations to the Board as are pertinent to the welfare of the Summa Foundation. Summa Physicians, Inc.: The Code of Regulations provides for an Executive Committee to be comprised of three (3) directors. The Executive Committee may make governance decisions between Board meetings. Cuyahoga Falls General Hospital (merged December 31, 2013): Prior to its merger into Summa Akron City and St. Thomas Hospitals, Cuyahoga Falls General Hospital had an Executive Committee comprised of the Board Chair and two (2) other directors named by the Chair. All members of the Executive Committee are Directors of Cuyahoga Falls General Hospital. The Executive Committee had the power to transact all regular business of Cuyahoga Falls General Hospital between meetings of the Board of Directors, subject only to prior limitations established by the Board of Directors and the Member's Reserved Powers.
Form 990, Page 6, Part VI, Line 2 Summa Akron City and St. Thomas Hospitals: Nicholas Browning, Anthony Lockhart, Thomas Strauss, R. Douglas Trochelman, M.D., Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Nicholas Browning, Anthony Lockhart, Thomas Strauss, and R. Douglas Trochelman, M.D., are Directors of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Dennis Chack, Anthony Lockhart, and Thomas Clark have a business relationship through First Energy: Dennis Chack is employed as an officer of First Energy and Anthony Lockhart and Thomas Clark are retired officers of First Energy. Thomas Knoll, Thomas Strauss, and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: all are on the Board of Managers of Summa Western Reserve Hospital. Robert Harrigan, Thomas O'Neill, and Erik Steele, D.O. have a business relationship through Crystal Clinic Orthopaedic Center, LLC: Robert Harrigan, Thomas O'Neill and Erik Steele, D.O. all were on the Board of Managers of Crystal Clinic Orthopaedic Center, LLC during the year. Robert Harrigan and Thomas Strauss have a business relationship through Summa Accountable Care Organization: both are Directors of Summa Accountable Care Organization. Michael Bage, M.D. and Hitesh Makkar, M.D have a business relationship through Continuity Medical, LLC. Thomas Knoll, Brian Derrick, William A. Powel, III, and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation. Summa Barberton Citizens Hospital: Thomas Strauss, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss is a Director of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Thomas Knoll, Thomas Strauss, and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: all are on the Board of Managers of Summa Western Reserve Hospital. Thomas Knoll, Brian Derrick, William A. Powel, III, and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation. Summa Wadsworth-Rittman Hospital: Thomas Strauss, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss is a Director of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Eric Graf and Thomas Knoll have a business relationship through Ritzman Pharmacies: Eric Graf is the CEO of Ritzman Pharmacies and Thomas Knoll is a Director of Ritzman Pharmacies. Thomas Knoll, Thomas Strauss, and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: all are on the Board of Managers of Summa Western Reserve Hospital. Thomas Knoll, Brian Derrick, William A. Powel, III, and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation. Summa Foundation: Thomas Strauss, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss is a Director of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Samir Gibara and Scott Honnold have a business relationship through Goodyear Tire and Rubber Company: Samir Gibara is a retired officer of Goodyear and Scott Honnold is a current officer of Goodyear. George Daverio, Jr. and C. Gordon Ewers have a business relationship through Merrill Lynch: George Daverio, Jr. is retired from Merrill Lynch and C. Gordon Ewers is an officer at Merrill Lynch. Jason Butterworth and Mark Krohn have a business relationship through Brennan, Manna & Diamond: both are partners at this law firm. Summa Physicians, Inc.: Dale Murphy, M.D. and William A. Powel, III have a business relationship through Middlebury Assurance Corporation: both are Directors of Middlebury Assurance Corporation. Cuyahoga Falls General Hospital: Thomas Strauss, Norman Wells, Brian Derrick and William A. Powel, III have business relationships through Summa Health System Community: Thomas Strauss and Norman Wells are Directors of Summa Health System Community; Brian Derrick and William A. Powel, III are Officers of Summa Health System Community. Stephen Hailer, Thomas Strauss, Joseph Nienaltowksi, D.O., and William A. Powel, III have a business relationship through Summa Western Reserve Hospital: Stephen Hailer, Thomas Strauss, and William A. Powel, III are on the Board of Managers of Summa Western Reserve Hospital and Joseph Nienaltowski, D.O. is Director, Patient Experience at Summa Western Reserve Hospital, LLC. Douglas Chonko, D.O. and Ronald Russ, D.O. have a business relationship through Kent Management Group: each is employed by Kent Management Group. William A. Powel, III, Brian Derrick and Thomas Strauss have a business relationship through Middlebury Assurance Corporation: all are Directors of Middlebury Assurance Corporation.
Form 990, Page 6, Part VI, Line 4 Summa Akron City and St. Thomas Hospitals: The following material changes were made to the Code of Regulations during the 2013 tax year: (i)Reduced the number of Directors from 23 to 16; specified that one of the Directors must be on the Medical Staff of the Corporation (ii) Specified that the Chief Medical Officer of Summa Health System is a Special Voting Director (iii) Redefined quorum to be number of current Directors multiplied by 50% (rounded up to whole number). Previously, quorum defined as 40%. (iv) Defined the reserved powers to be the same reserved powers that Summa Health System has over all of its subsidiaries (v) Changed title of Corporation's President from "President & COO" to "President" (vi) Deleted the requirement that the Code of Regulations be reviewed biennially Summa Barberton Citizens Hospital: The following material changes were made to the Code of Regulations during the 2013 tax year: (i) Changed the sole member of the Corporation from Summa Barberton Wadsworth Rittman Hospitals, LLC to Summa Health System. (ii) Increased the number of Directors from 14 to 16; specified that one of the Directors must be on the Medical Staff of the Corporation (iii) Specified that the Chief Medical Officer of Summa Health System is a Special Voting Director (iv) Redefined quorum to be number of current Directors multiplied by 50% (rounded up to whole number). Previously, quorum defined as a majority of the current Directors. (v) Defined the reserved powers to be the same reserved powers that Summa Health System has over all of its subsidiaries Summa Wadsworth-Rittman Hospital: The following material changes were made to the Code of Regulations during the 2013 tax year: (i) Changed the sole member of the Corporation from Summa Barberton Wadsworth Rittman Hospitals, LLC to Summa Health System. (ii) Increased the number of Directors from 14 to 16; specified that one of the Directors must be on the Medical Staff of the Corporation (iii) Specified that the Chief Medical Officer of Summa Health System is a Special Voting Director (iv) Redefined quorum to be number of current Directors multiplied by 50% (rounded up to whole number). Previously, quorum defined as a majority of the current Directors. (v) Defined the reserved powers to be the same reserved powers that Summa Health System has over all of its subsidiaries (vi) Deleted a provision delineating specific charitable organizations for the distribution of assets upon a dissolution of the Corporation Summa Foundation: N/A Summa Physicians, Inc.: N/A Cuyahoga Falls General Hospital (merged December 31, 2013): Cuyahoga Falls General Hospital merged with Summa Akron City and St. Thomas Hospitals effective as of December 31, 2013. Summa Akron City and St. Thomas Hospitals was the surviving entity. Prior to the merger, the following changes were made to the Code of Regulations during the 2013 tax year: (i) Re-defined the Reserved Powers to be the same Reserved Powers that Summa Health System has over each subsidiary corporation (ii) Reduced the number of Directors on the Board of Directors from 15 to 6 (iii) Specified that at least 3 of the 6 Directors are to be Community Directors (iv) Specified that President & CEO of Summa Health System is a Director (v) Deleted all defined committees except for the Executive Committee; specified that the Executive Committee is comprised of the Board Chair and 2 other Directors named by the Chair (vi) Changed the title of the President & COO to President; specified that the President & CEO of Summa Health System shall be the President of the Corporation
Form 990, Page 6, Part VI, Line 6 Summa Akron City and St. Thomas Hospitals: Summa Health System is the sole member of Summa Akron City and St. Thomas Hospitals. Summa Barberton Citizens Hospital: Prior to adopting an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Barberton Citizens Hospital was Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. Following the adoption of an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Barberton Citizens Hospital is Summa Health System. Summa Wadsworth-Rittman Hospital: Prior to adopting an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Wadsworth-Rittman Hospital was Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. Following the adoption of an Amended and Restated Code of Regulations in October 2013, the sole member of Summa Wadsworth-Rittman Hospital is Summa Health System. Summa Foundation: Summa Health System is the sole member of Summa Foundation. Summa Physicians, Inc.: Summa Physicians, Inc. has stockholders; the stock is held in trust for the benefit of Summa Health System. Cuyahoga Falls General Hospital (merged December 31, 2013): Summa Health System was the sole member of Cuyahoga Falls General Hospital.
Form 990, Page 6, Part VI, Line 7a Summa Akron City and St. Thomas Hospitals: Prior to the adoption of Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation were elected as set forth below: (i) The medical staff of Summa Akron City and St. Thomas Hospitals elects two (2) directors: the President of the Medical Staff and the President-Elect of the Medical Staff. (ii) The Chairs of the medical staff departments elect two (2) department chairs to be directors (iii) The following individuals are directors by designation: (a) President & CEO of Summa Health System; (b) President & COO of Summa Akron City and St. Thomas Hospitals; (c) Chair of Summa Akron City and St. Thomas Hospitals Foundation; and (d) The Presidents of The Women's Board of St. Thomas Hospital and the Women's Board of Summa Health System shall rotate annually to provide a single representative. (iv) Other than as set forth above, Summa Health System is the sole member of Summa Akron City and St. Thomas Hospitals and has the right to elect the Board of Directors of Summa Akron City and St. Thomas Hospitals. Following the adoption of the Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation are to be elected as set forth below: (i) Nine (9) non-physician Directors are to be elected by Summa Health System as the sole member of the Corporation. (ii) Six (6) physician Directors are to be elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals (iii) The Chief Medical Officer of Summa Health System is to be a Special Voting Director Summa Barberton Citizens Hospital: Prior to the adoption of Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation were elected as set forth below: The sole member of Summa Barberton Citizens Hospital is Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. The sole member elects the Board of Directors of Summa Barberton Citizens Hospital subject to the approval of Summa Health System. Following the adoption of the Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation are to be elected as set forth below: (i) Nine (9) non-physician Directors are to be elected by Summa Health System as the sole member of the Corporation. (ii) Six (6) physician Directors are to be elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals (iii) The Chief Medical Officer of Summa Health System is to be a Special Voting Director Summa Wadsworth-Rittman Hospital: Prior to the adoption of Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation were elected as set forth below: The sole member of Summa Wadsworth-Rittman Hospital is Summa Barberton Wadsworth-Rittman Hospitals, LLC, an Ohio non-profit limited liability company whose sole member is Summa Health System. The sole member elects the Board of Directors of Summa Wadsworth-Rittman Hospital subject to the approval of Summa Health System. Following the adoption of the Amended and Restated Code of Regulations in October 2013, the Directors of the Corporation are to be elected as set forth below: (i) Nine (9) non-physician Directors are to be elected by Summa Health System as the sole member of the Corporation. (ii) Six (6) physician Directors are to be elected from a slate of nominees nominated through a process to be developed by the Medical Staffs of the Summa Hospitals (iii) The Chief Medical Officer of Summa Health System is to be a Special Voting Director Summa Foundation: In addition to directors elected by the Summa Health System Board as the sole member of Summa Foundation, the President and CEO of Summa Health System serves as a director of Summa Foundation. Summa Physicians, Inc.: Summa Physicians, Inc. is affiliated with Summa Akron City and St. Thomas Hospitals and only persons approved by Summa Akron City and St. Thomas Hospitals or employed by Summa Akron City and St. Thomas Hospitals or an affiliated entity may serve as a director of Summa Physicians, Inc. Cuyahoga Falls General Hospital (merged December 31, 2013): Summa Health System was the sole member of Cuyahoga Falls General Hospital and had the right to elect the Board of Directors of Cuyahoga Falls General Hospital.
Form 990, Page 6, Part VI, Line 7b Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizens Hospital, Summa Wadsworth-Rittman Hospital: Summa Health System is the sole member of each of Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizens Hospital, and Summa Wadsworth-Rittman Hospital. As the sole member, Summa Health System has the power and authority to approve or disapprove of each of the following on behalf of each of Summa Akron City and St. Thomas Hospitals, Summa Barberton Citizens Hospital, and Summa Wadsworth-Rittman Hospital: (i) Any modification of the essential nature, purpose, mission or operations of the Corporation; (ii) Adoption of a Code of Regulations, Bylaws or other constitutive document of the Corporation and any and all amendments thereto; (iii) Adoption of any amendments to the Articles of Incorporation or similar charter or organizational document or agreement and/or any other change in the corporate structure or governance of the Corporation; (iv) Establishment of qualifications for the selection of Directors, Directors or Managers of the Corporation; (v) Appointment or election and removal of members of the governing body of the Corporation; (vi) Appointment or election and removal of the President and/or Chief Executive Officer or similar officer(s) of the Corporation; (vii) Adoption of annual operating and capital budgets of the Corporation; (viii) The borrowing of money or other incurring or creating of any indebtedness of the Corporation, including by way of a guaranty of the debt of another, in an amount greater than $1,000,000 or that will increase the amount of indebtedness incurred in the current calendar year, in the aggregate, to more than $3,500,000; (ix) Adoption of the long range plans of the Corporation; (x) Determinations as to the use and occupancy of any building owned or leased by the Corporation; (xi) The sale, encumbrance, lease or disposition of real property of the Corporation other than in the ordinary course of the operations of the Corporation; and (xii) The merger, reorganization, dissolution or other corporate action of a similar nature, including participation in a joint venture, proposed by the Corporation. Summa Foundation: Summa Health System is the sole member ("Member") of Summa Foundation. The following are the matters ("Reserved Powers") which must be submitted to, and receive the approval of both the Board of Directors of Summa Foundation and the Member: (i) Adoption of the Foundation's annual operating and capital budgets; (ii) Expenditures for (a) non budgeted items in excess of certain dollar limits set from time to time by the Member and (b) items which are included in the Foundation's annual budgets but which exceed the budgeted amount by an amount in excess of certain dollar limits set from time to time by the Member; (iii) Incurrence, assumption or guarantee of any indebtedness if following the incurrence, assumption, or guarantee of such indebtedness the aggregate amount of all outstanding indebtedness incurred, assumed or guaranteed by the Foundation which has not been previously approved by the Member exceeds certain dollar limits set from time to time by the Member; (iv) Submission of any certificate of need application with any State or Federal Regulatory Agency; (v) Execution of any contract that calls for the Foundation to expand a sum in excess of certain dollar limits set from time to time by the Member or to provide services with a value in excess of certain dollar limits set from time to time by the Member; (vi) Election of such officers as are required to be elected under this Code of Regulations; (vii) Appointment of the Foundation's auditors and/or accountants; (viii) Adoption of the Foundation's long range plans and management objective, including the execution of any agreement with consortiums, alliances, etc; (ix) Sale, lease or other disposition of any real or personal property of the Foundation with a value in excess of certain dollar limits to be set from time to time by the Member; (x) Sale, release, dissolution, transfer, exchange, or other disposition of any organization (or of all or substantially all of the assets of such organization) controlled by the Foundation if after such sale, release, dissolution, transfer, exchange or other disposition, such organization (or all or substantially all of the assets of such organization) would no longer be controlled by the Foundation; (xi) Adoption or amendment of the Foundation's Code of Regulations or Articles of Incorporation; (xii) Any other matter which may be specified by the Member or by the Board or required by law. Summa Physicians, Inc. - N/A Cuyahoga Falls General Hospital (merged December 31, 2013): Summa Health System was the sole member of Cuyahoga Falls General Hospital. As the sole member, Summa Health System had the power and authority to approve or disapprove of each of the following on behalf of Cuyahoga Falls General Hospital: (i) Any modification of the essential nature, purpose, mission or operations of Cuyahoga Falls General Hospital; (ii) Approval of the Codes of Regulations, Bylaws or other constitutive document of Cuyahoga Falls General Hospital and any corporation or entity controlled by, related to or affiliated with Cuyahoga Falls General Hospital (an "Affiliated Corporation") and any and all amendments thereto; (iii) The adoption of any amendments to the Articles of Incorporation or similar charter or organizational document or agreement and/or any other change in the corporate structure or governance of Cuyahoga Falls General Hospital or any Affiliated Corporation; (iv) The establishment of qualifications for the selection of Directors, Directors or Managers of Cuyahoga Falls General Hospital; (v) The appointment or election and removal of members of the governing body of Cuyahoga Falls General Hospital; (vi) The appointment or election and removal of the President and/or Chief Executive Officer or similar officer of Cuyahoga Falls General Hospital; (vii) The adoption of annual operating and capital budgets of Cuyahoga Falls General Hospital; (viii) The adoption of the long range plans of Cuyahoga Falls General Hospital; (ix) Determinations as to the use and occupancy of any building owned or leased by Cuyahoga Falls General Hospital; (x) The sale, encumbrance, lease or disposition of real property of Cuyahoga Falls General Hospital other than in the ordinary course of the operations of Cuyahoga Falls General Hospital; and (xi) The merger, reorganization, dissolution or other corporate action of a similar nature undertaken by Cuyahoga Falls General Hospital.
Form 990, Page 6, Part VI, Line 11b The return was reviewed in detail by a committee consisting of internal and external legal counsel, financial management, and an external auditor. The review committee included the Senior Vice President, Finance & CFO and the Senior Vice President, Legal Services & General Counsel. This detailed review occurred in September 2013. Following this review and incorporation of changes recommended by this committee, the return was provided to the Summa Health System Committee on Governance prior to its September 2013 meeting for further review. The Committee on Governance is a standing committee appointed by the Summa Health System Board of Directors and includes members of the Board of Directors. Schedule H of the return was also reviewed by the Summa Health System Community Benefits Committee. After these reviews by the Committee on Governance and the Community Benefits Committee, and prior to filing with the IRS, an email was sent to each voting member of the Boards of Directors. This email included instructions and a link to a password-protected web site on which the entire Form 990 was available for viewing.
Form 990, Page 6, Part VI, Line 12c Conflict of Interest Process Summary: A Conflict of Interest Questionnaire is sent annually to all Summa Health System entities' Boards of Directors, Key Employees, Senior Managers, Medical Directors, Employed Physicians, Contracted Physicians, Administrative Directors, Executive Directors, Department Heads, Managers, Supervisors, and Members of Purchasing Committees for completion. Responses are individually reviewed for determination of potential conflicts. Those responses deemed to present potential conflicts are then presented to the Governance Committee (Sub-Committee of the Summa Health System Board of Directors). The Governance Committee reviews each response that presents a potential conflict and determines whether additional action is required to eliminate or mitigate the potential conflict. This annual conflict of interest questionnaire process is managed by the Corporate Compliance Department pursuant to the Summa Health System Policy on Conflict of Interest as approved by the Summa Health System Board of Directors. In addition to the annual Conflict of Interest Questionnaire, the Conflict of Interest Policy imposes a duty to disclose conflicting interests on an ongoing basis. Disclosure Procedure: Any person with a conflicting interest in any transaction or arrangement is required to disclose the conflicting interest to the Board or committee considering such transaction or arrangement prior to or at the beginning of any meeting at which such transaction or arrangement is under consideration. The person with a conflicting interest is prohibited from using his/her personal influence on the matter but may briefly state his/her position on the transaction or arrangement and answer questions raised by members of the Board or committee. The person with a conflicting interest is prohibited from otherwise participating in the decision and may be required to leave the meeting during the discussion and vote on the transaction or arrangement. In addition, if appropriate, a non-interested person or committee may be appointed to investigate alternatives to the proposed transaction or arrangement. The minutes of Board meetings and committee meetings reflect whether any conflicting interests were disclosed, the nature of the conflicting interests, and the names of persons who were present for discussion and votes relating to the transaction or arrangement.
Form 990, Page 6, Part VI, Line 15a & 15b Executive Compensation: The Compensation Committee of the Summa Health System Board of Directors meets at least twice each year to review and approve base compensation and total remuneration for executive staff. Each voting member of the Compensation Committee is an independent director and is not affiliated with management with the exception of one board member who is an independent contractor who recuses himself on voting regarding the CEO evaluation and compensation package. The Compensation Committee engages outside consulting support to provide independent market data, advice and counsel to the Compensation Committee. For the past four years, the Compensation Committee has used Hay Group, a nationally recognized consulting firm, to assist their efforts. The Hay Group provides the following services to the Compensation Committee: (a) education of Committee members regarding executive compensation trends and best practices in healthcare organizations; (b) assessment of the market competitiveness and reasonableness of Summa's executive compensation programs including base salary, incentive compensation, core and executive benefits, as well as their alignment with the mission and future performance expectations; (c) written, detailed evaluation of the market reasonableness of Summa's executive compensation and benefits program; and (d) ongoing support and independent advice to the Compensation Committee on matters related to executive compensation. Each year the Compensation Committee reviews and approves the compensation for the following positions: Summa Health System: President & CEO Senior Vice President, Finance & CFO Senior Vice President, Legal Services & General Counsel Senior Vice President, IT&S & CIO Senior Vice President, Service Lines, Ambulatory & Ancillary Senior Vice President, Planning & Marketing Senior Vice President & Chief Nursing Officer Senior Vice President, Human Resources Senior Vice President, Chief Medical Officer President, SummaCare Summa Akron City and St. Thomas Hospitals: President & COO Summa Foundation: President Summa Barberton Citizens Hospital & Summa Wadsworth-Rittman Hospital: President & COO Summa Physicians, Inc.: President Cuyahoga Falls General Hospital: Note: Cuyahoga Falls General Hospital did not employ a President & COO during 2013
Form 990, Page 6, Part VI, Line 19 Summa Health System makes its Conflicts of Interest policy available upon request. The Articles of Incorporation of Summa Health System and its related entities are available on the website of the Ohio Secretary of State (www.sos.state.oh.us). Summa Health System makes its financial statements available on its website (www.summahealth.org). The financial statements are also available through the Electronic Municipal Market Access (www.emma.msrb.org).
Form 990, Page 12, Part XI, Line 9 Other Changes in Net Assets or Fund Balances: FASB 106 Post Retirement (44,069) Net Assets released from restriction 128,446 Minimum Pension Liability 26,813,193 Transfers between affiliates 28,050,757 Change in Trust Value 750,749 Other changes in Net Assets (361,400) ----------- Total Changes in Net Assets 55,337,676
FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED MEDICAL SERVICES TOTAL FEES:39878355
FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES-AFFILIATE TOTAL FEES:52404016
FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN PRACTICE SUPPORT TOTAL FEES:24730957
FORM 990 PART IX LINE 11G DESCRIPTION:NON-MEDICAL PURCHASED SERVICES TOTAL FEES:70707310
FORM 990 PART IX LINE 11G DESCRIPTION:REPAIR & MAINTENANCE TOTAL FEES:13113267
FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION SERVICES TOTAL FEES:6947477
FORM 990 PART IX LINE 11G DESCRIPTION:HOSPICE SERVICES TOTAL FEES:3914611
FORM 990 PART IX LINE 11G DESCRIPTION:PERFUSION/BLOOD PROCESSING TOTAL FEES:3726787
FORM 990 PART IX LINE 11G DESCRIPTION:AMBULANCE SERVICE TOTAL FEES:325945
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Summa Health System Group Return
 
Employer identification number

90-0640432
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) Summa Enterprise Group LLC
525 East Market Street
Akron,OH44304
03-0507853 		Consulting OH 2,737,204 19,411,709 SACSTH
 
(2) Summa Enterprise Group Properties LLC
525 East Market Street
Akron,OH44304
55-0837372 		Real Estate OH 0 0 SEG
 
(3) Akron Endoscopy ASC LLC
525 East Market Street
Akron,OH44309
62-1865245 		prof.med.svcs OH 0 0 sacsth
 






Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) St Thomas Medical Center Women's Board

444 North Main Street

Akron,OH44310
34-6576575 		Support OH 3 11-I SACSTH
 
 
No
(2) Summa Health System Community

525 East Market Street

Akron,OH44304
46-3018310 		Support Org OH Applied for 11 NA
 
Yes
 










For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Ohio Sleep Disorders Center

130 West Exchange Street
Akron,OH44302
34-1872278 		Office Physic OH SACSTH & SBH
  		related 0 0   No 0     66.670 %
(2) Summa Rehab Hospital LLC

4550 Lena Drive
Mechanicsburg,PA17055
27-1952573 		Rehab Hospita OH SACSTH
  		related 12,567,497 4,814,205   No 0     52.000 %










Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Ohio Health Choice Inc

525 East Market Street
Akron,OH443041619
34-1895396 		PPO OH NA
  		C Corp 2,575,718 2,752,112 80.000 % Yes  
(2) Summa Insurance Company Inc

10 North Main Street
Akron,OH44308
34-1809108 		Prop/Cas. Ins OH NA
  		C Corp 219,615,623 92,429,484 100.000 % Yes  
(3) Summa Health System Corp

525 East Market Street
Akron,OH443041619
34-1515252 		Mgmt Services OH NA
  		C Corp 761,754 6,733,783 100.000 % Yes  
(4) Wadsworth-Rittman Prof Services Corp

195 Wadsworth Road
Wadsworth,OH442819504
01-0842997 		Prof. Med. Sv OH NA
  		C Corp 0 10,237 100.000 % Yes  
(5) Middlebury Assurance Company

PO Box 1051 KY1-1102
Grand Cayman,Cayman Islands  
CJ
98-0405096 		Self Insurance CJ NA
  		Foreign Corp 13,635,724 65,267,485 100.000 % Yes  
(6) SummaCare Inc

525 East Market Street
Akron,OH44309
34-1726655 		Insurance OH NA
  		C Corp 277,579,780 104,838,092 100.000 % Yes  
(7) Health Care Center Physicians Inc

525 East Market Street
Akron,OH443041619
34-1692767 		Inactive OH NA
  		C Corp 0 0 100.000 % Yes  
(8) Summa Accountable Care Organization

525 East Market Street
Akron,OH44304
27-3857055 		Contracting OH NA
  		C Corp 3,595,001 2,569,026 100.000 % Yes  
(9) Aris Teleradiology Holdings Inc

5655 Hudson Drive
Hudson,OH44236
45-3697866 		Radiology Svc DE SACSTH
  		C Corp 12,789,339 5,337,617 57.900 %   No
(10) Summa Management Services Organization

10 North Main Street
Akron,OH44308
46-1145832 		Mgmt Services OH SHS Corp
  		C Corp 35,161,961 9,308,891 100.000 % Yes  
(11) Summa Integrated Services Organization

10 North Main Street
Akron,OH44308
46-1159251 		Mgmt Services OH SHS Corp
  		C Corp 20,142,570 22,047,851 100.000 % Yes  
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
 
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Summa Rehab Hospital LLC

 a 2,586,679 FMV
(2) Summa Akron City and St Thomas Hospital

 b 212,252 FMV
(3) Summa Foundation

 b 845,165 FMV
(4) Summa Foundation

 b 100,000 FMV
(5) Summa Foundation

 c 212,252 FMV
(6) Summa Akron City and St Thomas Hospital

 c 845,165 FMV
(7) Summa Barberton Citizens Hospital

 c 100,000 FMV
(8) Summa Physicians Inc

 j 3,016,116 FMV
(9) Summa Physicians Inc

 j 223,595 FMV
(10) Summa Physicians Inc

 j 114,881 FMV
(11) Summa Akron City and St Thomas Hospital

 k 3,016,116 FMV
(12) Summa Barberton Citizens Hospital

 k 223,595 FMV
(13) The Wadsworth-Rittman Area Hospital Assn

 k 114,881 FMV
(14) Summa Akron City and St Thomas Hospital

 l 43,810,683 cost
(15) Summa Barberton Citizens Hospital

 l 7,200,473 cost
(16) The Wadsworth-Rittman Area Hospital Assn

 l 1,662,672 cost
(17) Summa Insurance Company Inc

 l 73,527,908 FMV
(18) Summa Insurance Company Inc

 l 11,086,919 FMV
(19) Summa Insurance Company Inc

 l 12,783,393 FMV
(20) Summa Insurance Company Inc

 l 3,750,964 FMV
(21) Summa Rehab Hospital LLC

 l 551,496 FMV
(22) Summa Health System

 m 1,032,648 FMV
(23) Summa Health System

 m 103,992 FMV
(24) Summa Health System

 m 80,208 FMV
(25) Summa Health System

 m 1,305,530 FMV
(26) Summa Physicians Inc

 m 43,810,683 cost
(27) Summa Physicians Inc

 m 7,200,473 cost
(28) Summa Physicians Inc

 m 1,662,672 cost
(29) Middlebury Assurance Company

 m 7,792,642 FMV
(30) Middlebury Assurance Company

 m 1,985,258 FMV
(31) Middlebury Assurance Company

 m 1,127,246 FMV
(32) Middlebury Assurance Company

 m 290,184 FMV
(33) Summa Integrated Services Organization

 m 1,495,245 FMV
(34) SummaCare Inc

 m 1,846,658 FMV
(35) Summa Health System

 p 26,579,941 cost
(36) Summa Health System

 p 5,782,043 cost
(37) Summa Health System

 p 2,142,996 cost
(38) Summa Health System

 p 1,417,884 cost
(39) Summa Health System

 s 5,199,999 cost
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No
(1) Crystal Clinic Orthopaedic Center LLC

3925 Embassy Parkway 250Akron,OH44333
26-1130649 		Ortho Hospital OH related
 
No
 61,039,993 26,652,012
 
No
 0
 
No
 49.650 %
(2) Summa Western Reserve Hospital LLC

1900 23rd StreetCuyahoga Falls,OH44223
26-3536780 		Hospital OH related
 
No
 45,982,000 10,467,352
 
No
 0
 
No
 40.000 %




























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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