TY 2018 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) WILLIAM CONSIDINE...................................................................... CEO EMERITUS (11/1/2018)	47.0 ................. 10.0	X	X	2,578,902	-61,713
(2) GRACE WAKULCHIK...................................................................... PRESIDENT & CEO (11/1/2018)	50.0 ................. 5.0	X	X	1,119,715	204,736
(3) JOHN CROW MD...................................................................... CHAIRMAN,PEDIATRIC SURGERY	47.0 ................. 0.0	X		1,063,096	36,621
(4) NORMAN CHRISTOPHER MD...................................................................... CHAIRMAN, DEPT OF PEDS	46.0 ................. 0.0	X		499,806	25,760
(5) ROBERT MCGREGOR MD...................................................................... CHIEF MEDICAL OFFICER	51.0 ................. 1.0	X		634,795	108,419
(6) LAURA POLLAUF MD...................................................................... PRESIDENT OF MEDICAL STAFF	47.0 ................. 0.0	X		426,085	7,715
(7) VIRGINIA ADDICOTT...................................................................... DIRECTOR	2.0 ................. 0.0	X		0	0
(8) DONNA AXSON...................................................................... DIRECTOR	14.0 ................. 0.0	X		0	0
(9) ROBERT BERK...................................................................... DIRECTOR	7.0 ................. 2.0	X		0	0
(10) PATRICK COVEY...................................................................... DIRECTOR	1.0 ................. 0.0	X		0	0
(11) JOHN P DELANEY...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0
(12) PAUL DUTTON...................................................................... DIRECTOR	2.0 ................. 12.0	X		0	0
(13) TAMMY GERSMAN...................................................................... DIRECTOR	14.0 ................. 0.0	X		0	0
(14) WILLIAM HOPKINS...................................................................... DIRECTOR	8.0 ................. 0.0	X		0	0
(15) DUANE ISHAM...................................................................... DIRECTOR	4.0 ................. 0.0	X		0	0
(16) WILLIAM KELLEHER...................................................................... DIRECTOR	3.0 ................. 0.0	X		0	0
(17) KIRSTEN KING...................................................................... SECRETARY	15.0 ................. 0.0	X	X	0	0

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) DALE KOBLENZER........................................................................ DIRECTOR	6.0 .......................0.0	X				0	0
(19) KATHLEEN LANE........................................................................ DIRECTOR	18.0 .......................8.0	X				0	0
(20) SCOTT LEVIN........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0
(21) KARA LEWIS........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0
(22) PHILIP MAYNARD........................................................................ DIRECTOR	8.0 .......................2.0	X				0	0
(23) GREGORY MCDERMOTT........................................................................ DIRECTOR	10.0 .......................2.0	X				0	0
(24) STEPHEN MYERS........................................................................ VICE CHAIRMAN FOR FINANCE	8.0 .......................0.0	X	X			0	0
(25) JOHN ORR........................................................................ CHAIRMAN	22.0 .......................1.0	X	X			0	0
(26) RICHARD ROGERS........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0
(27) DAVID SHOWERS........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0
(28) GLEN STEPHENS........................................................................ DIRECTOR	2.0 .......................0.0	X				0	0
(29) ELINORE MARSH STORMER........................................................................ DIRECTOR	5.0 .......................1.0	X				0	0
(30) LAURA THOMPSON........................................................................ DIRECTOR	1.0 .......................0.0	X				0	0
(31) BARBARA VARLEY........................................................................ DIRECTOR	14.0 .......................0.0	X				0	0
(32) ROBERT WELLS........................................................................ DIRECTOR	4.0 .......................0.0	X				0	0
(33) WILLIAM WOOLDREDGE........................................................................ DIRECTOR	8.0 .......................0.0	X				0	0
(34) SHAWN LYDEN........................................................................ CHIEF STRATEGY OFFICER	42.0 .......................2.0		X			797,026	138,293
(35) MICHAEL TRAINER........................................................................ CHIEF FINAN OFFICER/TREASURER	41.0 .......................14.0		X			679,947	28,441
(36) LISA AURILIO........................................................................ CHIEF OPERATING OFFICER	40.0 .......................13.0		X			587,078	76,985
(37) CYNTHIA DORMO........................................................................ VP, DEPT OF PEDS	40.0 .......................0.0			X		350,971	9,556
(38) SHARON HRINA........................................................................ VP, MAHONING VALLEY ENTERPRISE	42.0 .......................0.0			X		342,398	18,761
(39) CRAIG MCGHEE........................................................................ CHIEF NON HOSP SRVCS OFFICER	41.0 .......................0.0			X		306,699	56,458
(40) LINDA GENTILE........................................................................ VP SUPP SVC & CONSTRUCTION	40.0 .......................0.0			X		337,772	9,322
(41) LINDA HETSON........................................................................ VP PROFESSIONAL SERVICES	40.0 .......................0.0			X		285,552	148,376
(42) RHONDA LARIMORE........................................................................ CHIEF HUMAN RESOURCE OFFICER	40.0 .......................0.0			X		228,273	68,656
(43) BERNETT WILLIAMS........................................................................ INTERIM VP-HUMAN RESOURCES	41.0 .......................0.0			X		316,484	58,494
(44) HARUN RASHID........................................................................ CHIEF INFORMATION OFFICER	40.0 .......................0.0			X		401,026	90,551
(45) CHRISTINE YOUNG........................................................................ CHIEF NURSING OFFICER	42.0 .......................0.0			X		286,079	66,758
(46) ANTON MILO MD........................................................................ DIRECTOR OF ENT	40.0 .......................0.0				X	1,347,459	43,462
(47) ROBERT PARRY MD........................................................................ PEDIATRIC GENERAL SURGEON	40.0 .......................0.0				X	1,034,971	43,066
(48) TSULEE CHEN MD........................................................................ DIRECTOR OF NEUROLOGY	40.0 .......................0.0				X	962,192	23,665
(49) AVRAHAM SCHLAGER MD........................................................................ PEDIATRIC GENERAL SURGEON	40.0 .......................0.0				X	910,851	23,659
(50) SCOTT BOULANGER MD........................................................................ PEDIATRIC GENERAL SURGEON	40.0 .......................0.0				X	855,186	26,127

(A) Name and business address	(B) Description of services	(C) Compensation
MARCUS THOMAS LLC, 4781 RICHMOND ROAD CLEVELAND,OH44128	BROADCAST MEDIA	4,888,926
WELTY BUILDING COMPANY, 3421 RIDGEWOOD ROAD FAIRLAWN,OH44333	BLDG CONSTRUCTION	6,622,014
ROI HEALTHCARE SOLUTIONS LLC, 5555 GLENRIDGE CONNECTOR SUITE 200 ATLANTA,GA30342	ERP CONSULTING SVCS	4,208,251
PEDIATRIC ADOLESCENT UROLOGY, 215 W BOWERY STREET SUITE 3500 AKRON,OH44308	PHYSICIAN SERVICES	3,307,722
SHIFTWISE, PO BOX 70870 ST PAUL,MN55170	Workforce scheduling	1,852,560
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 45

- TIN:

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 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)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
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)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization Children's Hospital Medical Center of Akron

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization Children's Hospital Medical Center of Akron		Employer identification number 34-0714357

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization Children's Hospital Medical Center of Akron			Employer identification number 34-0714357
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

110,382

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

77,575

Total. Add lines 1c through 1i ....................................................................................................

187,957

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Part II-B, Line 1	CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ("CHMCA") PAID A TOTAL OF $636,185 TO OTHER ORGANIZATIONS THAT HAVE LOBBYING ACTIVITIES. OF THAT AMOUNT, $448,228 PERTAINED TO DUES, $110,382 RELATED TO VARIOUS LOBBYING EXPENSES AND $77,575 WAS PAID FOR LOBBYING EFFORTS AND VARIOUS COMMUNICATIONS ON BEHALF OF CHMCA WITH GOVERNMENTAL AUTHORITIES. THOSE COMMUNICATIONS AND LOBBYING EFFORTS INVOLVE THE FOLLOWING: MONTHLY LEGISLATIVE CONFERENCE CALLS WITH CHMCA STAFF IDENTIFIED CONCERNS WITH VARIOUS PAYMENT REFORM INITIATIVES AND SHARED THOSE CONCERNS WITH CONGRESSIONAL DELEGATION CONDUCTED MEETINGS WITH MEMBERS OF CONGRESS AND THEIR STAFF IN WASHINGTON, DC TO DISCUSS CHGME AND THE ACE KIDS ACT PREPARED TESTIMONY IN SUPPORT OF HB 286 (PALLIATIVE CARE) MET WITH OHIO DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES STAFF TO DISCUSS CAPITAL FUNDING MET WITH OHIO ATTORNEY GENERAL STAFF TO DISCUSS CAPITAL FUNDING MET WITH OHIO GOVERNOR'S STAFF TO DISCUSS CAPITAL FUNDING ATTENDED 2018 VOTE FOR OHIO KIDS SUMMIT THE FOLLOWING ARE 2018 LOBBYING EXPENSES: $ 236 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 53,115 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS 10,635 AMERICAN HOSPITAL ASSOCIATION 40,538 OHIO CHILDREN'S HOSPITAL ASSOCIATION 5,858 OHIO HOSPITAL ASSOCIATION 17,500 OTHER LOCAL AGENCIES $ 127,882 SUBTOTAL 60,075 LOBBYIST - CAPITAL CONSULTING GROUP $ 187,957 TOTAL ASSOCIATION OF AMERICAN MEDICAL COLLEGES, CHILDREN'S HOSPITALS ASSOCIATION (CHA) AND AMERICAN HOSPITAL ASSOCIATION ARE NATIONAL ORGANIZATIONS THAT CHMCA HOLDS MEMBERSHIPS. ALONG WITH OTHER HOSPITALS AS MEMBERS, THESE NATIONAL ORGANIZATIONS EXPRESS CONCERNS OF HEALTHCARE PROVIDERS IN ADVOCACY AND REPRESENTATION TO NATIONAL AND/OR STATE LEGISLATURES ON HEALTHCARE ISSUES THAT AFFECT CHMCA. AS AN EXAMPLE, CHA AND AMERICAN HOSPITAL ASSOCIATION HAVE BEEN A CONSTANT AND PERSUASIVE VOICE IN CHAMPIONING THE NEEDS OF CHILDREN AND THE HOSPITALS THAT CARE FOR THEM. OHIO CHILDREN'S HOSPITAL ASSOCIATION AND OHIO HOSPITAL ASSOCIATION ARE STATE OF OHIO ORGANIZATIONS THAT EXPRESS THE VIEWS OF OHIO CHILDREN'S HOSPITALS FOR MEDICAID AND CHILD HEALTHCARE ISSUES. LOCAL AGENCIES IN SUMMIT COUNTY, OHIO PROVIDE SERVICES TO RESIDENTS. THE IMPACT OF HEALTHCARE LEGISLATION HAS IMPLICATIONS ON OUR BUSINESS AND SERVICES WE PROVIDE.

Return Reference

Explanation

Part II-B, Line 1

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ("CHMCA") PAID A TOTAL OF $636,185 TO OTHER ORGANIZATIONS THAT HAVE LOBBYING ACTIVITIES. OF THAT AMOUNT, $448,228 PERTAINED TO DUES, $110,382 RELATED TO VARIOUS LOBBYING EXPENSES AND $77,575 WAS PAID FOR LOBBYING EFFORTS AND VARIOUS COMMUNICATIONS ON BEHALF OF CHMCA WITH GOVERNMENTAL AUTHORITIES. THOSE COMMUNICATIONS AND LOBBYING EFFORTS INVOLVE THE FOLLOWING: *MONTHLY LEGISLATIVE CONFERENCE CALLS WITH CHMCA STAFF *IDENTIFIED CONCERNS WITH VARIOUS PAYMENT REFORM INITIATIVES AND SHARED THOSE CONCERNS WITH CONGRESSIONAL DELEGATION *CONDUCTED MEETINGS WITH MEMBERS OF CONGRESS AND THEIR STAFF IN WASHINGTON, DC TO DISCUSS CHGME AND THE ACE KIDS ACT *PREPARED TESTIMONY IN SUPPORT OF HB 286 (PALLIATIVE CARE) *MET WITH OHIO DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES STAFF TO DISCUSS CAPITAL FUNDING *MET WITH OHIO ATTORNEY GENERAL STAFF TO DISCUSS CAPITAL FUNDING *MET WITH OHIO GOVERNOR'S STAFF TO DISCUSS CAPITAL FUNDING *ATTENDED 2018 VOTE FOR OHIO KIDS SUMMIT THE FOLLOWING ARE 2018 LOBBYING EXPENSES: $ 236 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 53,115 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS 10,635 AMERICAN HOSPITAL ASSOCIATION 40,538 OHIO CHILDREN'S HOSPITAL ASSOCIATION 5,858 OHIO HOSPITAL ASSOCIATION 17,500 OTHER LOCAL AGENCIES $ 127,882 SUBTOTAL 60,075 LOBBYIST - CAPITAL CONSULTING GROUP $ 187,957 TOTAL ASSOCIATION OF AMERICAN MEDICAL COLLEGES, CHILDREN'S HOSPITALS ASSOCIATION (CHA) AND AMERICAN HOSPITAL ASSOCIATION ARE NATIONAL ORGANIZATIONS THAT CHMCA HOLDS MEMBERSHIPS. ALONG WITH OTHER HOSPITALS AS MEMBERS, THESE NATIONAL ORGANIZATIONS EXPRESS CONCERNS OF HEALTHCARE PROVIDERS IN ADVOCACY AND REPRESENTATION TO NATIONAL AND/OR STATE LEGISLATURES ON HEALTHCARE ISSUES THAT AFFECT CHMCA. AS AN EXAMPLE, CHA AND AMERICAN HOSPITAL ASSOCIATION HAVE BEEN A CONSTANT AND PERSUASIVE VOICE IN CHAMPIONING THE NEEDS OF CHILDREN AND THE HOSPITALS THAT CARE FOR THEM. OHIO CHILDREN'S HOSPITAL ASSOCIATION AND OHIO HOSPITAL ASSOCIATION ARE STATE OF OHIO ORGANIZATIONS THAT EXPRESS THE VIEWS OF OHIO CHILDREN'S HOSPITALS FOR MEDICAID AND CHILD HEALTHCARE ISSUES. LOCAL AGENCIES IN SUMMIT COUNTY, OHIO PROVIDE SERVICES TO RESIDENTS. THE IMPACT OF HEALTHCARE LEGISLATION HAS IMPLICATIONS ON OUR BUSINESS AND SERVICES WE PROVIDE.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

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.

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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2018

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	75,724,721	70,020,604	69,532,079	84,300,290	71,912,635
b	Contributions ...	12,403,356	7,952,552	6,320,223	8,366,805	16,013,945
c	Net investment earnings, gains, and losses	-6,526,046	4,840,850	1,475,972	-2,702,700	215,179
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	5,809,723	7,089,285	7,307,670	20,432,316	3,841,469
f	Administrative expenses ....
g	End of year balance ......	75,792,308	75,724,721	70,020,604	69,532,079	84,300,290

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

3.850 %

Permanent endowment SchDMd Bullet

20.030 %

Temporarily restricted endowment SchDMd Bullet

76.120 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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" on 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 .....	16,970,331		16,970,331
b	Buildings ....	631,781,041	290,173,737	341,607,304
c	Leasehold improvements	18,421,272	8,853,045	9,568,227
d	Equipment ....	347,831,259	266,072,355	81,758,904
e	Other .....	46,768,729	3,391,965	43,376,764
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				493,281,530

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered "Yes" on 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) BENEFICIAL INT IN FOUNDATION				131,153,171
(2) UNAMORT HEALTHCARE SERVICE				1,553,793
(3) OTHER ASSETS				864,037
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				133,571,001

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
DEFERRED BENEFIT PENSION LIAB	116,519,513
POST RETIREMENT PLANS	26,703,631
PROFESSIONAL LIABILITY RESERVE	2,282,000
OTHER LIABILITIES	39,379,163
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	184,884,307
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) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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 (losses) 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' on 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 V, Line 4 - Intended Use of Endowment Funds

Temporarily restricted funds are subject to restrictions imposed by the donor or by time. These funds are held until the specific purpose or time element is met and they are released from restrictions. Permanently restricted funds are funds that are invested in perpetuity and are not available to fund any current operations. The earnings from the endowment funds can be used for the specific purpose imposed by the donor. The Board Designated funds include funds from unrestricted sources that have been internally designated by the Board of Directors to function as endowments. These funds are to be used for their designated purpose. CHMCA does have a policy in place to monitor all unrestricted, temporarily and permanently restricted funds.

Part X, LINE 2 - FIN 48(ASC 740)

CHMCA prepares consolidated financial statements including their affiliated subsidiaries. CHMCA adopted Accounting Standards Codification 740 (ASC 740) in 2007 which requires businesses to analyze and disclose income task risks. No disclosures were required under GAAP as CHMCA does not have any material tax contingencies that are required disclosures in the footnotes.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

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? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in region
	Middle East and North Africa	Investments	200,000
















3a	Sub-total .....		200,000
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)		200,000

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 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) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

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

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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" on 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 arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

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?

YesNo

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)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

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 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on 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 Charity Ball (event type)	(b) Event #2 Tree Festival (event type)	(c) Other events 7 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	219,045	201,117	246,399	666,561
2	Less: Contributions . . . .	164,284		213,049	377,333
3	Gross income (line 1 minus line 2) . . . . . .	54,761	201,117	33,350	289,228

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	112,102	201,984	80,765	394,851
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				394,851
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-105,623

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

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? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

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

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

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 provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	4,586,518		4,586,518	0.550 %
b	Medicaid (from Worksheet 3, column a) . . . . .	420,361,364	297,179,743	123,181,621	14.640 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	484,842	484,842
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	425,432,724	297,664,585	127,768,139	15.190 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	6,698,826	7,550	6,691,276	0.800 %
f	Health professions education (from Worksheet 5) . . .	23,417,521	10,916,595	12,500,926	1.490 %
g	Subsidized health services (from Worksheet 6) . . . .	297,705		297,705	0.040 %
h	Research (from Worksheet 7) .	7,434,966	524,256	6,910,710	0.820 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	751,833		751,833	0.090 %
j	Total. Other Benefits . .	38,600,851	11,448,401	27,152,450	3.240 %
k	Total. Add lines 7d and 7j .	464,033,575	309,112,986	154,920,589	18.430 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

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.

		(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	12,856		12,856
3	Community support	103,884		103,884	0.010 %
4	Environmental improvements
5	Leadership development and training for community members	25,264		25,264
6	Coalition building	69,448		69,448	0.010 %
7	Community health improvement advocacy	614,700	5,234	609,466	0.070 %
8	Workforce development	36,759		36,759
9	Other
10	Total	862,911	5,234	857,677	0.090 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

7,940,249

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

10,018,708

Enter Medicare allowable costs of care relating to payments on line 5.....

13,196,789

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-3,178,081

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	Children's Hospital Med Ctr of Akron One Perkins Square Akron,OH44308 www.akronchildrens.org No Ohio License #	X	X	X	X	A
2	Children's - Beeghly Campus 6505 Market Street Youngstown,OH44512 www.akronchildrens.org No Ohio License #	X	X	X	X	B

Schedule H (Form 990) 2018

Page 4

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)

	Facility Group A - Akron
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

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 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): see Part V Section C for URL

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Part V Section C for URL

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Group A - Akron
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.% and FPG family income limit for eligibility for discounted care of 300.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

Part V, Sect C for full URL

The FAP application form was widely available on a website (list url):

Part V, Sect C for full URL

A plain language summary of the FAP was widely available on a website (list url):
Part V, Sect C for URL

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Group A - Akron
Name of hospital facility or letter of facility reporting group

Yes

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 all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Facility Group A - Akron
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 4

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)

	Facility Group B - Mahoning Valley
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

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 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): see Part V, Section C for Full URL

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): see Part V, Section C for full URL

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

12a

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)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, 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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Group B - Mahoning Valley
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.% and FPG family income limit for eligibility for discounted care of 300.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

see Part V Section C for full URL

The FAP application form was widely available on a website (list url):

see Part V Sect C for full URL

A plain language summary of the FAP was widely available on a website (list url):
see Part V Sect C for URL

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Group B - Mahoning Valley
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Facility Group B - Mahoning Valley
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section B Group A	Part V, Section B. Facility Policies and Practices, Community Health Needs Assessments (CHNA) CHMCA (#1). Line 3e: The significant health needs of the community identified in the CHNA are presented as a prioritized description. Line 5: In addition to examining county-level epidemiologic data, interviews were conducted with community leaders representing the broad interest of a six-county area from March - June 2016 to gain insight on what they thought were significant health needs of children and adults in their communities, the factors that affect those health needs, other existing community health needs assessments, possible collaboration opportunities, and to get suggestions on what the hospitals can do to address the significant health needs identified in the community health needs assessment(hereafter CHNA). These community leaders represent the broad interest of the communities served by the hospital facilities including the medically underserved, low-income persons, those with chronic disease needs, and leaders from local public health agencies and departments who have special knowledge and expertise in Public Health and Children's Health. Children's Hospital Medical Center of Akron (CHMCA) held a community event in September 2018 where community partners heard report-outs on each CHNA implementation team's progress toward addressing the community needs identified in the 2016 assessment. CHMCA did not receive any feedback that would necessitate an adjustment to the CHNA. Community Resident Focus Groups: In addition to input from community leaders, focus groups were conducted with 178 community residents in the same six-county area from April - June 2016. In addition, a questionnaire was distributed to the focus group participants to gather demographic information and basic perceptions of community health. Due to the observed information gap in the epidemiologic data on the health of children, child substance abuse issues, and child mental health issues, several questions were asked to probe more deeply on these issues. The discussion guide, questionnaire, and protocol were reviewed and approved by the Kent State University Institutional Review Board. Leaders from the following community organizations were interviewed: Stark County Department of Job and Family Services Director and Deputy Director Stark County Health Commissioner Akron Public Schools Alchohol, Drug Addiction and Mental Health Board Akron Metropolitan Housing Authority Akron-Summit County Community Action Agency Kent City School District Medina County Health Department Commissioner Mental Health and Recovery Board of Wayne-Holmes County Director Open M Ministries Ohio State Representative John Boccieri Ohio State Representative Christina Hagan Akron-Summit County Library Aurora City School District Brunswick City School District Canal Fulton Chamber of Commerce, Director Children's Hospital Community Benefit/Community Health Needs Assessment Steering Committee City of Akron, Assistant to the Mayor for Education, Health and Families City of Hudson Mayor City of Kent Health Department Commissioner City of Massillon Mayor City of Medina Mayor City of New Franklin Mayor City of Orrville Mayor City of Rittman Mayor City of Stow Mayor Cloverleaf Local Schools Crestwood Local School District Faithful Servants Greater Akron Area Chamber of Commerce Executive Director Hudson School District International Institute of Akron Director of Refugee Resettlement Kent Chamber of Commerce, Executive Director Ohio State Representative Sarah LaTourette Oriana House, Inc. Portage County Combined General Health District Commissioner Portage County Mental Health and Recover Board, Director and Executive Director Rootstown Local Schools Summit County Alcohol, Drug Addiction, and Mental Board Director Summit County Children Services Summit County Executive Summit County Public Health Commissioner Tuslaw Local School District United Way of Stark County, Health Impact Counsel Director Director United Way of Summit County US Senator Sherrod Brown Legislative Aide US Senator Rob Portman Legislative Aide Wadsworth Chamber of Commerce Director Wadsworth City School District Wayne County Health Department Health Co-Commissioner Windham Village Mayor Focus Groups: Community residents were recruited in several ways. We conducted focus groups during scheduled community meetings and events, such as advisory groups and health and wellness center meetings. Sites were selected based upon proximity to population areas, ease of access (including free parking and bus lines), and the recommendations from local community leaders. 30.3% of participants were from Summit County, 6.2% from Wayne County, 12.4% from Medina County, 21.9% from Stark County, 13.5% from Portage County, and 15.7% from Richland County. The average number of years the participants lived in their home county was 31.7 years. Line 6a: Yes Cleveland Clinic-Akron General 1 Akron General Ave. Akron, Ohio 44307 Summa Health System 525 East Market Street Akron, Ohio 44304 Line 6b: Yes Kent State University of Public Health 800 East Summit Street Kent, Ohio 44240 Line 7(a)& Line 10 -Yes - Posted on our external website to https://www.akronchildrens.org/pages/Community_Health_Needs_Assessment.htm l Line 11 - The measured indicators in the 2016 CHNA have been addressed for many years through CHMCA's clinical and programmatic efforts. Our highly-qualified medical staff and professionals provide world-class patient centered care to address each of these indicators through our Center for Orthopedics and Sports Medicine, Center for Diabetes and Endocrinology, Robert T. Stone MD Respiratory Center, Heart Center, Division of Pediatric Psychiatry and Psychology, and the Showers Family Center for Childhood Cancer and Blood Disorders. The 2016 CHNA identified and prioritized several community health needs. We drafted, and our Board of Directors approved comprehensive implementation strategies that focused on addressing conditions related to diabetes, asthma, behavioral and mental health, and infant mortality. The remaining identified needs from the CHNA, including conditions related to child lifestyle factors, crime and violence, access to health care and environmental factors were not formally addressed through implementation strategies. Reasons for this vary, from other community agencies being better positioned to address these conditions to a lack of funding and staff, and a lower priority for certain conditions because of our focus on pediatric conditions. We will continue to look to CHNA data, as well as other data sources for these conditions to guide our efforts and advance our mission of improving the health of the communities we serve. Specific Needs Not Addressed - Although all of the community health needs identified by the CHNA are important, hospital teams deliberated and prioritized five high-priority areas based on the hospital's current activities, the potential for community impact, and available resources. Consequently, several areas will not be addressed through formal implementation strategies. These include health areas that ranked lower during the prioritization process. Additionally, certain health areas were beyond the scope of the hospital, with some health areas that require more resources than what are available: Access to Health Care - Health Insurance Coverage - Access to Dental Care - Mental Health Insurance Coverage - Dental Insurance Coverage - Vision Insurance Coverage Child Lifestyle Factors - Food Insecurity - Obesity Environmental Factors - Elevated Blood Lead Levels Crime And Violence - Child Trafficking While dental care was not selected to be addressed as part of the CHNA, the data showing high incidents of extraction in CHMCA's emergency department prompted the opening of the Celeste Myers Dental Clinic in 2016 to increase access to preventative pediatric oral health care services. Additionally, CHMCA's clinicians do not provide care services for pregnant women, other than those whose babies have been diagnosed before birth or prenatally with a condition or disease that must be monitored by our Maternal Fetal Medicine (MFM) Center or Genetics Center. Therefore, we will not be able to impact the service area's rate of infants born at low birth weights or very low birth weights (other than caring for them after birth), the rate of preterm births (other than those mothers and babies being followed by our MFM Center), or the rate of pregnant women receiving prenatal care (other than those seen by MFM Center) or the rate of births to women who smoke. We do care for babies born at low and very low birth weights and preterm infants requiring hospitalization in the Neonatal Intensive Care Unit (NICU) on the Akron campus or NICUs that we operate at Cleveland Clinic Akron General, Summa Health System, St. Elizabeth Hospital in Youngstown, and the special care nursery at our Mahoning Valley Campus in Boardman. Data Limi
Part V. Section B Group B	Part V, Section B. Facility Policies and Practices, Community Health Needs Assessments CHMCA - Beeghly Campus (#2). Line 3(e) - The significant health needs of the community identified in the CHNA are presented as a prioritized description. Line 5 - In addition to examining county-level epidemiologic data, interviews were conducted with community leaders representing the broad interest of a three-county area from March - June 2016 to gain insight on what they thought were the significant health needs of children and adults in their communities, the factors that affect those health needs, other existing community health needs assessments, possible collaboration opportunities, and to get suggestions on what the hospitals can do to address the significant health needs identified in the Community Health Needs Assessment(CHNA). Children's Hospital Medical Center of Akron (CHMCA) held a community event in September 2018 where community partners heard report-outs on each CHNA implementation team's progress toward addressing the community needs identified in the 2016 assessment. CHMCA did not receive any feedback that would necessitate an adjustment to the CHNA. These community leaders represent the broad interests of the communities served by the hospital facility including the medically underserved, low-income persons, minority groups, those with chronic disease needs and leaders from local public health agencies and departments who have special knowledge and expertise in public health and children's health issues. Leaders Interviewed: Youngstown City Health District, Health Commissioner Youngstown/Warren Regional Chamber, Executive Director Mahoning County Children's Services Executive Director Mahoning County Health Commissioner Trumbull County Mental Health and Recovery Board Director Trumbull County Children's Services Executive Director St. Joseph Health Center President Columbiana County Department of Job and Family Services Director Columbiana County Health Department Commissioner Alta Care Group Chief Executive Officer Children's Rehabilitation Center Interim Director Coleman Behavioral Health Supervisor Columbiana County Family and Children First Council Director Columbiana County Mental Health and Recovery Service Board, Executive Director Columbiana County WIC Program Supervisor Community Foundation of the Mahoning Valley President Compass Family and Community Service Executive Director Coordinated Action for School Health (CASH) Coalition Coordinator East Liverpool City Hospital Chief Nursing Officer Health And Nutrition, Alta Head Start Manager Mahoning County Board of Developmental Disabilities Superintendent Mahoning County Educational Service Center Superintendent Mahoning County Juvenile Court Judge Mahoning Family and Children First Council Coordinator Mercy Medical Center Manager of Community Health Information Mercy Medical Center WIC Program Manager Neighborhood Ministries Executive Director Ohio Organizing Collaborative Director of Operations Ohio Senator Capri Cafaro Ohio State Representative John Boccieri Ohio State Representative Timothy E Ginter Organizacion Civica y Cultural Hispana Americana, Inc. Executive Director and Program Manager Director of Potential Development Counseling Center Director of Youth & Community Support The Counseling Center Director of Nursing Practices Trumbull County Health Department Commissioner Trumbull Family and Children First Council Director United Way of Northern Columbiana County Executive Director United Way of Trumbull County President United Way of Youngstown President U.S. Senator Rob Portman Legislative Aide U.S. Senator Sherrod Brown Legislative Aide Youngstown Better Business Bureau President Youngstown City Schools Acting Superintendent Youngstown Neighborhood Development Center Manager Youngstown Office of Minority Health Director In addition to the input from community leaders, focus groups were conducted with 90 community residents in the same three-county area from April - June 2016 to get their input on what they thought were the significant health needs of children and adults in their communities, the factors that affect those needs, the solutions they thought would solve those needs, and what the hospitals and other community groups could do to address those needs. In addition, a questionnaire was distributed to the focus group participants to gather demographic information and basic perceptions of community health. Due to the observed information gap in the epidemiologic data on the health of children, child substance abuse issues, and child mental health issues, several questions were asked to probe more deeply on these issues. The discussion guide, questionnaire and protocol were reviewed and approved by the Kent State University Institutional Review Board. Community residents were recruited to participate in the focus groups in several ways. We conducted focus groups during scheduled community meetings and events, such as advisory groups, and wealth and wellness center meetings. Sites were selected based on proximity to population areas, ease of access (including free parking and bus lines), and the recommendations from community leaders. 16.9% of participants were from Trumbull County, 61.8% from Mahoning County, and 21.3% were from Columbiana County. The average number of years that participants lived in their home county was 25.5 years. Line 6(b) Kent State University of Public Health 800 East Summit Street Kent, Ohio 44240 Line 7(a)& Line 10 - Yes - https://www.akronchildrens.org/pages/Community_Health_Needs_Assessment.htm l Line 11: The measured indicators in the 2016 CHNA have been addressed for many years through CHMCA's clinical and programmatic efforts. Our highly-qualified medical staff and professionals provide world-class patient centered care to address each of these indicators through our Center for Orthopedics and Sports Medicine, Center for Diabetes and Endocrinology, Robert T. Stone MD Respiratory Center, Heart Center, Division of Pediatric Psychiatry and Psychology, and the Showers Family Center for Childhood Cancer and Blood Disorders. The 2016 CHNA identified and prioritized several community health needs. We drafted, and our Board of Trustees approved, implementation strategies that focused on addressing conditions related to diabetes, asthma, behavioral and mental health, injuries and infant mortality. The remaining identified needs from the CHNA, including conditions related to child lifestyle factors, crime and violence, access to health care, and environmental factors, were not formally addressed through implementation strategies. Reasons for this vary, from other community agencies being better positioned to address these conditions to lack of funding and staff and a lower priority for certain conditions because of our focus on pediatric conditions. We will continue to look at CHNA data, as well as other data sources, on these conditions to guide our efforts and advance our mission of improving the health of the communities we serve. Specific Needs Not Addressed - Although all of the community health needs identified by the CHNA and deliberated by our hospital teams are important, five emerged as high-priority areas based on the hospital's current activities, the potential for community impact, and available resources. Consequently, several areas will not be addressed in this Implementation Strategy. These include health areas that ranked lower during the prioritization process, health areas that were beyond the scope of the hospital, and health areas that require more resources than what are available: Access to Health Care - Health Insurance Coverage - Access to Dental Care - Mental Health Insurance Coverage - Dental Insurance Coverage - Vision Insurance Coverage Child Lifestyle Factors - Overweight & Obesity - Food Insecurity Environmental Factors - Elevated Blood Lead Levels Crime And Violence - Child Trafficking Additionally, CHMCA's clinicians do not provide care services for pregnant women, other than those whose babies have been diagnosed before birth or prenatally with a condition or disease that must be monitored by our Maternal Fetal Medicine (MFM) Center or Genetics Center, or the rate of women who smoke. Therefore, we will not be able to impact the service area's rate of infants born at low birth weights or very low birth weights(other than caring for them after birth), the rate of preterm births(other than those mothers and babies being followed by our MFM Center), or the rate of pregnant women receiving prenatal care(other than those seen by MFM Center). We do care for babies born at low and very low birth weights and preterm infants requiring hospitalization in the NICU on the Akron campus or NICUs that we operate at Cleveland Clinic-Akron General, Summa Health System and St. Elizabeth Hospital in Youngstown, and the special care nursery at our Mahoning Valley Campus in Boardman. Data Limitations and Gaps - Due to

Schedule H (Form 990) 2018

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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?56
Name and address		Type of Facility (describe)
1	CHMCA Partial Hospitalization Prog #16 388 South Main Street Suite 205 2 Akron,OH44311	Behavioral Health Day Programs
2	CHMCA Montrose Urgent Care #43 4125 Medina Road Akron,OH44333	Urgent Care
3	ACHP - New Philadelphia #17 1045 W High Avenue New Philadelphia,OH44663	General Outpatient Services
4	ACHP - Green #10 1600 E Turkeyfoot Lake Road Suite 1 Akron,OH44312	General Outpatient Services
5	ACHP - Fairlawn #12 701 White Pond Drive Suite 100 Akron,OH44320	General Outpatient Services
6	ACHP - Hudson #15 1365 Corporate Drive Suite A Hudson,OH44236	General Outpatient Services
7	CHMCA Hudson Specialties #6 5655 Hudson Drive Hudson,OH44236	Special Outpatient Services
8	ACHP - Warren #21 5000 E Market st Suite 30 Warren,OH44484	General Outpatient Services
9	ACHP - East Akron #32 891 East Exchange Street Akron,OH44306	General Outpatient Services
10	ACHP - Wooster #24 128 E Milltown Road Suite 209 Wooster,OH44691	General Outpatient Services
11	ACHP - Medina #25 3443 Medina Road Suite 115 Medina,OH44256	General Outpatient Services
12	ACHP - Boardman #23 6505 Market Street Bldg A First Flo Boardman,OH44512	General Outpatient Services
13	ACHP - Barberton #36 566 Robinson Avenue Barberton,OH44203	General Outpatient Services
14	ACHP - Ellet #33 1463 Canton Road Suite A Akron,OH44312	General Outpatient Services
15	ACHP - Twinsburg #26 8054 Darrow Road Suite 3 Twinsburg,OH44087	General Outpatient Services
16	ACHP - Kent #35 1951 State Rt 59 Kent,OH44240	General Outpatient Services
17	ACHP - Ashland #34 2212 Mifflin Avenue Suite 235 Ashland,OH44805	General Outpatient Services
18	ACHP - Wadsworth #30 323 High Street Suite A Wadsworth,OH44281	General Outpatient Services
19	ACHP - North Canton #13 6076 Whipple Ave NW Bldg B North Canton,OH44720	General Outpatient Services
20	ACHP - Tallmadge #38 143 Northeast Ave Bldg D 102 Tallmadge,OH44278	General Outpatient Services
21	ACHP - Streetsboro #45 9318 State Rt 14 Streetsboro,OH44241	General Outpatient Services
22	CHMCA Millersburg Hemophilia Clinic #8 1261 Wooster Road Suite 220 Millersburg,OH44654	Single Specialty Outpatient
23	ACHP - Ravenna #41 6847 N Chestnut Street Suite 200 Ravenna,OH44266	General Outpatient Services
24	CHMCA Care Center Stark County #20 213 Market Avenue N Suite 200 Canton,OH44702	Single Specialty Outpatient
25	ACHP - Brecksville #42 7001 s Edgerton Road Suite 500 Brecksville,OH44141	General Outpatient Services
26	ACHP - Alliance #31 1826 S Arch Avenue Alliance,OH44601	General Outpatient Services
27	CHMCA North Canton Rehab Services #7 6200 Whipple Ave NW Canton,OH44720	General Outpatient Services
28	CHMCA Beachwood Specialties #29 23250 Chagrin Blvd Building 5 Suit Beachwood,OH44122	Specialty Outpatient Services
29	ACHP - Perry #27 125 Whipple Ave S W Canton,OH44710	General Outpatient Services
30	CHMCA Medina Specialties #22 3443 Medina Rd Suite 108 Door 1 Medina,OH44256	Specialty Outpatient Services
31	CHMCA - AGMC Wellness - Rehab #51 4125 Medina Road Akron,OH44333	Physical Rehab Services
32	CHMCA Ctr for Allergy & Immunology #18 130 West Exchange Street Akron,OH44308	Single Specialty Group
33	CHMCA Medina Subspecialties #52 3443 Medina Rd Suite 108 Door 2 Medina,OH44256	Specialty Outpatient Services
34	CHMCA Wooster Specialty Care #53 546 Winter St Suite 10 Wooster,OH44691	Specialty Outpatient
35	CHMCA Warren Subspecialties #5 5000 E Market St Unit 29 Warren,OH44484	Specialty Outpatient Services
36	CHMCA Norwalk Subspecialties #54 282 Benedict Avenue Norwalk,OH44857	Specialty Outpatient Services
37	CHMCA Life Center Plus #48 5133 Darrow Rd Hudson,OH44236	Single Specialty Outpatient
38	ACHP - Ontario #39 2003 W 4th Street Ontario,OH44906	General Outpatient Services
39	CHMCA Mansfield Subspecialties #14 1029 S Trimble Road Mansfield,OH44906	Specialty Outpatient Services
40	ACHP - Warren Downtown #44 661 Mahoning Avenue NW Warren,OH44483	General Outpatient Services
41	CHMCA MFM Mercy Health #56 1330 Mercy Drive NW Suite 506 Canton,OH447082685	Single Specialty Outpatient
42	ACHP Mansfield #28 1029 S Trimble Rd Mansfield Ohio,OH44906	General Outpatient Services
43	ACHP Lisbon #40 400 N Market St Lisbon,OH44432	General Outpatient Services
44	ACHP Austintown #37 5480 Norquest Blvd Austintown,OH44515	General Outpatient Services
45	CHMCA North Canton Specialty Care #11 6200 Whipple Avenue SW Canton,OH44720	General Outpatient Services
46	CHMCA MFM Medina #55 3985 Medina Rd Suite 200 Medina,OH44256	Single Specialty Outpatient
47	Family Child Learning Center #49 143 Northwest Ave Bldg A Tallmadge,OH44278	General Outpatient Services
48	CHMCA At St Elizabeth's #1 8401 Market St Boardman,OH44512	NICU Nursery
49	CHMCA SCN Summa Akron City #2 525 E Market St Akron,OH44304	NICU Nursery
50	CHMCA SCN CCAG #3 1 Akron General Avenue Akron,OH44307	NICU Nursery
51	CHMCA Aultman #9 2600 6th Street SW Canton,OH44710	Pediatric Unit
52	CHMCA Mercy Health St Joseph Hosp #4 667 Eastland Avenue SE Warren,OH44484	Pediatric Unit NICU Nursery
53	CHMCA Wooster Community Hospital #19 1761 Beall Avenue Wooster,OH44691	NICU Nursery
54	CHMCA Warren Urgent Care #50 5000 E Market St Wooster,OH44691	General Outpatient Services
55	CHMCA Hudson Urgent Care #46 5655 Hudson Avenue Hudson,OH44236	General Outpatient Services
56	CHMCA Mansfield Urgent Care #47 1029 S Trimble Road Mansfield,OH44906	General Outpatient Services

Schedule H (Form 990) 2018

Page 10

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 I, Line 7 (a) Charity Care @ Cost	We believe that applying a cost-to-charge ratio developed for the hospital facility from the Ohio Medicaid cost report to hospital charity charges, as reported in detail schedules used in the preparation of the Audited Consolidated Financial Statements and other information is the most accurate costing methodology to calculate gross charity care at cost for the period. Total hospital costs from the Ohio Medicaid cost report used in this calculation include only allowable and reimbursable costs. The Hospital Care Assurance Program (HCAP) is Ohio's methodology to provide additional payments to hospitals that provide a disproportionate share of uncompensated care to the indigent and uninsured. The estimated HCAP amount applicable to charity care is reported as direct offsetting revenue to charity care expense.
Part I, Line 7 (b) Unreimbursed Medicaid & 7 (c) Other Means Tested	We believe that reporting program charges, costs and payments directly from CHMCA's Ohio Medicaid cost report along with similar calculations for services rendered by hospital employed physicians and other professional providers and services rendered to out-of-state Medicaid enrollees is the most accurate methodology to calculate unreimbursed Medicaid and other means-tested government program costs. Medicaid costs reported as Total Community Benefit Expense have been reduced by estimated health professional costs included in the Ohio Medicaid cost report and Medicaid revenues reported as direct offsetting revenue has been reduced by estimated Medicaid revenues related to health professional education. To avoid double counting of costs reported elsewhere in this schedule, gross costs for other reportable items have been reduced by the total government payor mix percentage of (55.20%) as reported on our internal payor mix report.
Part I, Line 7g Subsidized Health Services	Our expressive therapy center was built to enable children facing illness and their families to experience what it means to be human through whatever creative art inspires them. The children utilizing these services do not need to be a hospital patient. This service is not reimbursed by insurance and is a Non-Reimbursable Cost Center for Medicare. We recognize this as a Subsidized Health Service.
Part I, Line 7f - Health Professions Education:	The total costs of health professions education is reported as a total community benefit expense and direct offsetting revenues including Medicare and estimated Medicaid revenues related to health professional education.
Part II - Community Building Activities	Staying true to our mission, everything done by CHMCA is intended to benefit the communities we serve. Our primary benefit to each community is providing access to world-class health care to the children in the regions we serve. Additionally, we participate in a variety of other internal and community based efforts to improve the social and environmental conditions surrounding health. Our efforts include: A. Leadership development, under which we support various community-based programs that specifically develop community leaders, including such programs as Leadership Akron (for community leadership) and the Child & Family Leadership Exchange (for clinical and social service leadership). We support and are actively involved in initiatives such as Torchbearers, which is focused on developing and retaining strong community leadership. B. Coalitions and partnerships, in which CHMCA is strongly represented in committees and task forces are assigned to address specific health indicators and conditions.in addition to certain divergent population located throughout our region, state as well as nationally and internationally. As a teaching hospital, we partner with dozens of higher education institutions in providing training and hands-on instruction and shadowing opportunities for students who embark on health care careers. C. General community support, under which we provide financial and staff support for various community based initiatives, related to the healthy development of young people and their families in the service area. D. Community health improvement advocacy, under which we support multi-agency and governmental initiatives to encourage fitness, reduce gun related violence in our local community and promote fair housing practices. E. Workforce development through initiatives such as the College and Career Academy of Health and Human Services at North High School, established through a partnership with Akron Public Schools. This program offers high-school age career-focused pathways in health operations, early childhood education, biomedical science and allied health. Through the Academy, we also assist teachers in tailoring their curricula to health care applications.
Part III, Line 2 & 4 - Bad Debt Expense Explanation	We believe that applying a cost-to-charge ratio developed for the hospital facility from the Ohio Medicaid cost report to CHMCA's provision for bad debts is the most accurate costing methodology to calculate bad debt at cost for the period. Total hospital costs from the Ohio Medicaid cost report used in this calculation include only allowable and reimbursable costs. Therefore, the Cost To Charge Ratio multiplied by the Bad Debt Expense results in the cost of Bad Debt. The Hospital Care Assurance Program (HCAP) is Ohio's methodology to provide additional payments to hospitals that provide a disproportionate share of uncompensated care to the indigent and uninsured. Gross bad debt expense has been reduced by the estimated HCAP amount applicable to bad debt expense. The estimated amount of bad debt at cost attributable to patients eligible under the organization's charity policy is $-0-. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AS DESCRIBED IN PART VI, ITEM 3 - PATIENT EDUCATION FOR ASSISTANCE IS PROVIDED. See Pages 11, 12 & 13 to the footnotes to CHMCA's Audited Financial Statements that describe Charity Care and Bad Debt. CHMCA respectively submits that since we accept all patients, regardless of their ability to pay, that bad debts at cost, as reported herein, represent an unreimbursed cost of providing care to the patients we serve.
Part III, Line 8 - Medicare Explanation	We believe that reporting program charges, costs, and payments directly from CHMCA's Medicare cost report along with similar calculations for services rendered to patients enrolled in Medicare Advantage Plans and patients enrolled in TRICARE is the most accurate methodology to calculate unreimbursed Medicare and other means-tested government program costs. To avoid double counting of costs reported elsewhere in the Schedule, gross costs for other reportable items have been reduced by the total government payor mix percentage (55.20%) as reported on our internal payor mix report. CHMCA respectfully submits that its unreimbursed inpatient costs incurred in excess of the 1982 Tax Equity and Fiscal Responsibility Act(TEFRA) per discharge limit was $2,826,335, unreimbursed outpatient costs incurred in treating patients qualifying for Medicare End Stage Renal disease(ESRD), composite reimbursement was $233,292 unreimbursed costs of providing care to Medicare Advantage Plan enrollees was -$77,379 and unreimbursed costs for Tricare patients was $128,963, for a total of $3,112,211. The unreimbursed inpatient costs are costs incurred primarily in the treatment of burn victims who are Medicare enrollees. The unreimbursed ESRD costs are costs incurred in excess of the composite rate reimbursement applicable to patients who receive outpatient maintenance dialysis.
Part III, Line 9b - Collection Practices Explanation	CHMCA's policy applies to all patients - insured, underinsured and uninsured. The policy outlines the statement cycle, once a self-pay balance is reached, a Patient's eligibility for Financial Assistance may be identified any time during the revenue cycle. If a Patient has been determined to meet Financial Assistance Guidelines, free or discounted care, the account will not be transferred to a collection agency.
Part VI, Line 2 - Needs Assessment - Group A & B	LINE 2 - NEEDS ASSESSMENT - Describe how CHMCA assesses the health care needs of the communities it serves. Akron (#1); Beeghly (#2). In addition to our community health needs assessment conducted in 2016, CHMCA conducted a community health needs assessment in 2013 to assess the primary service areas surrounding our Akron hospital campus in collaboration with Cleveland Clinic - Akron General and Summa Health System. The CHNA process concluded in 2013 with the report being made available to the community through our organization's websites. Along with the CHNAs, the hospital performs strategic planning as an ongoing process with annual updates. As part of the annual update, we review population and demographic changes in our larger service area, focusing particularly on children and families. We give attention to the provision of health care services throughout our region, looking at our own and those provided by other health care organizations, using statewide data including all pediatric hospital discharges by zip code of patient residence. We also carefully track the demand for and supply of physicians, nurses and allied health providers evaluate the need for primary, secondary and tertiary services throughout our service area. In addition, we engage in multiple efforts to gauge the needs of our community through periodic surveys of the population, focusing on parental awareness and preference of pediatric health care services, and again estimating actual use of services from all providers. We are actively represented in dozens of community groups, and gather input from these groups both by active participation and by collecting and reviewing comprehensive data sets and studies produced by such groups, including school districts, health and human service agencies, as well as charitable and advocacy groups. We make an effort to listen to our staff, seeking and receiving feedback from our approximately 6600 staff and thousands of volunteers, who collectively provide a rich source of information regarding community needs and opportunities. Finally, we actively solicit input from our patients and their parents from our Parent Advisory Committee and gathering feedback through patient survey results and via multiple written and electronic (web-based) tools.
Part VI, Line 3-Patient Education of Eligibility for Assistance - A & B	CHMCA provides education to patients to inform them that they may qualify for care at no charge or at a reduced charge in a variety of ways: - CHMCA has signage at its registration sites to inform patients that they may qualify for free hospital care. Applications for free care are available at registration sites and throughout the hospital (Required by the Ohio Medicaid Hospital Care Assurance (HCAP) rules). - CHMCA has information regarding eligibility for free care on billing statements mailed to patients and their guarantors. - CHMCA employs financial counselors to explain the hospital's free care, charity care, and the various public assistance programs to uninsured and underinsured patients. - CHMCA's website provides patients with information relating to the hospital's free care, charity care and various public assistance programs available. - CHMCA contracts with an independent vendor to screen patients for public assistance eligibility and completion as well as submission of public assistance applications.
Part VI, Line 4 - Community Information - Group A	Note: The most recent demographic information was taken during 2017. Medina County - There are approximately 179,146 people living in Medina County, which is an increase of 1.1% since our last CHNA in 2016. It has 3 cities, 6 villages, and 17 townships in Medina County, with the largest being Brunswick and the county seat being the City of Medina. Compared to the State of Ohio, Medina County has a slightly larger proportion of children (under 18 years old) and older adults (65 years and older). In Medina county, 4.3% of the population is non-White, compared to 18.1% in the state. Educational attainment is higher than the State of Ohio, with 94% having a high school diploma or higher and 32.1% having a bachelor's degree or higher. Similarly, annual per capita income in Medina county is higher than the state average, and the percentage of Medina County residents living in poverty is less than half of that of the State, although Lodi meets Medically Underserved Population (MUP) designation criteria for low income residents. Portage County - There are approximately 162,927 people living in Portage County, which is an increase of .4% since our last CHNA in 2016. Portage County is comprised of 29 cities, villages, and townships in Portage County wirh the largest being the city of Kent and the county seat being Ravenna. Compared to the State of Ohio, Portage County has a smaller proportion of children(under 18 years old)and older adults (65 years or older). In Portage County, 9.1% of the population is non-White, compared to 18.1% in the State. Educational attainment is slightly higher in Portage County than in the State of Ohio, with 91.9% having a high school diploma or higher and 27.5% having a bachelor's degree or higher. Annual per capita income in Portage County is slightly higher than in the State of Ohio, but the percentage of Portage County residents living in poverty is only 2.2% lower than that of the State. East Kent City has a MUP(low income) designation. Richland County - There are approximately 121,099 people living in Richland County, which is a 0.5% decrease from 2016. There are 29 cities, villages, and townships in Richland County, with the largest being the city of Mansfield. Compared to the State of Ohio, Richland County has a smaller proportion of children (under 18 years old) and older adults (65 years and older). In Richland County, 12.9% of the population is non-White, compared to 18.1% in the State. The percentage of residents with a high school diploma or higher is lower in Richland County than in the State overall, as is the percentage of residents with a bachelor's degree or higher. Annual per capita income is lower and the percentage of residents living in poverty in Richland County is 0.6% lower than Ohio. The city of Mansfield has a MUP(low income) designation. Stark County - There are approximately 371,574 people living in Stark County, which is a 0.7% decrease from 2016. There are 36 cities, villages, and townships in Stark County, with the largest being the City of Canton. Compared to the State of Ohio, Stark County has a smaller proportion of children (under 18 years old) and a larger portion of older adults(65 years and older). In Stark County, 11.8% of the population is non-White, compared to 17.8% in the State. The percentage of residents with a high school diploma or higher is slightly higher in Stark County compared to the State but the percentage of residents with a bachelor's degree or higher is lower than the state. Annual per capita income and percentage of residents living in poverty in Stark County are lower than the state. Summit County - There are approximately 541,918 people living in Summit County, which is a unchanged from 2016. There are 31 cities, villages, and townships in Summit County, with the largest being the City of Akron. Compared to the State of Ohio, Summit County has a slightly smaller proportion of children (under 18 years old) and a slightly larger proportion of older adults (65 years and older). In Summit County, 21.6% of the population is non-White, compared to 18.1% in the state. Educational attainment is slightly higher in Summit County than in the state of Ohio, with 91.3% having a high school diploma or higher and 31.6% having a bachelor's degree or higher. Similarly, annual per capita income in Summit County is slightly higher than the State of Ohio and the percentage of Summit County residents living in poverty is 0.3% lower than that of the State. Two federally designated MUAs are present in Summit County; the Southeast Akron and Summit Service areas, Wayne County - There are approximately 115,967 people living in Wayne County, which is a decrease of .1% since 2016. There are 35 cities, villages, townships and unincorporated communities in Wayne County, with the largest being the City of Wooster. Compared to the State of Ohio, Wayne County has a higher proportion of children(under 18 years old) and older adults(65 years or older). In Wayne County, 4.8% of the population is non-White, compared to 18.1% in the State. Educational attainment is lower in Wayne County compared to the State of Ohio, with 85.8% having a high school diploma or higher and 21% having a bachelor's degree or higher. The annual per capita income in Wayne County is a lower than the State of Ohio, as is the percentage of Wayne County residents living in poverty. There are no federally designated MUA/Ps present in this community, although a large number of Amish residing in Wayne County are considered because they do not participate in traditional health insurance programs.
Part VI, Line 5 - Promotion of Community Health - Groups A & B	CHMCA intends that all of its activities either directly provide health care to all children who request our services or promote the health of the community, both by direct investments in the delivery of pediatric healthcare services and in providing specialized inpatient and outpatient care for patients of all ages throughout northeast Ohio. CHMCA was founded on the principle of serving the needs of the community. Within our doors, this means treating all children as if they were our own, turning no child or family away for any reason. CHMCA's governing Board of Directors is comprised of members of the community that makes up the hospital's primary service area. These community board members are neither employees nor independent contractors of the organization. CHMCA extends medical staff privileges to all qualified physicians in the communities we serve. CHMCA's excellent reputation is the result of the skills and experience of our medical staff and the health professionals with whom we collaborate; We value our partnership with primary care physicians and referring providers and work together to coordinate the care of the children. Our efforts include: 1. CHMCA's Paul and Carol David Foundation Burn Institute provides specialized inpatient and outpatient care for burn victims of all ages throughout northeast Ohio. CHMCA is one of only two pediatric hospitals in the country that treats adult burn patients. Each year the burn institute leads dozen of outreach and education activities on fire safety, in addition to burn survivorship support groups and camps. 2. The Rebecca D. Considine Research Institute is the hub for research activity. The institute facilitates sponsored clinical studies as well as internal investigator-initiated research programs across a spectrum of research subjects. The institute also offers research-oriented educational opportunities for fellows, students and faculty from around the globe. 3. Adult Congenital Heart Service provides ongoing monitoring and specialized care for adults with congenital heart disease(CHD). As children with CHD become adults, they can access lifetime care through our center. 4. The Cystic Fibrosis (CF) Center provides diagnosis and treatment to children and adults with CF, including respiratory therapy, physical therapy, genetic counseling and nutrition counseling. The center also actively participates in clinical trials to research new drug therapies to manage CF. 5. The Genetic Center offers diagnostic evaluation and medical management of genetic conditions, birth defects and developmental delays, as well as genetic testing and genetic counseling for pediatric and adult patients. 6. Our Maternal Fetal Treatment Center provides Genetic Counseling and Obstetric/delivery services to high risk pregnant women in the region. 7. We also make major investments of our funds and other resources in the provision of education for lay and professional persons, and in research that will improve health care for all children. We take an active role in advocating for improved health and improved access to health care for all. Services and activities provided by CHMCA benefit and/or promote health to the residents in the communities we serve. The primary benefit to our communities is providing health care for more than 1,000,000 children visits annually. In addition, we also provide community building activities as depicted in Part II of this schedule. 8. CHMCA's Neonatology department offers intensive care to sick and premature newborns. On any given day, there are 45 to 60 babies receiving care in CHMCA's neonatal intensive care unit (NICU). About 1/4 of these infants have been in utero for fewer than 32 weeks, 5 weeks less than what is considered necessary for full gestation. Some of them are as young as 24 weeks and weigh in at less than a kilogram. CHMCA's neonatal team is committed to providing the most effective and efficient care for our tiniest patients, as well as providing parents with the emotional and practical support they need. To this end, CHMCA is part of the Vermont Oxford Network, a collaboration of health professionals from 850 NICUs around the world who focus on research, education and projects that improve the quality and safety of medical care for newborns and their families. CHMCA's neonatal expertise expands beyond the Level III NICU at our Akron campus. We also own and operate newborn special care nurseries at Cleveland Clinic Akron General Medical Center and Summa's Akron City Hospital in Akron; CHMCA's Beeghly campus in Youngstown; Wooster Community Hospital, St. Elizabeth Hospital and St. Joe's Hospital. 9. A specially equipped ambulance and pediatric transport team handles the transfer of the newborns requiring the Level III neonatal intensive care provided at CHMCA in downtown Akron. 10. CHMCA is a level II pediatric trauma center, and participates in several research and quality performance efforts to better understand and address the needs of critically ill or injured patients. The Pediatric Intensive Care Unit (PICU) is an alpha site for the Virtual PICU Performance System, or VPS, a clinical quality collaborative aimed at standardizing data sharing for improved patient care among critical care units. 11. CHMCA's School Health Services supports the academic success of children through health promotion, education and child advocacy. School Health serves as a liaison among school staff, family, community and healthcare providers. CHMCA's pediatric registered nurses work closely with school staffs to ensure a comprehensive school health program is in place. With immediate access to pediatric healthcare professionals at CHMCA, schools are assured their program will effectively address the needs of their staff and students. Our School Health Services allows schools to focus on educating students, while we manage their district's medical needs. CHMCA employees have received through screening and background checks, reducing districts' liability. 12. CHMCA's Beeghly Campus, opened in December 2008 is the Mahoning Valley area's only Pediatric Hospital. This 43 bed pediatric hospital offers a full range of pediatric services to the children of the Mahoning Valley and surrounding areas. The hospital provides access to a 24/7 Emergency Department, Laboratory, Radiology, Outpatient Surgical Center, Endocrinology, Rehabilitation and EEG/Echo/EKG services, as well as a Hematology/Oncology Clinic, Infusion Center and Child Advocacy Center. Annually, the Beeghly campus sees the following patient encounters: 1,835 inpatient admissions, 34,493 emergency room visits, and 33,058 specialty visits. 13. Additionally, CHMCA brings pediatric primary care for babies, children and teens to many Northeast Ohio neighborhoods through our 27 Pediatrician Offices. Each office is staffed with experienced, Board Certified Pediatricians and experienced staff. 14. Also located in Mahoning Valley is the Community Outreach, Education & Support Center, which provides education and support for children and their families. These programs meet specified criteria of Nationally Accredited Disease Management Programs, as well as CHMCA's criteria and monitoring requirements. Our Community Health Outreach includes asthma and diabetes education and support, school programs, disease specific camps and support groups, fitness programs and education programs that touch more than 45,000 individuals annually. Parents and members of CHMCA's Family-Centered Care committee established The Parent Advisory Council (PAC) in 1995, as it still thrives today. It provides a way for parents and guardians to offer input on issues that impact the care of children. The council includes parents whose children have received care at CHMCA. Advisors will work with hospital liaisons to represent the voice of families as we work together to enhance the delivery of family-centered care. 15. CHMCA is a contracted care coordination agency of the Summit County Pathways Community HUB. Through this relationship, CHMCA and the HUB provide bidirectional referrals of women who are pregnant and up to one year postpartum, increasing their access to research such as prenatal care; food and housing assistance, adult education, tobacco cessation services, and others. Community health workers help to navigate these woman through the system, ensuring they receive the resources needed to provide a healthy environment for themselves and their children. 16. Our population health program work with patients on a "high risk" registry and provides case management and care coordination services to improve health outcomes and enhance patients' quality of life, These patients are generally income limited and medically complex, and often have a high no-show rate to their scheduled appointments and/or numerous hospitalizations and emergency department visits in a 12 month period. 17. CHMCA is a contracted care coordination agency of the Mahoning Valley Pathway
Part VI, Line 6 - Affiliated Health Care System - Groups A & B	N/A
Part VI, Line 7 - State Filing of community benefit report - Groups A & B	Ohio
Part VI Additional Information	In addition to the locations listed in Part V, Section A and C, CHMCA has physicians providing a variety of subspecialty services at many other locations throughout Northeast Ohio and Western Pennsylvania. Note: Census and other data reported in Section Part VI is the most recent information available.
Part VI, Line 4 - Community Information - Group B	CHMCA in the Mahoning Valley has and continues to serve patients and families from many communities across the region. Most people who receive services from the hospital are residents of Mahoning, Trumbull or Columbiana Counties. Prior to the opening of this facility, the Appalachian Regional Development Act of 2008 (S. 496) was signed into law. One of the components of this legislation was addition of Mahoning and Trumbull Counties to the Appalachian Region. Mahoning, Trumbull and Columbiana Counties represent most of the primary service area of the Beeghly Campus, and now, with this act becoming law, all three counties that make up the primary service area of this facility are located within the Appalachian Region. Trumbull, Mahoning, and Columbiana Counties are classified by the Appalachian Regional Commission as being transitional - they have worse economic rates than the national average for one or more of three economic indicators (three-year average unemployment, per capita market income, and poverty). However, they don't rate low enough to be classified as distressed. In addition, these counties have shortages of primary care health services by the Health Resources and Services Administration(HRSA) and their specific designation are indicated within the descriptions below. Trumbull County - There are approximately 199,627 people living in Trumbull County, which is a decrease of 2% since our last CHNA in 2016. There are 7 cities and 5 villages in Trumbull County, with the county seat being Warren. Compared to the State of Ohio, Trumbull County has a slightly smaller proportion of children(under 18 years old) and a larger proportion of older adults(65 years and older). In Trumbull County, 8.4% of the population is Black or African-American and 1.9% is Hispanic or Latino, compared to 13.1% and 3.9%, respectively, in the State of Ohio. Educational attainment in Trumbull County is lower than the State of Ohio, with 89% having a high school diploma or higher and 18.7% having a bachelor's degree or higher. Similarly, annual per capita income in Trumbull County is lower than the State of Ohio and the percentage of Trumbull County residents living in poverty is higher than that of the State. In addition, Trumbull Company is federally designated as a Medically Underserved Area(MUA). Mahoning County - There are approximately 229,642 people living in Mahoning County, which is a decrease of 1% since 2016. There are 7 cities and 7 villages in Mahoning County, with the largest being Youngstown. Compared to the state of Ohio, Mahoning county has a smaller proportion of children(under 18 years old) and a larger proportion of adults(65 years and older). 16% of the population is Black or African-American and 6.4% is Hispanic or Latino, compared to 13.1% and 3.9% respectively, in the State of Ohio. The percentage of Mahoning County residents with a high school diploma or higher is a bit higher than the State of Ohio, but the percentage with a bachelor's degree or higher is lower than the State. The annual per capita income in Mahoning County is lower than the state of Ohio and the percentage of Mahoning County residents living in poverty is higher than the State average. There are three federally designated MUAs within Mahoning County, both rural and non-rural. Columbiana County - There are approximately 102,665 people living in Columbiana County, which is a decrease of 1.7% since 2016. There are 3 cities, 11 villages and 18 townships in Columbiana County, with the largest being Salem. Compared to the State of Ohio, Columbiana county has a smaller proportion of children(under 18 years old) and a larger proportion of older adults(65 years and older), Approximately 2.4% of the population in Columbiana County is Black or African-American and is 1.7% Hispanic or Latino, compared to 12.9% and 3.8%, respectively, in the State of Ohio. The percentage of Columbiana County residents with a high school diploma or higher is lower than the State of Ohio and the percentage with a bachelor's degree or higher is nearly half the State average (13.9% versus 26.7%). The annual per capita income in Columbiana County is much lower than the State of Ohio and the percentage of Columbiana County residents living in poverty is higher than the State average.

Schedule H (Form 990) 2018

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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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Children's Hospital Medical Center of Akron

Employer identification number
34-0714357

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) AKRON CHILDREN'S HOSPITAL FOUNDATION ONE PERKINS SQUARE AKRON,OH44308	23-7114013	501(c)(3)	897,452	GENERAL SUPPORT
(2) GREATER AKRON CHAMBER 1 CASCADE PLAZA 17TH FLOOR AKRON,OH44308	34-1156576	501(c)(3)	50,000	GENERAL SUPPORT
(3) UNIVERSITY OF AKRON FOUNDATION DEPARTMENT OF DEVELOPMENT PO BOX 2203 AKRON,OH44325	34-6575496	501(c)(3)	5,800	NURSING EDUCATION
(4) UNITED WAY 37 N HIGH STREET AKRON,OH44308	34-1169257	501(C)(3)	50,000	GENERAL SUPPORT
(5) RAHAB MINISTRIES PO BOX 13866 FAIRLAWN,OH44334	20-3285531	501(C)(3)	10,000	GENERAL SUPPORT
(6) AKRON CHILDREN'S MUSEUM 216 S MAIN STREET AKRON,OH44308	46-3118462	501(C)(3)	10,000	GENERAL SUPPORT
(7) NATIONAL KIDNEY FOUNDATION 2831 PROSPECT AVENUE E CLEVELAND,OH44115	34-0827748	501(C)(3)	7,000	GENERAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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	CHMCA DONATES MONEY OCCASIONALLY TO PROGRAMS THROUGHOUT SUMMIT COUNTY THAT ARE ALSO 501(C)(3) ORGANIZATIONS. THE AMOUNTS DONATED TO THESE ORGANIZATIONS ARE MOSTLY IN SUPPORT OF MEDICAL AND NURSING EXCELLENCE IN THE COMMUNITY, ALONG WITH MEDICAL RESEARCH.

Schedule I (Form 990) 2018

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .........

Yes

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? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2018

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 on 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 in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1WILLIAM CONSIDINE CEO EMERITUS (11/1/2018)	(i) (ii)	1,462,211 ------------- 0	630,000 ------------- 0	486,691 ------------- 0	-79,719 ------------- 0	18,006 ------------- 0	2,517,189 ------------- 0	0 ------------- 0
2SHAWN LYDEN CHIEF STRATEGY OFFICER	(i) (ii)	628,579 ------------- 0	165,000 ------------- 0	3,447 ------------- 0	114,965 ------------- 0	23,328 ------------- 0	935,319 ------------- 0	0 ------------- 0
3MICHAEL TRAINER CHIEF FINAN OFFICER/TREASURER	(i) (ii)	513,241 ------------- 0	160,000 ------------- 0	6,706 ------------- 0	19,250 ------------- 0	9,191 ------------- 0	708,388 ------------- 0	0 ------------- 0
4GRACE WAKULCHIK PRESIDENT & CEO (11/1/2018)	(i) (ii)	808,619 ------------- 0	300,000 ------------- 0	11,096 ------------- 0	195,701 ------------- 0	9,035 ------------- 0	1,324,451 ------------- 0	0 ------------- 0
5JOHN CROW MD CHAIRMAN,PEDIATRIC SURGERY	(i) (ii)	1,059,484 ------------- 0	0 ------------- 0	3,612 ------------- 0	19,250 ------------- 0	17,371 ------------- 0	1,099,717 ------------- 0	0 ------------- 0
6NORMAN CHRISTOPHER MD CHAIRMAN, DEPT OF PEDS	(i) (ii)	427,407 ------------- 0	66,153 ------------- 0	6,246 ------------- 0	904 ------------- 0	24,856 ------------- 0	525,566 ------------- 0	0 ------------- 0
7ROBERT MCGREGOR MD CHIEF MEDICAL OFFICER	(i) (ii)	490,766 ------------- 0	138,000 ------------- 0	6,029 ------------- 0	91,325 ------------- 0	17,094 ------------- 0	743,214 ------------- 0	0 ------------- 0
8LISA AURILIO CHIEF OPERATING OFFICER	(i) (ii)	465,944 ------------- 0	120,000 ------------- 0	1,134 ------------- 0	67,368 ------------- 0	9,617 ------------- 0	664,063 ------------- 0	0 ------------- 0
9LAURA POLLAUF MD PRESIDENT OF MEDICAL STAFF	(i) (ii)	415,257 ------------- 0	10,000 ------------- 0	828 ------------- 0	-15,470 ------------- 0	23,185 ------------- 0	433,800 ------------- 0	0 ------------- 0
10CYNTHIA DORMO VP, DEPT OF PEDS	(i) (ii)	286,740 ------------- 0	62,400 ------------- 0	1,831 ------------- 0	643 ------------- 0	8,913 ------------- 0	360,527 ------------- 0	0 ------------- 0
11SHARON HRINA VP, MAHONING VALLEY ENTERPRISE	(i) (ii)	281,920 ------------- 0	56,942 ------------- 0	3,536 ------------- 0	9,829 ------------- 0	8,932 ------------- 0	361,159 ------------- 0	0 ------------- 0
12CRAIG MCGHEE CHIEF NON HOSP SRVCS OFFICER	(i) (ii)	255,040 ------------- 0	49,967 ------------- 0	1,692 ------------- 0	42,385 ------------- 0	14,073 ------------- 0	363,157 ------------- 0	0 ------------- 0
13ANTON MILO MD DIRECTOR OF ENT	(i) (ii)	1,339,977 ------------- 0	0 ------------- 0	7,482 ------------- 0	19,250 ------------- 0	24,212 ------------- 0	1,390,921 ------------- 0	0 ------------- 0
14ROBERT PARRY MD PEDIATRIC GENERAL SURGEON	(i) (ii)	948,486 ------------- 0	75,001 ------------- 0	11,484 ------------- 0	19,250 ------------- 0	23,816 ------------- 0	1,078,037 ------------- 0	0 ------------- 0
15TSULEE CHEN MD DIRECTOR OF NEUROLOGY	(i) (ii)	856,347 ------------- 0	105,005 ------------- 0	840 ------------- 0	13,750 ------------- 0	9,915 ------------- 0	985,857 ------------- 0	0 ------------- 0
16AVRAHAM SCHLAGER MD PEDIATRIC GENERAL SURGEON	(i) (ii)	855,306 ------------- 0	53,500 ------------- 0	2,045 ------------- 0	13,750 ------------- 0	9,909 ------------- 0	934,510 ------------- 0	0 ------------- 0
17SCOTT BOULANGER MD PEDIATRIC GENERAL SURGEON	(i) (ii)	814,513 ------------- 0	34,375 ------------- 0	6,298 ------------- 0	16,500 ------------- 0	9,627 ------------- 0	881,313 ------------- 0	0 ------------- 0
18LINDA GENTILE VP SUPP SVC & CONSTRUCTION	(i) (ii)	271,352 ------------- 0	62,976 ------------- 0	3,444 ------------- 0	-7,946 ------------- 0	17,268 ------------- 0	347,094 ------------- 0	0 ------------- 0
19LINDA HETSON VP PROFESSIONAL SERVICES	(i) (ii)	236,569 ------------- 0	47,526 ------------- 0	1,457 ------------- 0	140,120 ------------- 0	8,256 ------------- 0	433,928 ------------- 0	0 ------------- 0
20RHONDA LARIMORE CHIEF HUMAN RESOURCE OFFICER	(i) (ii)	195,332 ------------- 0	30,000 ------------- 0	2,941 ------------- 0	54,904 ------------- 0	13,752 ------------- 0	296,929 ------------- 0	0 ------------- 0
21BERNETT WILLIAMS INTERIM VP-HUMAN RESOURCES	(i) (ii)	262,915 ------------- 0	52,920 ------------- 0	649 ------------- 0	44,250 ------------- 0	14,244 ------------- 0	374,978 ------------- 0	0 ------------- 0
22HARUN RASHID CHIEF INFORMATION OFFICER	(i) (ii)	331,370 ------------- 0	66,783 ------------- 0	2,873 ------------- 0	67,500 ------------- 0	23,051 ------------- 0	491,577 ------------- 0	0 ------------- 0
23CHRISTINE YOUNG CHIEF NURSING OFFICER	(i) (ii)	270,450 ------------- 0	15,000 ------------- 0	629 ------------- 0	52,550 ------------- 0	14,208 ------------- 0	352,837 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

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 - Fringe or Expense Explanation	William Considine, CEO and Shawn Lyden, Executive VP, had a 2018 country club membership that was used by them for business purposes. William Considine also received grossed up payments for his automobile, life and other insurance payments made by CHMCA.
Part I, Line 4 - Severance, Nonqualified, and Equity Based Payments	William Considine is a participant in a Supplemental Executive Retirement Plan as of January 1, 2010. The Plan is a nonqualified deferred compensation plan. It is an unfunded plan maintained primarily for the purpose of providing deferred compensation benefits. The participant receives credits in the plan for each full calendar year of service and he is 100% vested. The non-qualified deferred payment to William Considine in 2018 was $406,000. The following individuals became participants in Supplemental Executive Retirement Plans during 2018, whereby they become vested per the terms of their employment agreement. CHMCA is accruing for the benefit that will occur, therefore these amounts are included in their deferred compensation. No distributions were made in 2018. Grace Wakulchik Shawn Lyden Robert McGregor, M.D. Lisa Aurilio Rhonda Larimore Craig McGhee Bernett Williams Harun Rashid Christine Young
Part I, Line 7 - Non Fixed Payments Provided	CHMCA does have contracts with certain physicians that earn bonuses based on Work Relative Value Units (WRVU's). Physicians work RVU: the relative level of time, skill, training and intensity to provide a given service. Each Current Procedural Terminology (CPT) code is targeted for review at least every five years to determine the work RVU for a particular service. A code with a higher RVU work takes more time, more intensity or some combination of the two.

Schedule J (Form 990) 2018

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Children's Hospital Medical Center of Akron

Employer identification number
34-0714357

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	AKRON BATH AND COPLEY JOINT TWSP HOSP DISTRICT	34-1448680	009730MY5	05-15-2012	102,559,004	Refund prior issue to construct ne		X		X		X
B	AKRON BATH AND COPLEY JOINT TWSP HOSP DISTRICT	34-1448680	009730NB4	05-05-2013	101,377,818	Construction of Critical Care Towe		X		X		X
C	AKRON BATH AND COPLEY JOINT TWSP HOSP DISTRICT	34-1448680	000000000	11-14-2013	27,405,000	Refund Prior Issue		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	80,432,291		0		0
2 Amount of bonds legally defeased ..............	0		0		0
3 Total proceeds of issue ..................	102,559,004		101,377,818		27,405,000
4 Gross proceeds in reserve funds .............	0		0		0
5 Capitalized interest from proceeds .............	1,010,250		10,229,217		280,035
6 Proceeds in refunding escrows ...............	0		0		0
7 Issuance costs from proceeds ...............	1,116,463		1,148,601		0
8 Credit enhancement from proceeds .............	0		0		0
9 Working capital expenditures from proceeds .............	0		0		0
10 Capital expenditures from proceeds .............	20,000,000		90,000,000		0
11 Other spent proceeds .............	80,432,291		0		27,124,965
12 Other unspent proceeds .............	0		0		0
13 Year of substantial completion .............	2013		2015		2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X	X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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) 2018

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		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?
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 ....	0 %		0 %		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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		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
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
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

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X
b Exception to rebate? ........		X		X		X
c No rebate due? .........	X		X			X
If "Yes" to 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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider ..........	0		0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2018

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
b Name of provider ..........	0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
PART 1(f)A	FROM THE $102,559,004 PROCEEDS, $80,432,921 WAS USED TO REFUND THE SERIES 2001 BONDS AND $20,000,000 WAS USED FOR CONSTRUCTION OF A NEW PARKING DECK ON THE AKRON CAMPUS CONTAINING APPROXIMATELY 1200 SPACES AND CONNECTED TO THE KAY JEWELERS PAVILION. THE DATE THE REBATE COMPUTATION WAS PERFORMED WAS 02/13/2017
PART 1(f)B	$101,377,818 WAS USED TO CONSTRUCT AN APPROXIMATELY 366,000 SQUARE FOOT KAY JEWELERS PAVILION ON THE AKRON CAMPUS. THE DATE THE REBATE COMPUTATION WAS PERFORMED WAS 03/13/2017
PART 1(f)C	$27,405,000 OF BOND PROCEEDS REFUNDED THE SERIES 2003 BONDS AND IS HELD BY KEY GOVERNMENT FINANCE, INC.

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting 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) 2018

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) CATHRYN O'MALLEY	FAMILY MEMBER OF WILLIAM CONSIDINE, CHIEF EXECUTIVE OFFICER EMERITUS	114,971	COMPENSATION		No
(2) LAURIE SCHUELER	FAMILY MEMBER OF DUANE ISHAM, BOARD DIRECTOR	52,609	COMPENSATION		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
SCHEDULE L, PART IV

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

Return Reference	Explanation
Form 990, Part III, Line 4d - All Other Accomplishments	Children's Hospital Medical Center of Akron ("CHMCA") operates one of the largest pediatric primary care networks in nine different counties including Summit, Columbiana, Cuyahoga, Mahoning, Medina, Stark, Wayne, Tuscawaras and Portage. The pediatricians and staff at Akron Children's Hospital Pediatrics ("ACHP") maintain cooperative relationships with many area health providers, including several hospitals. Patient care is available 24 hours a day through the physician office; Children's After Hours, a 24-hour nurse triage phone line; and CHMCA. By sharing information between our offices and with area health care providers, we ensure that all children receive the finest care - from preventative checkups to treatment for chronic health problems. ACHP visits were 465,698 and 450,633 for 2018 and 2017 respectively. The Surgical Services Department at CHMCA performs general and specialized surgical procedures each year, ranging from uncomplicated tonsillectomies to neurosurgery, open heart, orthopedic, and plastic and reconstructive surgery to children in the serving areas. Total surgical cases for 2018 and 2017 were 18,011 and 17,068 respectively. The entire staff at CHMCA, from pediatric surgeons to pediatric anesthesiologists and nurses are carefully trained in meeting the unique surgical needs and concerns of children and their families. The pediatric anesthesiologists are experienced at helping a child go to sleep with as little anesthesia as possible. They understand the medical differences between children and adults. Special equipment and techniques suited to the size of the patient, from infants to young adults, help assure successful outcomes to the surgery and anesthesia.
Form 990, Part VI, Line 6 - Classes of Members or Stockholders	The duly elected, qualified and acting Directors and the active members of the Women's Board of Akron Children's Hospital are members of the Corporation.
Form 990, Part VI, Line 7a - Election of Members and Their Rights	The number of the Directors of CHMCA shall be set by the members. Five of the members shall consist of the Women's Board of CHMCA. The President of the Medical Staff shall be a member of the Board of Directors. The remaining members of the Board of Directors shall be elected by the members of CHMCA. A director shall be elected for a three-year term, but a person may be nominated for and elected to a shorter term so that the terms of approximately one-third of the directors shall expire each year. Each director shall serve until his successor is elected and qualified. Upon unanimous resolution of the members, a person who has rendered long and outstanding service to the Hospital may be elected to a life term as a director. The director's responsibilities include: (1) to ensure the Hospital is meeting the community's health needs and is informed about the availability of the Hospital's services; (2) believe strongly in the Hospital's mission and serve as active public advocates for the Hospital; (3) establish goals and policies for the Hospital; (4) work with the Hospital President to develop and update long-range plans and provide for financial stability; (5) identify, recruit and select new Directors; (6) periodically evaluate the performance of Director Committees, individual Directors and Board of Directors performance as a whole; (7) select and evaluate the President and Chief Executive Officer; (8) approve Medical Staff appointments and privileges; (9) maintain authority for the overall functioning and support of a Hospital-wide quality assurance program; and (10) participate in and provide leadership for Hospital fund-raising programs. The Corporate powers, property, and affairs of CHMCA shall be exercised, conducted, and controlled by the Directors. The Directors shall elect the members of the Executive Committee of the Board.
Form 990, Part VI, Line 7b - Decisions Subject to Approval of Members	Subject to the direction and control of the Directors, or the Executive Committee of the Board, the management of the Hospital shall be vested in the President and Chief Executive Officer. The Chief Executive Officer shall, in all matters pertaining to Hospital administration, directly represent the Executive Committee of the Board of Directors and shall be responsible to them respectively for the proper performance of her duties. It shall be the duty of the Chief Executive Officer to make known and enforce all rules and regulations which shall be made by and under the authority of the Directors or the Executive Committee of the Board. In all cases of disputed authority, or uncertainty as to the meaning of these regulations, the decision of the Chief Executive Officer is absolute until a ruling is rendered by the Executive Committee of the Board of Directors.
Form 990, Part VI, Line 11b - Organization's Process to Review Form 990	The Form 990 is provided to the Audit Committee and Chairman of the Board of Directors of CHMCA for review and discussion prior to filing the return with the Internal Revenue Service. The Audit Committee is a Committee of the Board of Directors and empowered to complete the review on behalf of the Board of Directors.
Form 990, Part VI, Line 12c - Enforcement of Conflicts Policy	It is CHMCA's policy that all employees disclose real and apparent conflicts of interest as a condition of employment with CHMCA. CHMCA also requires that each employee disclose in writing, annually, to the President a list of all businesses or other organizations in which he/she is an officer, member, owner, shareholder, trustee or employee for which he/she acts as an agent or might reasonably in the future enter into a relationship or transaction in which the employee could have a duality of interest. If a situation arises in which there is a duality of interest, or a question of duality of interest, and, as such, potential for a conflict of interest, it is the primary responsibility of the individual directly involved and responsibility of other personnel, to the extent that they become aware of a duality of interest, to make immediate and complete disclosure to the appropriate Vice President. He/she will review the situation with the Human Resources Chief Officer who will present it to the President or his designee. It is the responsibility of the President or his designee to evaluate any circumstances in which a duality of interest exists, (if known, when disclosed or undisclosed), to determine whether such conflict is so substantial that it is deemed to be detrimental to CHMCA. Any employee who is directly or indirectly involved in a situation which represents a duality of interest, and as such, a potential conflict of interest, will abide by the following policies: (1) Individual will not be permitted access to any information which may provide an unfair advantage to that individual or the firm he/she represents. (2) Individual will be required to withdraw from any meeting in which the matter is discussed. (3) Individual will not be permitted to participate in deliberation or vote on the matter and will be required to leave the room during voting. (4) Any employee is expressly prohibited from releasing any "sensitive information" regarding a decision made or being considered to any person who may have a duality of interest, and as such, a potential conflict of interest. (5) Any attempt on the part of an employee to unfairly influence or impact the decision making process in favor of personal interest may be considered breach of trust and may be cause for removal from his/her position of responsibility or other disciplinary action up to and including discharge.
Form 990, Part VI, Line 15a-Compensation Process for Top Official	CHMCA's executive total compensation program is governed by the Compensation Committee (Committee) of the Board of Directors. Key Committee responsibilities include: (a) ensure executive total compensation is appropriate in light of CHMCA's mission and values, and (b) approve an executive compensation philosophy, the associated programs, and all compensation actions for individual executives. The Committee is comprised of independent members of CHMCA's Board who have no personal interest in any executive compensation transaction. Should a potential conflict of interest be identified, the Committee determines the extent of the conflict and the means to address it. In certain cases, a Committee member may be asked not to participate in discussions of, or vote on, a particular compensation transaction. The Committee follows all steps required by the Internal Revenue Service to qualify for the safe harbor under the Intermediate Sanctions regulations. The Committee reviews market compensation data for comparable positions at similar organizations which are compiled by an independent consultant. The Committee uses the data to make executive decisions and documents its compensation deliberations and decisions in a timely manner.
Form 990, Part VI, Line 15b - Compensation Process for Officers	An independent salary survey was completed in 2018 and recommendations were provided and presented by the independent consultant to the Committee for approval.
Form 990, Part VI, Line 19 - Governing Documents Disclosure Explanation	CHMCA MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, THE GOVERNING DOCUMENTS ARE LOCATED ON THE OHIO SECRETARY OF STATE'S WEBSITE. THE FINANCIAL STATEMENTS ARE ALSO DISCLOSED ON THE EMMA (ELECTRONIC MUNICIPAL MARKET ACCESS) WEBSITE.
Form 990, Part XI, Line 9 - Reconciliation of other changes in net assets	$ (736,696) Investment in Foundation 1,742,548 Adjustment - ASC - OPEB 30,416,422 Adjustment - ASC - Pension 569,267 Hemophilia Treatment Center Net Income -2,441,121 Equity Transfer to Children's Home Care 30,000,000 CDIC Dividend 7,335 Partnership Loss $ 59,557,755 Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Children's Hospital Medical Center of Akron

Employer identification number

34-0714357

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

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?
(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	Yes	No
(1)AKRON CHILDREN'S HOSPITAL FOUNDATION ONE PERKINS SQUARE AKRON,OH44308 23-7114013	FOUNDATION	OH	501(c)(3)	7	CHMCA	Yes
(2)CHILDREN'S HOME CARE GROUP ONE PERKINS SQUARE AKRON,OH44308 34-1575266	HOME CARE	OH	501(c)(3)	12a	CHMCA	Yes
(3)CHILD DIMENSIONS INSURANCE COMPANY ONE PERKINS SQUARE AKRON,OH44308 03-0317160	INSURANCE	OH	501(c)(3)	12a	CHMCA	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2018

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No

Schedule R (Form 990) 2018

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

Yes

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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) CHILDREN'S HOME CARE GROUP	O	4,908,426	ACTUAL PER GL
(2) CHILDREN'S HOME CARE GROUP	Q	2,834,407	ACTUAL PER GL
(3) AKRON CHILDREN'S HOSPITAL FOUNDATION	Q	1,526,400	ACTUAL PER GL
(4) AKRON CHILDREN'S HOSPITAL FOUNDATION	C	6,563,679	ACTUAL PER GL
(5) AKRON CHILDREN'S HOSPITAL FOUNDATION	O	2,864,863	ACTUAL PER GL
(6) AKRON CHILDREN'S HOSPITAL FOUNDATION	B	897,452	ACTUAL PER GL
(7) CHILDREN'S HOME CARE GROUP	N	203,783	ACTUAL PER GL
(8) CHILD DIMENSIONS INSURANCE COMPANY	F	30,000,000	ACTUAL PER GL

Schedule R (Form 990) 2018

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

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) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ("CHMCA") IS DEDICATED TO IMPROVING THE HEALTH OF CHILDREN THROUGH QUALITY PATIENT CARE, RESEARCH & EDUCATION, COMMUNITY SERVICE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	32
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	26
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	6,858
6	Total number of volunteers (estimate if necessary) .............	6	1,675
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,468,199
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	12,319,440	10,809,912
9	Program service revenue (Part VIII, line 2g) .........	838,464,229	874,069,009
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	15,691,094	17,119,112
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	7,007,403	7,277,609
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	873,482,166	909,275,642
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	761,755	1,035,252
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)	518,966,915	546,169,078
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	281,616,330	294,014,910
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	801,345,000	841,219,240
19	Revenue less expenses. Subtract line 18 from line 12.......	72,137,166	68,056,402
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,364,560,247	1,422,952,377
21	Total liabilities (Part X, line 26).............	543,276,398	500,227,013
22	Net assets or fund balances. Subtract line 21 from line 20.....	821,283,849	922,725,364

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 239,784,709 including grants of $ ) (Revenue $ 194,479,477 )
	Program Achievement #1 - Subspecialty Physicians In keeping with Chmca's Mission to provide quality medical and surgical care for infants, children, adolescents, and burn victims of all ages, CHMCA offers unique services in a broad range of pediatric subspecialties as described herein. Some of CHMCA's Subspecialty areas include: Heart Center, Neurosurgery, Sedation Service, Maternal Fetal Medicine, Care Center, Gastroenterology, Urology, Sports Medicine, Neurology, Nephrology, Endocrinology, Adolescent Medicine, Infectious Diseases, Hematology Services, Pulmonary Medicine, Palliative Care Program, locust Pediatrics, Rheumatology, Clinical Pharmacology and Toxicology, Psychiatric Services, Genetics, Dentistry, Orthopedics and Skeletal Dysplasia. The Showers Family Center for Childhood Cancer and Blood Disorders provides comprehensive care to children, teens and young adults with all types of childhood cancer, sickle cell disease, hemoglobinopathies and bleeding/clotting disorders, as well as those who require stem cell/bone marrow transplants. The team includes board-certified pediatric hematologists-oncologists, advance practice nurses, physician assistants, certified pediatric oncology nurses, pharmacists, social workers, clinical research associates, child life specialists, counselors and educators. As a major teaching institution, CHMCA offers fellowship training in pediatric hematology-oncology and is a major pediatric teaching hospital affiliated with Northeast Ohio Medical University. The division of hematology-oncology also actively participates in national clinical trials for childhood cancer and blood disorders, and continues to explore the causes and treatments of these diseases through our basic science research program. As a member of the Children's Oncology Group (COG), we participate in the development of National Cancer Institute-approved treatment protocols and offer the most up-to-date cancer therapies. CHMCA's Center for Diabetes and Endocrinology consists of a team of board-certified pediatric endocrinologists, certified nurse practitioners and pediatric nurses who diagnose and treat infants, children and teens. Recognized by the American Diabetes Association for Quality Self-Management Education, our center is backed by a full-service lab, registered dietitians, social worker, child psychologist and others. The most common endocrine disorders we treat are diabetes, short stature, thyroid disease, metabolism disorders and pubertal disorders. In addition, we offer specialized care in bone health, endocrine disorders in cancer survivors and cystic fibrosis patients. CHMCA's NeuroDevelopmental Science Center (NDC) brings together 5 pediatric specialties - developmental-behavioral pediatrics, neurology, neurosurgery, physiatry, and behavioral neuropsychology, under one roof to deliver the best outcomes and quality of life for patients. CHMCA's NDC is dedicated to easing the circumstances each step of the way, from referral to diagnosis to treatment. Our goal is provide care that enriches the quality of life for children and families affected by neurological and developmental disorders. CHMCA's Division of Orthopedics specializes in the diagnosis and surgical and/or non-surgical treatment of all types of bone, joint, muscle and spine disorders and injuries in children, teens and young adults. Our experienced pediatric orthopedic surgeons offer complete care for conditions affecting the musculoskeletal system, with the support of pediatric nurse practitioners, nurses and orthopedic technicians and includes: pediatric spine trauma and deformity, sports injury reconstruction, musculoskeletal neurology, congenital hand and musculoskeletal deformity, hip reconstruction, chest reconstruction, fragile bone evaluation and treatment, skeletal dysplasia, and brachial plexus treatment. CHMCA's Robert T. Stone Respiratory Center provides services for patients with all types of respiratory illnesses, including allergies, cystic fibrosis, bronchopulmonary dysplasia, and chronic respiratory failure. The Center has a team of doctors, nurse practitioners, nurse clinicians, pulmonary function technicians, dieticians, physical therapists and a social worker. We provide direct and consultative diagnosis and treatment, education, case management, and research. Our Center includes: cystic fibrosis center, which treats patients from birth through adulthood, asthma education program, pulmonary medicine, pulmonary function testing lab, sleep center, and cardiopulmonary exercise testing. CHMCA's Pediatric Urology department diagnoses and treats children and teens with problems related to the genito-urinary systems. Services include laser, laparoscopy, lithotripsy and other minimally invasive techniques to treat diseases. Our staff also uses urodynamic tests to show how well the bladder and sphincter muscles work and to help explain various urinary diseases. CHMCA operates 4 pediatric urgent care centers in our service area to treat children for minor illnesses and injuries. Total urgent care visits were 29,820 and 29,846 in 2018 and 2017, respectively.

4b	(Code: ) (Expenses $ 168,374,522 including grants of $ ) (Revenue $ 299,185,335 )
	Program Achievement #2 - Inpatient Services Total Inpatient Days 78,510 (2018) and 77,747 (2017) CHMCA's philosophy of care is centered around the families we serve. This means we respect each child and family's individual needs and strive to make the hospital experience as pleasant as possible. The routine care units, which consist of private rooms and accommodations for overnight stay by parents, are based upon the concept of family-centered care. The primary focus of the facility is to provide an environment conducive to pediatric patients, aiding their recovery in a modern hospital setting. Inpatient services include Routine Care, Neonatal Intensive Care Unit, Pediatric Intensive Care Unit, Psychiatric Care, Regional Burn Center, and Trauma Services. The 100 bed neonatal intensive care unit located in the new Key Jewelers Pavilion on the Akron campus opened in 2015. Our neonatologists provide the highest level of intensive care for our youngest patients. Our neonatal expertise expands beyond our NICU in the Kay Jewelers Pavilion. We also operate the NICU's at Cleveland Clinic Akron General, Summa Akron City Hospital and St. Elizabeth Boardman Hospital, as well as special care nurseries at our Beeghly campus location, St. Joseph Warren Hospital, and Wooster Community Hospital. CHMCA's neonatology division is ranked among the best in the nation, according to the U.S. News and World Report. A transport team from the NICU is also available at all times for transfer of patients by ambulance or helicopter from any one of the thirty-five (35) network hospitals in the area. Total NICU patient days: 2018 2017 Satellite facilities: Neonatal at Akron 22,415 21,603 Neonatal at CCAG 2,291 2,702 Neonatal at St. Elizabeth's 5,863 6,653 Neonatal at Summa 4,814 4,370 Neonatal at Beeghly 3,521 3,623 Neonatal at Wooster 556 586 Neonatal at St. Joseph 1,230 975 The Division of Pediatric Critical Care is responsible for overseeing and delivering care in the Pediatric Intensive Care Unit (PICU). Each year, the PICU cares for about 1,500 children and teens in Northeast Ohio with life-threatening medical and surgical problems. The 25,200 square foot pediatric intensive care unit includes 27 private rooms with pull-out sofas to encourage parents to stay overnight. Total patient days were 5,967 and 6,185 in 2018 and 2017, respectively. Since 1978, the Regional Burn Center has provided specialized care for burn victims of all ages throughout Northeastern Ohio. The Burn Center is verified by the American Burn Association and The Committee on Trauma of the American College of Surgeons, which recognizes individual and institutional commitment to total burn care and a formal system for quality burn care delivery. Each year, more than 250 burn victims are admitted to the Burn Center, which features 12 private patient rooms with bathrooms and accommodations for one parent or family member. The Burn Center also has a treatment room, physical therapy room, operating room and tub room. The Burn Center comprehensively treats seriously burned victims by combining the skills of physicians, nurses, occupational therapists, physical therapists, dieticians, social workers, respiratory therapists, psychologists and psychiatrists. Besides providing expert treatment, the center's staff is actively involved in burn research and burn care training for professional and community groups. Total patient days for the burn center were 2,623 and 2,091 for 2018 and 2017, respectively. The Division of Emergency/Trauma Services supplies the emergency care needs of children from birth to twenty-one (21) years of age. As the sole pediatric institution in the area, the Division of Emergency/Trauma Services is the designated treatment center for all emergent pediatric problems. Children from Akron and the surrounding counties in Northeast Ohio accounted for the majority of the 1,125,607 visits during 2018. A full-time attending pediatric emergency medicine specialist is on duty twenty-four (24) hours a day involved in the direct care of patients and teaching fellows, residents, and medical students. Rounding out the specialized medical care in the Emergency Department are child life specialists who are accustomed to explaining procedures to children and comforting parents; social workers trained to identify needs of families and point them to helpful services; and chaplains and bereavement staff who are always on call. CHMCA is verified as a pediatric trauma center by the American College of Surgeons. The pediatric trauma verification is based on its ability to provide quality trauma care to trauma patients and their families from the time of injury, through the acute care phase, into the rehabilitation phase.

4c	(Code: ) (Expenses $ 126,341,892 including grants of $ ) (Revenue $ 254,152,321 )
	Program Achievement #4 - Ancillary/Support Medical Services Some of the key departments of Ancillary/Support Medical Services include: Centralized Core Lab, Microbiology/Virology labs, Cytogenetics, Radiology Diagnostic Imaging, Radiology MRI, Radiology CT, Radiology Ultrasound, Radiology Nuclear Medicine, Physical Therapy, Speech Pathology, Audiology, Occupational Therapy. The Centralized Core Lab (CCL) includes the Chemistry, Hematology, Coagulation, Urinalysis, Special Chemistry and Blood Bank laboratories. The chemistry analyzers tests for more than 60 different substances found in blood, urine and cerebrospinal fluid specimens. In addition to routine chemistries, testing is performed for therapeutic and immunosuppressive drug monitoring. Instruments are selected to use the smallest amounts of blood for testing in order to minimize blood loss for our pediatric patients. In addition to the CCL, laboratory services are provided by the Infectious Disease Laboratories (Microbiology, Virology, Immunology, and Molecular Diagnostics). The Radiology Division at CHMCA performs a full spectrum of diagnostic imaging procedures inclusive of Diagnostic/Fluoroscopic xrays, CT, Nuclear Medicine, Ultrasound, and MRI. The Radiology division is staffed with licensed Diagnostic Imaging Technologists and all our Pediatric imaging procedures are read by qualified Pediatric Radiologists with Board Certification and Certificate of Added Qualification (CAQ) credentials inclusive of expertise in specific radiology subspecialty areas of imaging. CHMCA's physical and occupational therapists are devoted to providing quality care in the hospital and to outpatients, schools and community programs. Our staff of pediatric therapists can provide specialized treatment from birth to age 21. We are affiliated with universities for teaching of students. Incorporating the support of families and skills of various medical professionals, the Occupational Therapy, Physical Therapy, Speech, Audiology, and Social Services staff strive to provide patients with the skills needed to overcome a variety of developmental, physical, and emotional disabilities. The Family Child Learning Center (FCLC), a cooperative effort of CHMCA and Kent State University, offers a host of therapy and educational services to handicapped infants, preschoolers and their families. Therapists and educators work together to significantly enhance the development of these children at an early age. FCLC provides an educational training ground for graduate students in education, speech pathology, motor learning and physical and occupational therapy.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 139,513,698 including grants of $ 1,035,252 ) (Revenue $ 126,251,876 )
4e	Total program service expenses674,014,821

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	16,352,363	0	1,252,168

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	377,333
d	Related organizations		1d	6,563,679
e	Government grants (contributions)		1e	2,982,193

f	All other contributions, gifts, grants, and similar amounts not included above		1f	886,707

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		10,809,912

		Business Code
2a	SUBSPECIALTY PHYSICIANS	900099	194,479,477	194,479,477
b	INPATIENT SERVICES	900099	299,185,335	299,185,335
c	ANCILLARY	621500	254,152,321	254,152,321
d	OTHER NET PATIENT SERVICES	900099	105,017,478	105,017,478
e	OTHER DEPARTMENT REVENUE	900099	21,234,398	21,234,398
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		874,069,009

3 Investment income (including dividends, interest, and othersimilar amounts) ......			11,603,856			11,603,856
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,143,200	281,625,828
b	Less: cost or other basis and sales expenses	599,104	276,654,668
c	Gain or (loss)	544,096	4,971,160
d	Net gain or (loss).....			5,515,256			5,515,256
8a	Gross income from fundraising events (not including $ 377,333of contributions reported on line 1c). See Part IV, line 18 ....
	a		289,228
b	Less: direct expenses ...b		394,851
c	Net income or (loss) from fundraising events..			-105,623			-105,623
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA		722514	3,215,113			3,215,113
b	PARKING DECK		812930	1,299,034			1,299,034
c	OUTPATIENT PHARMACY		446110	577,962		577,962
d	All other revenue ....			2,291,123		890,237	1,400,886
e	Total. Add lines 11a–11d ......			7,383,232
12	Total revenue. See Instructions......			909,275,642	874,069,009	1,468,199	22,928,522

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,035,252	1,035,252
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0
4	Benefits paid to or for members	0
5	Compensation of current officers, directors, trustees, and key employees ....	12,333,891	2,059,083	10,274,808
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	167,580		167,580
7	Other salaries and wages	412,624,026	356,745,261	55,878,765
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	28,696,304	23,382,504	5,313,800
9	Other employee benefits .......	65,365,400	50,599,144	14,766,256
10	Payroll taxes ...........	26,981,877	22,766,280	4,215,597
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	919,397	2,266	917,131
c	Accounting ...........	448,107		448,107
d	Lobbying ...........	77,575	77,575
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	619,763		619,763
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	48,841,986	44,074,103	4,767,883
12	Advertising and promotion ....	8,919,181	118,100	8,801,081
13	Office expenses .......	11,517,198	8,971,201	2,545,997
14	Information technology ......	8,280,985		8,280,985
15	Royalties ..	0
16	Occupancy ...........	10,569,510	9,397,035	1,172,475
17	Travel ............	6,934,214	4,244,176	2,690,038
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	7,349,071	7,349,071
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	52,414,237	27,119,851	25,294,386
23	Insurance ...	8,675,066	4,040,063	4,635,003
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/SURGICAL SUPPLIES	81,243,346	80,810,753	432,593
b	EQUIPMENT RENTAL/MAINTENANCE	21,861,683	7,862,691	13,998,992
c	PROVISION FOR FRANCHISE FEE	13,870,285	13,870,285
d	PROVISION FOR HCAP	3,812,542	3,812,542
e	All other expenses	7,660,764	5,677,585	1,983,179
25	Total functional expenses. Add lines 1 through 24e	841,219,240	674,014,821	167,204,419	0
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			37,275	1	37,875
2	Savings and temporary cash investments .........			49,085,992	2	53,625,419
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			124,692,742	4	116,934,233
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 ....			5,092,893	7	9,330,230
8	Inventories for sale or use ........			7,485,531	8	7,739,550
9	Prepaid expenses and deferred charges ......			11,003,929	9	10,269,132
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,061,772,632
b	Less: accumulated depreciation	10b	568,491,102	444,281,785	10c	493,281,530
11	Investments—publicly traded securities .			584,611,735	11	593,251,516
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			3,038,140	13	4,911,891
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			135,230,225	15	133,571,001
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,364,560,247	16	1,422,952,377

17	Accounts payable and accrued expenses .....	121,275,632	17	113,005,202
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	207,308,621	20	202,337,504
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	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 ..	0	23	0
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	214,692,145	25	184,884,307
26	Total liabilities. Add lines 17 through 25..	543,276,398	26	500,227,013

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	741,544,152	27	842,128,087
28	Temporarily restricted net assets ...........	64,393,559	28	65,413,856
29	Permanently restricted net assets	15,346,138	29	15,183,421
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	821,283,849	33	922,725,364
34	Total liabilities and net assets/fund balances ........	1,364,560,247	34	1,422,952,377

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately 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; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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 separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No