TY 2022 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/1099-NEC)
(1) CHRISTOPHER GESSNER...................................................................... PRESIDENT & CEO	40.00 ................. 5.00	X	X	1,015,692	248,210
(2) ROBERT MCGREGOR MD...................................................................... DIRECTOR / CHIEF MEDICAL OFFICER	46.00 ................. 2.00	X	X	763,436	127,907
(3) SHEFALI MAHESH MD...................................................................... DEPARTMENT CHAIR OF PEDIATRICS	48.00 ................. 13.00	X		458,259	40,210
(4) VIRGINIA C ADDICOTT...................................................................... CHAIR OF BOARD OF DIRECTORS	19.00 ................. 1.00	X	X	0	0
(5) LISA M BANDWEN...................................................................... SECRETARY	14.00 ................. 0.00	X	X	0	0
(6) ROBERT C BERK...................................................................... DIRECTOR	7.00 ................. 0.00	X		0	0
(7) TIMOTHY M BURKE...................................................................... DIRECTOR/CHAIR FINANCE COMMITTEE	4.00 ................. 0.00	X		0	0
(8) PAUL N CATANIA...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(9) PATRICK M COVEY...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(10) VIRGINIA C DROSOS...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(11) PAUL M DUTTON...................................................................... DIRECTOR	3.00 ................. 1.00	X		0	0
(12) WILLIAM M HOPKINS...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(13) MONTRELLA S JACKSON...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(14) WILLIAM KELLEHER...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(15) JOAN LAUCK...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(16) KARA LEWIS...................................................................... DIRECTOR	1.00 ................. 0.00	X		0	0
(17) MICHELLE M LUECKE...................................................................... DIRECTOR	1.00 ................. 0.00	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/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) REV LEWIS MACKLIN........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(19) JOHN F MAYER........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(20) STEPHEN E MYERS........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(21) JOHN C ORR........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(22) RICHARD S ROGERS........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(23) MARGARET L STALTER........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(24) GLEN L STEPHENS........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(25) SHELLEY TAYLOR........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(26) BARBARA J VARLEY........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(27) ROBERT J WELLS........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(28) DARREN R WELLS........................................................................ DIRECTOR	1.00 .......................0.00	X					0	0	0
(29) MICHAEL FORBES MD........................................................................ INTERIM CHAIR OF PEDIATRICS	40.00 .......................0.00	X					453,289	0	-64,229
(30) MARK WULKAN MD........................................................................ CHAIR OF SURGERY	40.00 .......................0.00	X					1,038,618	0	43,357
(31) ALICIA LAMANCUSA........................................................................ TREASURER - PART YEAR	40.00 .......................5.00		X				615,367	0	-185,457
(32) ANTHEA DANIELS........................................................................ ASST SEC /CHIEF LEGAL OFFICER	46.00 .......................5.00		X				558,764	0	103,678
(33) GORDON EDWARDS........................................................................ CFO AND TREASURER - PART YEAR	50.00 .......................0.00		X				220,119	0	6,508
(34) LISA AURILIO........................................................................ CHIEF OPERATING OFFICER	46.00 .......................1.00			X			1,082,363	0	-51,106
(35) CHRSTINE YOUNG........................................................................ CHIEF NURSING OFFICER	50.00 .......................0.00			X			667,324	0	112,125
(36) SHAWN LYDEN........................................................................ CHIEF STRATEGY OFFICER	48.00 .......................3.00			X			849,365	0	141,590
(37) HARUN RASHID........................................................................ CHIEF INFORMATION OFFICER	50.00 .......................0.00			X			563,826	0	125,555
(38) MICHAEL BIGHAM MD........................................................................ CHIEF QUALITY OFFICER	50.00 .......................1.00			X			567,078	0	128,221
(39) RHONDA LARIMORE........................................................................ CHIEF HUMAN RESOURCES OFFICER	50.00 .......................0.00			X			478,159	0	120,039
(40) MICHELE BROWN........................................................................ CHIEF DEVELOPMENT OFFICER	2.00 .......................50.00			X			0	418,106	74,419
(41) CRAIG MCGHEE........................................................................ CHIEF NON HOSPITAL SVS OFFICER	50.00 .......................0.00			X			381,991	0	18,693
(42) KRISTENE GRAYEM........................................................................ CHIEF POPULATION HEALTH OFFICER	48.00 .......................20.00			X			384,136	0	-219,347
(43) BERNETT WILLIAMS........................................................................ CHIEF DIVERSITY, EQUITY, INCLUSION OFFICER	50.00 .......................0.00			X			345,886	0	82,795
(44) KATHERINE WOLFE MD........................................................................ CHIEF MATERIAL FETAL MED SVS	50.00 .......................0.00				X		1,054,012	0	50,417
(45) ROBERT STEWART MD........................................................................ DIRECTOR CARDIOTHORACIC SURGERY	50.00 .......................0.00				X		1,015,668	0	54,022
(46) ABDELAZIZ SALEH MD........................................................................ PERINATOLOGIST	50.00 .......................0.00				X		1,016,433	0	49,986
(47) TSULEE CHEN MD........................................................................ NEUROSURGEON	48.00 .......................1.00				X		979,453	0	38,870
(48) JODI REGAN MD........................................................................ PERINATOLOGIST	50.00 .......................0.00				X		971,088	0	0
(49) GRACE WAKULCHIK........................................................................ FORMER PRESIDENT	48.00 .......................2.00					X	1,883,276	0	0
(50) WILLIAM CONSIDINE........................................................................ CEO EMERITUS	48.00 .......................3.00					X	72,856	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
QUALIVIS LLC 5930 CORNERSTONE COURT WEST SUITE SAN DIEGO,CA92121	CLINICAL TEMP SVCS	13,341,980
MCKESSON PLASMA & BIOLOGICSLLC 2615 MEDICAL CENTER PARKWAY SUITE MURFREESBORO,TN37129	MEDICAL SERVICES	12,447,800
MARCUS THOMAS LLC 4781 RICHMOND ROAD CLEVELAND,OH44128	BROADCAST MEDIA	6,429,473
PEDIATRIC & ADOLESCENT UROLOGY 215 W BOWERY STREET SUITE 3500 AKRON,OH44308	MEDICAL SERVICES	3,961,926
SUMMIT CONSTRUCTION CO LLC 1095 HOME AVENUE AKRON,OH44310	CONSTRUCTION SVCS	2,653,256
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 61

- TIN:

SCHEDULE A
(Form 990)

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 instructions and the latest information.

OMB No. 1545-0047

2022

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).)

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 33 1/3% 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 33 1/3% 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 on 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) 2022

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 5 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 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 on 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 5 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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2022

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2022

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 0.015 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 0.035	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) 2022

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2022 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2022

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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON

Part I Contributors	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) (2022)

Schedule B (Form 990) (2022)

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) (2022)

Schedule B (Form 990) (2022)

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) (2022)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

2021

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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) 2021

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|No

(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? ..........................................................

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

196,713

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

196,713

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 $196,713 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 * PARTICIPATED IN MEETINGS WITH LEGISLATORS AND CONGRESSIONAL STAFF TO PROVIDE ORGANIZATIONAL UPDATES AND DISCUSS LEGISLATIVE INITIATIVES * COMMUNICATED WITH MEMBERS REQUESTING SUPPORT FOR CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION (CHGME) THE FOLLOWING ARE 2022 LOBBYING EXPENSES: $18,500 NATIONAL ASSOCIATION OF CHILDREN' S HOSPITALS $42,925 AMERICAN HOSPITAL ASSOCIATION $68,432 OHIO CHILDREN'S HOSPITAL ASSOCIATION $6,806 OHIO HOSPITAL ASSOCIATION $60,050 LOBBYIST CAPITAL CONSULTING GROUP $196,713 TOTAL CHILDREN'S HOSPITALS ASSOCIATION (CHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA) ARE NATIONAL ORGANIZATIONS TO WHICH CHMCA IS A MEMBER 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 AND THE DELIVERY OF HEALTH CARE TO CHILDREN AND OTHER PATIENTS. AS AN EXAMPLE, CHA AND AHA HAVE BEEN A CONSTANT AND PERSUASIVE VOICE IN CHAMPIONING THE NEEDS OF CHILDREN AND THE HOSPITALS THAT CARE FOR THEM. THE OHIO CHILDREN'S HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION ARE STATE OF OHIO ORGANIZATIONS THAT PROMOTE THE VIEWS OF OHIO CHILDREN'S HOSPITALS FOR MEDICAID AND CHILD HEALTHCARE ISSUES. LOCAL AGENCIES IN SUMMIT COUNTY, OHIO, ALSO PROVIDE SERVICES TO RESIDENTS. THE IMPACT OF HEALTHCARE LEGISLATION HAS IMPLICATIONS ON OUR BUSINESS, OUR PATIENTS AND FAMILIES, AND THE SERVICES THAT WE PROVIDE.

Return Reference

Explanation

PART II-B, LINE 1:

CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ("CHMCA") PAID A TOTAL OF $196,713 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 * PARTICIPATED IN MEETINGS WITH LEGISLATORS AND CONGRESSIONAL STAFF TO PROVIDE ORGANIZATIONAL UPDATES AND DISCUSS LEGISLATIVE INITIATIVES * COMMUNICATED WITH MEMBERS REQUESTING SUPPORT FOR CHILDREN'S HOSPITAL GRADUATE MEDICAL EDUCATION (CHGME) THE FOLLOWING ARE 2022 LOBBYING EXPENSES: $18,500 NATIONAL ASSOCIATION OF CHILDREN' S HOSPITALS $42,925 AMERICAN HOSPITAL ASSOCIATION $68,432 OHIO CHILDREN'S HOSPITAL ASSOCIATION $6,806 OHIO HOSPITAL ASSOCIATION $60,050 LOBBYIST CAPITAL CONSULTING GROUP $196,713 TOTAL CHILDREN'S HOSPITALS ASSOCIATION (CHA) AND AMERICAN HOSPITAL ASSOCIATION (AHA) ARE NATIONAL ORGANIZATIONS TO WHICH CHMCA IS A MEMBER 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 AND THE DELIVERY OF HEALTH CARE TO CHILDREN AND OTHER PATIENTS. AS AN EXAMPLE, CHA AND AHA HAVE BEEN A CONSTANT AND PERSUASIVE VOICE IN CHAMPIONING THE NEEDS OF CHILDREN AND THE HOSPITALS THAT CARE FOR THEM. THE OHIO CHILDREN'S HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION ARE STATE OF OHIO ORGANIZATIONS THAT PROMOTE THE VIEWS OF OHIO CHILDREN'S HOSPITALS FOR MEDICAID AND CHILD HEALTHCARE ISSUES. LOCAL AGENCIES IN SUMMIT COUNTY, OHIO, ALSO PROVIDE SERVICES TO RESIDENTS. THE IMPACT OF HEALTHCARE LEGISLATION HAS IMPLICATIONS ON OUR BUSINESS, OUR PATIENTS AND FAMILIES, AND THE SERVICES THAT WE PROVIDE.

Schedule C (Form 990) 2021

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 instructions and the latest information.

OMB No. 1545-0047

2021

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 FASB 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 FASB 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 FASB 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) 2021

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 ....	38,005,847	30,205,732	24,391,406	19,888,825	20,908,929
b	Contributions ...	19,682,558	4,390,474	1,246,737	851,929	1,312,133
c	Net investment earnings, gains, and losses	-4,520,397	1,918,829	3,213,212	3,133,097	-2,263,920
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...				291,024	557,496
f	Administrative expenses ....	823,639	-1,490,812	-1,354,377	-808,577	-489,179
g	End of year balance ......	52,344,369	38,005,847	30,205,732	24,391,404	19,888,825

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

Board designated or quasi-endowment SchDMd Bullet

19.166 %

Permanent endowment SchDMd Bullet

10.669 %

Term endowment SchDMd Bullet

70.165 %

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 .....	18,006,491		18,006,491
b	Buildings ....	866,426,547	415,215,383	451,211,164
c	Leasehold improvements	57,353,788	21,572,461	35,781,327
d	Equipment ....	466,134,643	384,720,714	81,413,929
e	Other .....	32,776,971	4,843,582	27,933,389
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				614,346,300

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other 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

Investments - Program 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				189,203,224
(2)UNAMORT HEALTHCARE SERVICE				36,963,233
(3)HTC TRANASFER FROM UNRESTRICTED				8,795,191
(4)OTHER ASSETS				1,932,223
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				236,893,871

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	134,678,662
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) 2021

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:

ENDOWMENT FUNDS RELATING TO AKRON CHILDREN'S HOSPITAL FOUNDATION AND CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ARE RELATED TO BOARD DESIGNATED FUNDS WHICH INCLUDE FUNDS WITHOUT DONOR RESTRICTION THAT HAVE BEEN INTERNALLY DESIGNATED BY THE BOARD OF DIRECTORS TO FUNCTION AS ENDOWMENTS. THESE FUNDS ARE TO BE USED FOR THE SOLE PURPOSE FOR WHICH THEY WERE DESIGNED. CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON DOES HAVE A POLICY IN PLACE TO MONITOR WITHOUT DONOR RESTRICTION AND WITH DONOR RESTRICTION FUNDS.

PART X, LINE 2:

CHMCA PREPARES CONSOLIDATED FINANCIAL STATEMENTS INCLUDING ITS AFFILIATED SUBSIDIARIES. CHMCA ADOPTED ACCOUNTING STANDARDS CODIFICATION 740 (ASC 740) IN 2007 WHICH REQUIRES BUSINESSES TO ANALYZE AND DISCLOSE INCOME TAX 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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

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

2022

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 10 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) 2022

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 HOLIDAY TREE FESTIVAL (event type)	(b) Event #2 CHARITY BALL (event type)	(c) Other events 7 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	480,895	128,775	294,282	903,952
2	Less: Contributions . . . .	360,671	96,581	220,711	677,963
3	Gross income (line 1 minus line 2) . . . . . .	120,224	32,194	73,571	225,989

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	534,639	382,999	138,614	1,056,252
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				1,056,252
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-830,263

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) 2022

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) 2022

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 20a.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

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? . . . . . .

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) . . .	2,668,091		2,668,091	0.240 %
b	Medicaid (from Worksheet 3, column a) . . . . .	610,099,341	428,931,655	181,167,686	16.270 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	1,844,604	1,412,712	431,892	0.040 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	614,612,036	430,344,367	184,267,669	16.550 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	17,219,276	9,342,263	7,877,013	0.710 %
f	Health professions education (from Worksheet 5) . . .	25,482,369	16,719,921	8,762,448	0.790 %
g	Subsidized health services (from Worksheet 6) . . . .	16,467,646	12,746,365	3,721,281	0.330 %
h	Research (from Worksheet 7) .	9,752,197	1,562,744	8,189,453	0.740 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	69,984		69,984	0.010 %
j	Total. Other Benefits . .	68,991,472	40,371,293	28,620,179	2.580 %
k	Total. Add lines 7d and 7j .	683,603,508	470,715,660	212,887,848	19.130 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1,152	1,152	0 %
3	Community support	12,637	12,637	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	3,709	3,709	0 %
7	Community health improvement advocacy	506,509	506,509	0.050 %
8	Workforce development	53,446	53,446	0 %
9	Other
10	Total	577,453	577,453	0.050 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

12,084,177

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).....

9,610,830

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

13,323,345

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

-3,712,515

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) 2022

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?1Name, 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)
1	CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON ONE PERKINS SQUARE AKRON,OH44308 WWW.AKRONCHILDRENS.ORG	X	X	X	X

Schedule H (Form 990) 2022

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)

	CHILDREN'S HOSPITAL MEDICAL CENTER OF AK
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 22

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

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): HTTPS://TINYURL.COM/BPXZBUM3

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 20

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

Yes

If "Yes" (list url): HTTPS://TINYURL.COM/BPXZBUM3

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	CHILDREN'S HOSPITAL MEDICAL CENTER OF AK
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 200.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

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):

HTTPS://TINYURL.COM/3H4VDXEP

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

HTTPS://TINYURL.COM/3H4VDXEP

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://TINYURL.COM/3H4VDXEP

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) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	CHILDREN'S HOSPITAL MEDICAL CENTER OF AK
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 (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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) 2022

Page 7

Part VFacility Information (continued)

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

	CHILDREN'S HOSPITAL MEDICAL CENTER OF AK
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) 2022

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, 20a, 20b, 20c, 20d, 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
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON	PART V, SECTION B, LINE 5: IN ADDITION TO EXAMINING COUNTY-LEVEL EPIDEMIOLOGIC DATA, SEVERAL METHODS WERE USED TO GATHER DATA FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF A TWELVE-COUNTY AREA. DUE TO THE COVID-19 PANDEMIC, CHNA METHODOLOGY PLACED AN EMPHASIS ON THE USE OF TECHNOLOGY TO ENGAGE COMMUNITY MEMBERS. AFTER COLLECTING THE FIRST ROUND OF PARENT AND CAREGIVER SURVEY RESPONSES IN DECEMBER 2021 DURING SCHOOL-BASED VACCINE CLINICS, CHMCA TOOK THE SURVEY ONLINE, LEVERAGING DIRECT EMAIL COMMUNICATIONS TO PATIENT FAMILIES AND COMMUNITY PARTNERS TO SHARE THE LINK WITH THEIR CLIENTS. THE 810 RESPONDENTS FROM THE REGION WERE MOSTLY WOMEN, WITH ALMOST THREE-QUARTERS BETWEEN THE AGES OF 24 AND 44. OVER 11 PERCENT WERE BLACK, WHICH IS A LARGER SHARE THAN THE POPULATION OF THE REGION. ABOUT 2.5 PERCENT WERE HISPANIC OR LATINX. THE MAJORITY OF SURVEY RESPONSES WERE FROM TWO-PARENT HOUSEHOLDS WITH INCOMES GREATER THAN $55,000 PER YEAR. TO GATHER INPUT FROM FAMILIES WHO ARE CONSIDERED VULNERABLE, THE CHNA TEAM LEVERAGED A PARTNERSHIP WITH THE AKRON CANTON REGIONAL FOODBANK TO ATTEND TWO POP-UP FOOD DISTRIBUTION EVENTS, SURVEYING ATTENDEES IN LINE FOR THEIR FOOD. ALTHOUGH RESPONSES WERE COLLECTED ON PAPER, THIS FORMAT GAVE THE CHNA TEAM AN OPPORTUNITY TO HEAR FROM COMMUNITY MEMBERS DIRECTLY. THOSE WHO PARTICIPATED RECEIVED A SMALL CASH INCENTIVE. IN ADDITION, CHNA TEAM MEMBERS SPENT TIME IN TWO MAHONING COUNTY WIC OFFICES AND OFFERED CLIENTS A SMALL INCENTIVE FOR PARTICIPATING IN A BRIEF INTERVIEW. DURING THE ASSESSMENT PERIOD, MOST AGENCIES INCLUDING CHMCA CONTINUED TO FOLLOW COVID-19 PROTOCOLS AND WERE CONSERVATIVE IN PERMITTING IN-PERSON GATHERINGS. CONDUCTING VIRTUAL ROUNDTABLE DISCUSSIONS WITH STAKEHOLDERS ENABLED US TO GATHER INPUT FROM A WIDE RANGE OF INDIVIDUALS WHO REPRESENT MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS AND THE BROAD INTERESTS OF CHILDREN IN THE REGION. PARTICIPANTS FROM ANY OF THE COUNTIES REPRESENTED IN OUR CHNA FOOTPRINT COULD LOG ONTO ONE OF THE FIVE SESSIONS OFFERED. DISCUSSIONS WERE CENTERED AROUND THE SIGNIFICANT HEALTH, SOCIAL AND ENVIRONMENTAL FACTORS AFFECTING CHILDREN IN THEIR COMMUNITIES, PARTICULARLY AS THEY NAVIGATED PANDEMIC LIFE AND ITS AFTERMATH. ONE VIRTUAL ROUNDTABLE WAS RESERVED FOR PUBLIC HEALTH COMMISSIONERS AND/OR THEIR DESIGNEES. PARTICIPATING HEALTH DISTRICTS FROM THE REGION INCLUDED SUMMIT, ASHLAND, RICHLAND, WAYNE, MAHONING, AND TRUMBULL COUNTIES, AS WELL AS THE CITY OF YOUNGSTOWN. A FULL LISTING OF PARTICIPATING AGENCIES THAT SERVE THE REGION IS BELOW: AETNA AKRON COMMUNITY FOUNDATION AKRON PUBLIC SCHOOLS AKRON-SUMMIT COUNTY PUBLIC LIBRARY ALTA CARE GROUP, INC.AMERIHEALTH CARITASASHLAND COUNTY HEALTH DEPARTMENT BELMONT PINES HOSPITALBRIGHT BEGINNINGS CHILD GUIDANCE AND FAMILY SOLUTIONS CITY OF AKRON COLEMAN HEALTH SERVICES COMMUNITY ACTION WAYNE/MEDINA COMMUNITY FOUNDATION OF LORAIN COUNTY COMMUNITY LEGAL AID DALTON LOCAL SCHOOL DISTRICT EARLY CHILDHOOD RESOURCE CENTER FATHERS AND SONS OF NORTHEAST OHIO, INC. FEEDING MEDINA COUNTY GREENLEAF FAMILY CENTER HOPE AND HEALING BATTERED WOMEN'S SHELTER KIDSPEAK, LLCMAHONING COUNTY BOARD OF DEVELOPMENTAL DISABILITIESMAHONING COUNTY JUVENILE COURTMAHONING COUNTY MENTAL HEALTH AND RECOVERY BOARDMAHONING COUNTY PUBLIC HEALTHMAHONING COUNTY WOMEN, INFANTS AND CHILDREN (WIC) MAHONING YOUNGSTOWN COMMUNITY ACTION PROGRAM (MYCAP)MENTAL HEALTH & RECOVERY BOARD OF ASHLAND COUNTY MENTAL HEALTH AND RECOVERY BOARD OF WAYNE AND HOLMES COUNTIES MERCY HEALTH NEIL KENNEDY RECOVERY CENTER OBERLINKIDS COMMUNITY COLLABORATIVE OHIOGUIDESTONE OHUDDLE PORTAGE COUNTY JOB AND FAMILY SERVICES RICHLAND COUNTY MENTAL HEALTH AND RECOVERY SERVICES BOARD RICHLAND PUBLIC HEALTH SAFE LANDING YOUTH SHELTER SUMMIT COALITION FOR COMMUNITY HEALTH IMPROVEMENT SUMMIT COUNTY ADM BOARD SUMMIT COUNTY CHILDREN SERVICES SUMMIT COUNTY CONTINUUM OF CARE SUMMIT COUNTY PUBLIC HEALTH THE CHILDREN'S CENTER OF MEDINA COUNTY THE COUNSELING CENTER OF COLUMBIANA COUNTYTRUMBULL COUNTY HEALTH DEPARTMENT TRUMBULL NEIGHBORHOOD PARTNERSHIP TRUMBULL COUNTY EDUCATIONAL SERVICE CENTER TRUMBULL COUNTY HEALTH DEPARTMENT UNITED WAY OF GREATER STARK COUNTY UNITED WAY OF SUMMIT & MEDINA UNITED HEALTHCARE WARREN CITY SCHOOLSWAYNE COUNTY HEALTH DEPARTMENT YOUNGSTOWN AREA PFLAG (PARENTS, FAMILIES AND FRIENDS OF LESBIANS AND GAYS) YOUNGSTOWN CITY HEALTH DISTRICT YOUNGSTOWN NEIGHBORHOOD DEVELOPMENT CORPORATION FINALLY, THE CHNA TEAM MADE OTHER EFFORTS TO CONNECT WITH PARENTS AND PROFESSIONALS WHO WORK ON BEHALF OF CHILDREN AND FAMILIES. WE PARTNERED WITH AKRON METROPOLITAN HOUSING AUTHORITY AND RICHLAND PUBLIC HEALTH TO IDENTIFY CLIENTS WILLING TO PROVIDE INPUT. ADDITIONALLY, WE HELD A VIRTUAL CONVERSATION WITH FAMILY SUPPORT SPECIALISTS WORKING IN STARK COUNTY SCHOOLS, AND WERE FORTUNATE BE PART OF A VIRTUAL CONVERSATION WITH COMMUNITY HEALTH WORKERS FROM THE SUMMIT COUNTY PATHWAYS COMMUNITY HUB, HOSTED BY SUMMIT COUNTY PUBLIC HEALTH.
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON	PART V, SECTION B, LINE 6B: THE CENTER FOR COMMUNITY SOLUTIONS: 1501 EUCLID AVE #310, CLEVELAND, OH 44115
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON	PART V, SECTION B, LINE 11: THE MEASURED INDICATORS IN THE 2022 CHNA HAVE BEEN ADDRESSED FOR MANY YEARS THROUGH CHMCA'S CLINICAL AND PROGRAMMATIC EFFORTS. THE 2022 CHNA IDENTIFIED AND PRIORITIZED SEVERAL COMMUNITY HEALTH NEEDS. OUR BOARD OF DIRECTORS APPROVED COMPREHENSIVE IMPLEMENTATION STRATEGIES AROUND MENTAL AND BEHAVIORAL HEALTH, AS WELL AS COMMUNITY-BASED HEALTH AND WELLNESS WITH A FOCUS ON FOOD SECURITY, DISPARITIES IN PREVENTIVE CARE, AND SCHOOL-BASED HEALTH. UNDERPINNING THESE BROAD PRIORITY AREAS ARE CROSS-CUTTING COMMITMENTS TO ADVANCING HEALTH EQUITY, IMPROVING HEALTH ACCESS, AND FOSTERING RESILIENCY. THE REMAINING IDENTIFIED NEEDS FROM THE CHNA, INCLUDING CONDITIONS RELATED TO CHILD LIFESTYLE FACTORS, ASTHMA, MATERNAL AND INFANT HEALTH, CRIME AND VIOLENCE, ACCESS TO HEALTH CARE AND ENVIRONMENTAL FACTORS, WERE NOT FORMALLY SELECTED AS PRIORITIES, BUT WILL BE ADDRESSED AS RELEVANT THROUGH STRATEGIES ASSOCIATED WITH THE THREE PRIORITIES NAMED ABOVE. WE WILL CONTINUE TO LOOK TO 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 COMMUNITY HEALTH NEEDS IDENTIFIED BY THE CHNA ARE IMPORTANT, HOSPITAL TEAMS DELIBERATED AND PRIORITIZED 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 ISSUES WERE BEYOND THE SCOPE OF THE HOSPITAL, WITH SOME REQUIRING MORE RESOURCES THAN WHAT CHMCA COULD REALISTICALLY DEVOTE TO THEM. ASTHMA WAS NOT SELECTED IN THE PRIORITIZATION PROCESS. STAFF WORKING ON THIS PRIORITY OVER THE LAST DECADE HAVE BEEN EXTREMELY SUCCESSFUL AT IDENTIFYING HIGH RISK ASTHMA PATIENTS AND PROVIDING THEM WITH EDUCATION AND SUPPORTS TO REDUCE THEIR RISK OF EXACERBATIONS LEADING TO EMERGENCY DEPARTMENT VISITS AND HOSPITALIZATIONS. WHILE ASTHMA CONTINUES TO BE A NEED IN OUR COMMUNITY, LEADERS WHO AIDED IN CHNA PRIORITIZATION DETERMINED RESOURCES SHOULD BE SHIFTED TO MAKE IMPROVEMENTS IN OTHER AREAS, AND ASTHMA SHOULD SERVE AS A MODEL FOR THOSE EFFORTS. INFANT MORTALITY ALSO CAME OFF THE LIST OF CHNA PRIORITIES. CHMCA 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, OUR EFFORTS TO IMPACT BIRTH OUTCOMES SUCH AS PREMATURITY AND LOW BIRTH WEIGHT ARE, BY AND LARGE, CARRIED OUT IN RELATION TO COALITION WORK WITH COMMUNITY AGENCIES AND LOCAL BIRTHING HOSPITALS. WE WILL CONTINUE TO CARRY OUT EFFORTS TO PROMOTE SAFE SLEEP, WHICH HAS BEEN A LARGE FOCUS OF OUR INFANT MORTALITY PREVENTION STRATEGY. IN ADDITION, WE HOPE TO SEE OUR FOCUS ON HEALTH EQUITY LEAD TO BETTER LONG-TERM OUTCOMES FOR MOTHERS AND BABIES IN THE BLACK COMMUNITY. OTHER SIGNIFICANT HEALTH NEEDS NOT SPECIFICALLY SELECTED FOR IMPLEMENTATION INCLUDED:- ORAL HEALTH- PHYSICAL ACTIVITY- NUTRITION- SCREEN TIME- UNINTENTIONAL INJURY- COMMUNICABLE DISEASE INCLUDING COVID-19- REPRODUCTIVE AND SEXUAL HEALTH- SOCIAL DETERMINANTS OF HEALTH INCLUDING HOUSING, EDUCATION, AND TRANSPORTATION- CRIME AND VIOLENCE DATA LIMITATIONS AND GAPS: DUE TO LIMITED RESOURCES AND A GLOBAL PANDEMIC, COMPLETE AND TIMELY DATA WERE NOT AVAILABLE FOR EVERY POPULATION OF INTEREST IN THE REGION. WHERE AVAILABLE, THE MOST CURRENT DATA WERE USED TO DETERMINE THE HEALTH NEEDS OF THE COMMUNITY, PARTICULARLY THOSE WHO ARE VULNERABLE OR UNDERSERVED. ALTHOUGH DATA THAT WERE AVAILABLE ARE RICH WITH INFORMATION, NOT SURPRISINGLY, SOME DATA GAPS AND LIMITATIONS IMPACTED THE ABILITY TO CONDUCT A MORE THOROUGH AND RIGOROUS ASSESSMENT. FOR EXAMPLE:1. LAG TIME FOR DATA TO BE REPORTED BY THE STATE AND SOME LOCAL SOURCES OFTEN EXCEEDS A YEAR TO 18 MONTHS.2. COVID-19 DISRUPTED SURVEILLANCE ACTIVITIES WITHIN SCHOOLS, NOTABLY THE YOUTH RISK BEHAVIOR SURVEY (YRBS), WHICH TYPICALLY SERVES AS THE MOST RICH SOURCE OF LOCAL DATA ON BEHAVIORS IMPACTING PHYSICAL AND MENTAL HEALTH, AS WELL AS GENERAL MENTAL/BEHAVIORAL HEALTH STATUS. 3. WITH LIMITATIONS ON IN-PERSON GATHERINGS AND MANY FAMILIES STILL OPTING TO STAY HOME WHEN POSSIBLE, IN-PERSON FOCUS GROUPS/COMMUNITY CONVERSATIONS WERE AVOIDED. DESPITE ADVERTISING VIRTUAL CONVERSATIONS WITH INCENTIVES FOR PARTICIPATION, ATTENDANCE WAS VERY LOW. WE BELIEVE THIS CAN BE PARTIALLY ATTRIBUTED TO THE FATIGUE EXPERIENCED BY PARENTS AND CAREGIVERS COMING OUT OF THE PANDEMIC. IN ADDITION, OVER-STRETCHED PUBLIC HEALTH AND SOCIAL SERVICE AGENCIES WERE LESS AVAILABLE TO ASSIST IN COORDINATING THESE COMMUNITY ENGAGEMENT OPPORTUNITIES.
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON	PART V, SECTION B, LINE 13H: PATIENTS OR FAMILIES WHO MAY NOT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON RESIDENCE AND INCOME MAY STILL QUALIFY FOR FINANCIAL ASSISTANCE BASED UPON DOCUMENTED EXTENUATING CIRCUMSTANCES WHERE PURSUIT OF PAYMENT WOULD CAUSE UNDUE HARDSHIP ON THE PATIENT/FAMILY. EXTENUATING CIRCUMSTANCES MAY BE BROUGHT TO THE ATTENTION OF THE DIRECTOR, REVENUE CYCLE, AND REVIEWED BY THE FINANCIAL ASSISTANCE COMMITTEE, CHAIRED BY THE CHIEF FINANCIAL OFFICER AND CHIEF MEDICAL OFFICER.
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON	PART V, SECTION B, LINE 15E: FINANCIAL COUNSELORS ARE EMPLOYED AT THE HOSPITAL TO DISCUSS THE AVAILABILITY AND APPLICATION FOR ALL FINANCIAL ASSISTANCE FOR ALL PATIENTS.
CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON	PART V, SECTION B, LINE 20E: YES - THIRD PARTY COLLECTION AGENCIES WILL EXPLAIN THE AVAILABILITY OF FREE CARE AND CHARITY CARE AND THE FINANCIAL ASSISTANCE APPLICATION.

Schedule H (Form 990) 2022

Page 9

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?61
Name and address		Type of Facility (describe)
1	1 - CHILDREN'S - BEEGHLY CAMPUS 6505 MARKET STREET YOUNGSTOWN,OH44512	NICU, PEDIATRIC UNIT, EMERGENCY DEPARTMENT
2	2 - AULTMAN HOSPITAL 2600 6TH ST SW CANTON,OH447101702	NICU AND PEDIATRIC UNIT
3	3 - ST ELIZABETH'S BOARDMAN HEALTH CENTER 8401 MARKET ST BOARDMAN,OH445126725	NICU NURSERY
4	4 - SUMMA HOSPITAL 525 E MARKET ST AKRON,OH443041619	NICU NURSERY
5	5 - NORTH CANTON 6076 WHIPPLE 6076 WHIPPLE AVE NORTH CANTON,OH44720	PRIMARY CARE & SPECIALTY - ACP
6	6 - WARREN 5000 E MARKET ST WARREN,OH444842259	PRIMARY CARE & SPECIALTY - ACP
7	7 - MANSFIELD HEALTH CENTER 1029 SOUTH TRIMBLE ROAD MANSFIELD,OH44906	PRIMARY CARE & SPECIALTY - ACP
8	8 - BOSTON HEIGHTS 328 EAST HINES HILL ROAD HUDSON,OH44236	PRIMARY CARE & SPECIALTY - ACP
9	9 - CLEVELAND CLINIC AKRON GENERAL MEDICAL 1 AKRON GENERAL AVE AKRON,OH443072432	NICU NURSERY
10	10 - MEDINA 3443 MEDINA RD MEDINA,OH442565965	PRIMARY CARE & SPECIALTY - ACP
11	11 - GREEN 1622 EAST TURKEYFOOT LAKE RD SUITE 100 AKRON,OH443125277	PRIMARY CARE & SPECIALTY - ACP
12	12 - ST JOSEPH'S HOSPITAL MERCY HEALTH 667 EASTLAND AVE SE WARREN,OH444844503	SPECIAL CARE NURSERY
13	13 - NEW PHILADELPHIA 1045 W HIGH AVE NEW PHILADELPHIA,OH446632071	PRIMARY CARE & SPECIALTY - ACP
14	14 - PORTAGE HEALTH CENTER 2497 STATE ROUTE 59 RAVENNA,OH44266	PRIMARY CARE & SPECIALTY - ACP
15	15 - FAIRLAWN 701 WHITE POND DR SUITE 100 AKRON,OH443201193	PEDIATRIC PRIMARY CARE - ACP
16	16 - MASSILLON 1149 LINCOLN WAY E MASSILLON,OH44646	PRIMARY CARE & SPECIALTY - ACP
17	17 - AMHERST HEALTH CENTER 47185 COOPER FOSTER PARK RD AMHERST,OH44053	PRIMARY CARE & SPECIALTY - ACP
18	18 - WOOSTER COMMUNITY HOSPITAL 1761 BEALL AVE WOOSTER,OH446912342	NICU NURSERY
19	19 - PERRY TOWNSHIP 125 WHIPPLE AVE SW CANTON,OH447101374	PEDIATRIC PRIMARY CARE - ACP
20	20 - ALLIANCE 1826 S ARCH AVE ALLIANCE,OH446014332	PRIMARY CARE & SPECIALTY - ACP
21	21 - WADSWORTH 323 HIGH ST SUITE A WADSWORTH,OH442811869	PRIMARY CARE & SPECIALTY - ACP
22	22 - WOOSTER 128 EAST MILLTOWN RD 209 WOOSTER,OH446911276	NICU NURSERY
23	23 - BARBERTON 566 ROBINSON AVENUE BARBERTON,OH442039002	PEDIATRIC PRIMARY CARE - ACP
24	24 - HUDSON 1365 CORPORATE DR SUITE A HUDSON,OH442364432	PEDIATRIC PRIMARY CARE - ACP
25	25 - AKRON EAST 891 E EXCHANGE ST AKRON,OH443061127	PEDIATRIC PRIMARY CARE - ACP
26	26 - ELLET 1463 CANTON RD SUITE A AKRON,OH443124022	PEDIATRIC PRIMARY CARE - ACP
27	27 - AUSTINTOWN 5480 NORQUEST BLVD AUSTINTOWN,OH445151820	PRIMARY CARE & SPECIALTY - ACP
28	28 - ASHLAND 2212 MIFFLIN AVE SUITE 235 ASHLAND,OH448058847	PRIMARY CARE & SPECIALTY - ACP
29	29 - TWINSBURG 8054 DARROW RD SUITE 3 TWINSBURG,OH440872387	PEDIATRIC PRIMARY CARE - ACP
30	30 - TALLMADGE 143 NORTHWEST AVE TALLMADGE,OH442781806	PRIMARY CARE & SPECIALTY - ACP
31	31 - LISBON 400 N MARKET ST LISBON,OH444321146	PRIMARY CARE & SPECIALTY - ACP
32	32 - MONTROSE URGENT CARE 4125 MEDINA RD AKRON,OH443332483	URGENT CARE
33	33 - WADSWORTH PSA 1225 HIGH ST WADSWORTH,OH44281	PRIMARY CARE & SPECIALTY - ACP
34	34 - CUYAHOGA FALLS - PSA 1100 PORTAGE TRAILS CUYAHOGA FALLS,OH44223	PRIMARY CARE & SPECIALTY - ACP
35	35 - MERCY LORAIN HOSPITAL 3700 KOLBE RD LORAIN,OH44053	SCN & PRIMARY CARE & SPECIALTY
36	36 - STOW GRAHAM RD 3019 GRAHAM ROAD STOW,OH44224	PRIMARY CARE & SPECIALTY - ACP
37	37 - BRECKSVILLE 7001 S EDGERTON RD SUITE 500 BRECKSVILLE,OH441414206	PRIMARY CARE & SPECIALTY - ACP
38	38 - WARREN DOWNTOWN 661 MAHONING AVE NW WARREN,OH444834607	PEDIATRIC PRIMARY CARE - ACP
39	39 - LIBERTY 3530 BELMONT AVE YOUNGSTOWN,OH44505	PRIMARY CARE & SPECIALTY - ACP
40	40 - EAST LIVERPOOL - ACP 15655 STATE ROUTE 170 EAST LIVERPOOL,OH43920	PEDIATRIC PRIMARY CARE - ACP
41	41 - STREETSBORO 9150 MARKET SQUARE SUITE 203 STREETSBORO,OH442415224	PEDIATRIC PRIMARY CARE - ACP
42	42 - BEACHWOOD CENTER 23250 CHAGRIN BLVD SUITE325 BEACHWOOD,OH441225417	PRIMARY CARE & SPECIALTY - ACP
43	43 - BEACHWOOD ACHP 3733 PARK EAST DR STE 102 BEACHWOOD,OH44122	PEDIATRIC PRIMARY CARE - ACP
44	44 - MILLERSBURG 1261 WOOSTER RD SUITE 220 MILLERSBURG,OH446541570	PRIMARY CARE & SPECIALTY - ACP
45	45 - NORWALK MEDICAL PARK II 282 BENEDICT AVE NORWALK,OH448572712	PRIMARY CARE & SPECIALTY - ACP
46	46 - MEDINA EAST 313 MEDINA ROAD MEDINA,OH44256	SPECIALTY CARE - ACP
47	47 - SANDUSKY 2800 HAYES AVENUE SANDUSKY,OH44870	PRIMARY CARE & SPECIALTY - ACP
48	48 - OBERLIN ACP 224 W LORAIN ST OBERLIN,OH44704	PRIMARY CARE & SPECIALTY - ACP
49	49 - WOOSTER HEALTH CENTER 3807 FRIENDSVILLE ROAD WOOSTER,OH44691	PRIMARY CARE & SPECIALTY - ACP
50	50 - MARIETTA MEMORIAL 401 MATTHEW STREET MARIETTA,OH45750	PRIMARY CARE & SPECIALTY - ACP
51	51 - CHILD ADVOCACY CENTER 213 MARKET AVE N SUITE 200 CANTON,OH447021440	SPECIALTY CARE - ACP
52	52 - LIFE CENTER PLUS 5133 DARROW RD HUDSON,OH442364003	SPECIALTY CARE - ACP
53	53 - FISHER TITUS MEDICAL CENTER 272 BENEDICT AVE NORWALK,OH448572374	PRIMARY CARE & SPECIALTY - ACP
54	54 - WOOSTER SPECIALTY CARE 546 WINTER ST SUITE 110 WOOSTER,OH446912339	PRIMARY CARE & SPECIALTY - ACP
55	55 - HATTIE LARLHAM FOUNDATION 9772 DIAGONAL RD MANTUA,OH442559128	PRIMARY CARE & SPECIALTY - ACP
56	56 - HUDSON URGENT CARE & SPECIALTY OFFICE 5655 HUDSON DRIVE HUDSON,OH442364451	URGENT CARE
57	57 - MERCY MEDICAL CENTER 1330 MERCY DR NW SUITE 506 CANTON,OH447082625	PRIMARY CARE & SPECIALTY - ACP
58	58 - NORTH CANTON SPECIALTY CARE 6100 WHIPPLE AVE NW NORTH CANTON,OH447207618	PRIMARY CARE & SPECIALTY - ACP
59	59 - SHARON HEART CENTER 740 E STATE ST SHARON,PA16146	SPECIALTY CARE - ACP
60	60 - TRIPOINT MEDICAL CENTER 7580 AUBURN RD SUITE 214 PAINESVILLE,OH440779176	SPECIALTY CARE - ACP
61	61 - WAYNE COUNTY CHILDREN'S ADVOCACY CENTER 1734 GASCHE STREET WOOSTER,OH44691	SPECIALTY CARE - ACP

Schedule H (Form 990) 2022

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:	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 SCHEDULE 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 AND 7 (C) OTHER MEANS TESTED PROGRAMSWE 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 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 (54.8%) AS REPORTED ON OUR INTERNAL PAYOR MIX REPORT.
PART I, LINE 7G:	OUR GROUND AND AIR TRANSPORT SERVICES ARE HIGHLY SPECIALIZED FOR THE PEDIATRIC POPULATION AND ADDRESS NEEDS FOR TRAUMA/EMERGENCY MEDICAL RESPONSE THAT WOULD OTHERWISE BE UNMET OR NEARLY UNMET IN A LARGE PART OF OUR SERVICE AREA. WE RECOGNIZED THESE AS SUBSIDIZED HEALTH SERVICES IN 2022. IN 2022, CHILDREN'S HOME CARE GROUP TRANSITIONED UNDER THE CHMCA UMBRELLA. THIS SERVICE PLACES NURSES IN THE HOMES OF PATIENTS WHO ARE MEDICALLY FRAGILE OR COMPLEX AND SUPPORTS FAMILIES IN THEIR ONGOING CARE. THE UNIQUENESS OF THIS SERVICE LINE AND OVERALL FINANCIAL LOSS LED TO ITS RECOGNITION AS A SUBSIDIZED HEALTH SERVICE. THE CELESTE MYERS DENTAL CLINIC AT CHMCA WAS ESTABLISHED LARGELY IN RESPONSE TO HOSPITAL DATA INDICATING AN ALARMINGLY HIGH NUMBER OF FAMILIES SEEKING EMERGENCY MEDICAL CARE FOR THEIR CHILDREN DUE TO ACUTE DENTAL CONDITIONS. THEY CONTINUE TO BE A "DENTAL HOME" FOR THEIR PATIENTS, PROVIDING PREVENTATIVE SERVICES AND ORAL HEALTH EDUCATION. IN ITS FIFTH YEAR AS OF 2022, THE CLINIC SERVES AS A SAFETY NET FOR DENTAL HEALTH CARE, WITH 86 PERCENT OF PATIENTS ON MEDICAID AND 30 PERCENT NON-ENGLISH SPEAKING. WE RECOGNIZED THIS AS A SUBSIDIZED HEALTH SERVICE IN 2022.CHMCA'S LOCUST PEDIATRIC CARE GROUP PROVIDES PRIMARY CARE TO OVER 1,500 REFUGEE CHILDREN, AND OTHER LOW-INCOME FAMILIES IN OUR COMMUNITY. THE HOSPITAL'S LANGUAGE ACCESS SERVICES PROGRAM CENTRALIZES AND COORDINATES LANGUAGE ACCESS INITIATIVES AND SERVICES. IT IS THE ONLY ONE OF ITS KIND IN OUR COMMUNITY AND IT ADDRESSES THE COMMUNICATION NEEDS OF PATIENTS/FAMILIES WHO HAVE LIMITED ENGLISH PROFICIENCY, AS WELL AS THOSE WHO ARE DEAF, HARD OF HEARING, BLIND OR HAVE VISUAL IMPAIRMENTS. WE RECOGNIZED THIS AS A SUBSIDIZED HEALTH SERVICE IN 2022. WE ALSO RECOGNIZED A SUBSET OF PRIMARY CARE OFFICES WITH NET FINANCIAL LOSSES THAT ARE LOCATED IN MEDICALLY UNDERSERVED COMMUNITIES (AS DESIGNATED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION) AND/OR WHERE A CONSIDERABLE PORTION OF THE POPULATION SERVED IS ECONOMICALLY DISADVANTAGED. DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS PROVIDES DIAGNOSTIC AND ONGOING SUPPORT FOR FAMILIES WITH CHILDREN WHO HAVE LEARNING, DEVELOPMENTAL, OR BEHAVIORAL PROBLEMS SUCH AS AUTISM, DOWN SYNDROME AND TICS/TOURETTE'S SYNDROME. DEMAND FOR THESE SERVICES IS HIGH, AND THE REGION OFFERS FEW OTHER SIMILAR OPTIONS. THIS WAS RECOGNIZED AS A SUBSIDIZED HEALTH SERVICE IN 2022. CHMCA'S CHILDREN AT RISK EVALUATION (CARE) CENTER IN AKRON AND CHILDREN'S ADVOCACY CENTER IN MAHONING VALLEY EVALUATE AND INITIATE TREATMENT FOR CHILDREN SUSPECTED OF PHYSICAL OR SEXUAL ABUSE AND NEGLECT. THE CARE CENTER USES AN ENHANCED SCREENING PROCESS FOR AT-RISK PATIENTS AGES 12 YEARS AND OLDER; ON AVERAGE, 80% TO 100% OF AT-RISK PATIENTS INVOLVED IN SUSPECTED CHILD ABUSE/NEGLECT INCIDENCES ARE NOW RECEIVING SCREENINGS FOR HUMAN TRAFFICKING. THE CARE CENTER'S TEAM OF DOCTORS, NURSES, AND SOCIAL WORKERS TREAT CHILDREN AND TEENS REFERRED BY PRIVATE PHYSICIANS, LAW ENFORCEMENT, CHILD PROTECTION, AND OTHER COMMUNITY AGENCIES. THIS TEAM IS ABLE TO PROVIDE CONSULTATION WHEN ABUSE IS SUSPECTED OF A CHILD ON AN INPATIENT UNIT OR FROM OTHER REFERRAL SOURCES, SUCH AS OUTREACH PROGRAMMING.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 (A), BUT SUBTRACTED FOR THE PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $12,084,177.
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. WE PARTICIPATE IN VARIOUS COMMUNITY-BASED PROGRAMS THAT SPECIFICALLY DEVELOP COMMUNITY LEADERS, INCLUDING LEADERSHIP AKRON (FOR COMMUNITY LEADERSHIP) AND THE CHILD & FAMILY LEADERSHIP EXCHANGE (FOR CLINICAL AND SOCIAL SERVICE LEADERSHIP). CHMCA IS STRONGLY REPRESENTED IN COMMITTEES AND TASK FORCES ASSIGNED TO ADDRESS SPECIFIC HEALTH INDICATORS AND CONDITIONS, IN ADDITION TO CERTAIN DIVERGENT POPULATIONS LOCATED THROUGHOUT OUR REGION, STATE, AND BEYOND.LOCAL EXAMPLES INCLUDE THE CITY OF AKRON'S FULL TERM FIRST BIRTHDAY INFANT VITALITY INITIATIVE AND MAHONING COUNTY'S STAND GROW THRIVE RESILIENCY MOVEMENT, AMONG OTHERS. 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 CAREER TRAJECTORIES.FOR EXAMPLE, OUR LONGSTANDING ASSURING SUCCESS WITH A COMMITMENT TO ENHANCE NURSE DIVERSITY (ASCEND) PROGRAM PROVIDES A 10-WEEK, PAID, HANDS-ON EXPERIENCE FOR YOUNG NURSING STUDENTS WHO ARE UNDERREPRESENTED IN THE NURSING PROFESSION. CHMCA PROVIDES FINANCIAL AND IN-KIND STAFF SUPPORT FOR VARIOUS COMMUNITY-BASED ORGANIZATIONS AND INITIATIVES WHOSE MISSIONS ARE AIMED AT IMPROVING CONDITIONS SURROUNDING HEALTH AND WELLBEING FOR CHILDREN AND THEIR FAMILIES WITHIN OUR SERVICE AREA. WE EVALUATE SPONSORSHIP REQUESTS AND DESIGNATE A PORTION OF FUNDS TO ORGANIZATIONS THAT ARE WORKING TO ENHANCE DIVERSITY, EQUITY AND INCLUSION, PROMOTE YOUTH ENGAGEMENT IN HEALTHY ACTIVITIES, AND OFFER SERVICES THAT HELP TO CLOSE GAPS IN ACCESS. CHMCA ALSO WORKS CLOSELY WITH STATE AND NATIONAL ADVOCACY ORGANIZATIONS SUCH AS OHIO CHILDREN'S HOSPITAL ASSOCIATION TO KEEP CHILDREN'S HEALTH AT THE FOREFRONT OF POLICY CONVERSATIONS. WE ENGAGE IN WORKFORCE DEVELOPMENT EFFORTS 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-SCHOOLERS CAREER-FOCUSED PATHWAYS IN HEALTH CARE 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:	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 UNDERSERVED. 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 12 & 13 TO THE FOOTNOTES TO CHMCA'S AUDITED FINANCIAL STATEMENTS THAT DESCRIBE CHARITY CARE AND IMPLICIT PRICE CONCESSIONS (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:	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 (57.2%) AS REPORTED ON OUR INTERNAL PAYOR MIX REPORT. IN REGARD TO MEDICARE, CHMCA RESPECTIVELY SUBMITS THAT INCLUDED IN ITS UNREIMBURSED INPATIENT COSTS INCURRED IN EXCESS OF THE 1982 TAX EQUITY AND FISCAL RESPONSIBILITY (TEFRA) PER DISCHARGE LIMIT WAS $1,052,014, UNREIMBURSED OUTPATIENT COSTS INCURRED IN TREATING PATIENTS QUALIFYING FOR MEDICARE END STAGE RENAL DISEASE (ESRD), COMPOSITE REIMBURSEMENT WAS $773,608, UNREIMBURSED COSTS OF PROVIDING CARE TO MEDICARE ADVANTAGE PLAN ENROLLEES WAS $457,303. 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. SINCE THESE PROGRAMS ARE GOVERNMENT MEANS TESTED PROGRAMS THAT TYPICALLY REIMBURSE CHMCA LESS THAN IT COSTS TO PROVIDE THAT CARE, WE BELIEVE THAT IT QUALIFIES AS COMMUNITY BENEFIT IN THE SAME REGARD AS MEDICAID.
PART III, LINE 9B:	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:	IN ADDITION TO OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2022, CHMCA CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019 TO ASSESS THE PRIMARY SERVICE AREAS SURROUNDING OUR AKRON HOSPITAL CAMPUS. UPON REVIEWING PATIENT DENSITY DATA FROM 2021, WE ADDED TWO COUNTIES TO OUR 2022 CHNA FOOTPRINT, LORAIN AND TUSCARAWAS. ALONG WITH THE CHNA, WE REGULARLY PERFORM 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, AND 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 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, AND CHARITABLE AND ADVOCACY GROUPS. WE MAKE AN EFFORT TO LISTEN TO OUR STAFF, SEEKING AND RECEIVING FEEDBACK FROM OUR 6,600+ STAFF AND THOUSANDS OF VOLUNTEERS AND PHYSICIANS, 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 GATHER FEEDBACK THROUGH PATIENT SURVEY RESULTS AND VIA MULTIPLE WRITTEN AND ELECTRONIC (WEB-BASED) TOOLS.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE -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:	FOUNDED IN 1890, CHMCA BEGAN AS A DAY NURSERY AND IS NOW A WORLD-CLASS PEDIATRIC HEALTH CARE INSTITUTION SERVING A REGION OF MORE THAN 25 COUNTIES SPREAD ACROSS NORTHEAST AND NORTH-CENTRAL OHIO, IN ADDITION TO TWO COUNTIES ON THE BORDER OF WESTERN PENNSYLVANIA. APPROXIMATELY 55% OF THE PATIENTS WE TREAT ARE COVERED BY MEDICAID. ADDITIONALLY, WE SERVE AS THE MEDICAL HOME FOR CHILDREN WHO ARE PART OF PRIORITY POPULATIONS OR COMMUNITIES THAT ARE CONSIDERED VULNERABLE. THESE INCLUDE FAMILIES LIVING IN POVERTY, BOTH WITHIN THE URBAN CORE AND THE RURAL FRINGE; CHILDREN WHO ARE PART OF THE CHILD WELFARE AND JUVENILE JUSTICE SYSTEMS; CHILDREN FROM NON-ENGLISH SPEAKING FAMILIES (SUCH AS RECENT IMMIGRANTS AND REFUGEES FROM SOUTHEAST ASIA, THE MIDDLE EAST, AND PARTS OF AFRICA); AND THE AMISH. WE HAVE DEDICATED PROVIDERS FROM THE AMISH COMMUNITY AT THE NEW LEAF CENTER IN WAYNE COUNTY, WHERE WE SPECIALIZE IN TREATING CHILDREN WITH SPECIAL NEEDS DUE TO INHERITED DISORDERS. SUMMIT COUNTY IS A REFUGEE RESETTLEMENT COMMUNITY AND HAS SEEN A SIGNIFICANT INCREASE IN SECONDARY MIGRATION OF REFUGEES WHO INITIALLY SETTLE IN OTHER AREAS OF THE U.S. BUT RELOCATE HERE BECAUSE OF THE STRONG REFUGEE COMMUNITY. IN AKRON, THERE ARE REFUGEES FROM NUMEROUS COUNTRIES INCLUDING NEPAL, MYANMAR, SOMALIA, DEMOCRATIC REPUBLIC OF CONGO, SYRIA, AFGHANISTAN, AND OTHERS. MOST PEOPLE WHO RECEIVE SERVICES FROM OUR BOARDMAN CAMPUS ARE RESIDENTS OF MAHONING, TRUMBULL OR COLUMBIANA COUNTIES. PRIOR TO THE OPENING OF THIS CAMPUS, 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. MAHONING AND COLUMBIANA COUNTIES ARE CLASSIFIED BY THE APPALACHIAN REGIONAL COMMISSION AS BEING TRANSITIONAL, AND TRUMBULL IS CLASSIFIED AS AT-RISK. THIS MEANS THE COUNTIES HAVE WORSE ECONOMIC RATES THAN THE NATIONAL AVERAGE FOR ONE OR MORE OF THREE ECONOMIC INDICATORS, BUT DON'T RATE LOW ENOUGH TO BE CLASSIFIED AS DISTRESSED. HOWEVER, IN 2022, MAHONING COUNTY CONTAINED 31 DISTRESSED CENSUS TRACTS, THE MOST OF ALL COUNTIES IN APPALACHIAN OHIO. IN ADDITION, THESE COUNTIES HAVE SHORTAGES OF PRIMARY CARE HEALTH SERVICES. FOR THE PURPOSES OF THE 2022 CHNA, WE FOCUSED ON A 12-COUNTY REGION REPRESENTATIVE OF WHERE THE MAJORITY OF PATIENTS RESIDE. DEMOGRAPHIC INFORMATION ON THESE COUNTIES IS DETAILED BELOW. ASHLAND COUNTY THERE ARE APPROXIMATELY 52,181 PEOPLE LIVING IN ASHLAND COUNTY, A SLIGHT DECLINE FROM THE 2020 CENSUS COUNT. IT HAS 1 CITY, 8 VILLAGES, AND 15 TOWNSHIPS, WITH THE LARGEST BEING THE CITY OF ASHLAND. COMPARED TO THE STATE OF OHIO, ASHLAND COUNTY HAS A SLIGHTLY LARGER PROPORTION OF CHILDREN (UNDER 18 YEARS OLD) AND A LARGER PROPORTION OF OLDER ADULTS (65 YEARS AND OLDER). 3.5% OF THE POPULATION IS NON-WHITE, COMPARED TO 18.8% IN THE STATE. EDUCATIONAL ATTAINMENT IS SLIGHTLY LOWER THAN THE STATE OF OHIO, WITH 90.1% HAVING A HIGH SCHOOL DIPLOMA (COMPARED TO 90.8%) AND 22% HAVING A BACHELOR'S DEGREE OR HIGHER (COMPARED TO 28.9%). ANNUAL PER CAPITA INCOME IS LOWER THAN THE STATE AVERAGE, AS IS THE PERCENTAGE OF ASHLAND COUNTY RESIDENTS LIVING IN POVERTY. COLUMBIANA COUNTY THERE ARE APPROXIMATELY 100,511 PEOPLE LIVING IN COLUMBIANA COUNTY, WHICH IS A DECREASE OF 1.3% SINCE 2020. 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 AND A LARGER PROPORTION OF OLDER ADULTS. APPROXIMATELY 2.6% PERCENT OF THE POPULATION IN COLUMBIANA COUNTY IS BLACK OR AFRICAN-AMERICAN AND 2.1% IS HISPANIC OR LATINX, COMPARED TO 13.2% AND 4.3%, 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 (14.5% VERSUS 28.9%). THE ANNUAL PER CAPITA INCOME IN COLUMBIANA COUNTY IS LOWER THAN THE STATE OF OHIO AND THE PERCENTAGE OF COLUMBIANA COUNTY RESIDENTS LIVING IN POVERTY IS HIGHER THAN THE STATE AVERAGE. COLUMBIANA IS DESIGNATED AS AN MUA (MEDICAID ELIGIBLE POPULATION) THROUGH A GOVERNOR'S EXCEPTION. LORAIN COUNTY THERE ARE APPROXIMATELY 316,268 PEOPLE LIVING IN LORAIN COUNTY, WHICH IS A 1% INCREASE FROM THE 2020 CENSUS. IT HAS 34 CITIES, VILLAGES AND TOWNSHIPS WITH THE LARGEST BEING THE CITY OF LORAIN AND THE COUNTY SEAT BEING ELYRIA. 10.8% OF THE POPULATION IS HISPANIC/LATINX, IN FACT IT RANKS NUMBER ONE IN THE STATE FOR HISPANIC/LATINX RESIDENTS. THERE IS A SLIGHTLY HIGHER PROPORTION OF OLDER ADULTS, AND A SLIGHTLY LOWER PROPORTION OF CHILDREN COMPARED WITH THE STATE. WHILE EDUCATIONAL ATTAINMENT AVERAGES SLIGHTLY LOWER THAN THE STATE, MEDIAN HOUSEHOLD INCOME IS JUST ABOVE IT, AND PERSONS LIVING IN POVERTY COMES IN BELOW. MAHONING COUNTY THERE ARE APPROXIMATELY 225,636 PEOPLE LIVING IN MAHONING COUNTY, WHICH IS A DECREASE OF 1.3% SINCE 2020. 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 AND A LARGER PROPORTION OF OLDER ADULTS. APPROXIMATELY 16 % OF THE POPULATION IN MAHONING COUNTY IS BLACK OR AFRICAN-AMERICAN AND 7% IS HISPANIC/LATINX, COMPARED TO 13.2% AND 4.3%, RESPECTIVELY, IN THE STATE OF OHIO. THE HISPANIC/LATINX COMMUNITY IN THE CITY OF CAMPBELL IS ONE OF THE FASTEST GROWING IN OHIO. THE PERCENTAGE OF MAHONING COUNTY RESIDENTS WITH AT LEAST A HIGH SCHOOL DIPLOMA, AND THE PERCENTAGE WITH AT LEAST A BACHELOR'S DEGREE, IS LOWER THAN THE STATE AVERAGE. THE ANNUAL PER CAPITA INCOME IN MAHONING COUNTY IS LOWER THAN THE STATE OF OHIO AND THE PERCENTAGE OF RESIDENTS LIVING IN POVERTY IS SIGNIFICANTLY HIGHER THAN THE STATE AVERAGE. THERE ARE THREE FEDERALLY DESIGNATED MUAS WITHIN MAHONING COUNTY, BOTH RURAL AND NON-RURAL. MEDINA COUNTY THERE ARE APPROXIMATELY 183,512 PEOPLE LIVING IN MEDINA COUNTY, WHICH IS AN INCREASE OF 0.6% SINCE 2020. IT HAS 3 CITIES, 6 VILLAGES, AND 17 TOWNSHIPS, 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 OLDER ADULTS. 4.8% OF THE POPULATION IS NON-WHITE, COMPARED TO 18.8% IN THE STATE. EDUCATIONAL ATTAINMENT IS HIGHER THAN THE STATE OF OHIO, WITH 95.1% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 35% 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 161,745 PEOPLE LIVING IN PORTAGE COUNTY, WITH THE POPULATION REMAINING RELATIVELY STABLE SINCE 2020. PORTAGE COUNTY IS COMPRISED OF 29 CITIES, VILLAGES, AND TOWNSHIPS, WITH 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 AND OLDER ADULTS. IN PORTAGE COUNTY, 9.7% OF THE POPULATION IS NON-WHITE, COMPARED TO 18.8% IN THE STATE. EDUCATIONAL ATTAINMENT IS SLIGHTLY HIGHER IN PORTAGE COUNTY THAN OHIO, WITH 92.5% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 30.1% HAVING A BACHELOR'S DEGREE OR HIGHER. ANNUAL PER CAPITA INCOME IN PORTAGE COUNTY IS SLIGHTLY HIGHER THAN THAT OF THE STATE, AND THE PERCENTAGE OF PERSONS LIVING IN POVERTY IS LOWER. EAST KENT CITY HAS A MUP (LOW INCOME) DESIGNATION. RICHLAND COUNTY THERE ARE APPROXIMATELY 125,319 PEOPLE LIVING IN RICHLAND COUNTY, WITH THE POPULATION REMAINING RELATIVELY STABLE SINCE 2020. THERE ARE 29 CITIES, VILLAGES, AND TOWNSHIPS IN RICHLAND COUNTY, WITH THE LARGEST BEING MANSFIELD. COMPARED TO THE STATE OF OHIO, RICHLAND COUNTY HAS A SLIGHTLY LARGER PROPORTION OF OLDER ADULTS. IN RICHLAND COUNTY, 13.1% OF THE POPULATION IS NON-WHITE, COMPARED TO 18.8% 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 ABOUT EQUAL WITH THE STATE OF OHIO. THE CITY OF MANSFIELD HAS A MUP (LOW INCOME) DESIGNATION.
LINE 4, COMMUNITY INFORMATION CONTINUED:	STARK COUNTY THERE ARE APPROXIMATELY 372,657 PEOPLE LIVING IN STARK COUNTY, WHICH IS A SLIGHT DECREASE FROM 2020. 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 LARGER PROPORTION OF OLDER ADULTS, AND THE PROPORTION OF CHILDREN IS BARELY BELOW THE STATE'S. IN STARK COUNTY, 12.5% OF THE POPULATION IS NON-WHITE, COMPARED TO 18.8% 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 6% LOWER THAN THE STATE. ANNUAL PER CAPITA INCOME IS LOWER AND THE PERCENTAGE OF RESIDENTS LIVING IN POVERTY IS SLIGHTLY LOWER. THERE ARE TWO FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS (MUAS) IN STARK COUNTY: MASSILLON AND EAST CANTON. IN ADDITION, NORTHEAST ALLIANCE WAS DESIGNATED IN 2016 AS A MUP, MEETING THE MEDICAID ELIGIBILITY CRITERION. SUMMIT COUNTY THERE ARE APPROXIMATELY 535,882 PEOPLE LIVING IN SUMMIT COUNTY. SINCE 2020, THE POPULATION HAS DECREASED SLIGHTLY, BY LESS THAN 1%. 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 AND A SLIGHTLY LARGER PROPORTION OF OLDER ADULTS. IN SUMMIT COUNTY, 22.7 % PERCENT OF THE POPULATION IS NON-WHITE, COMPARED TO 18.8% IN THE STATE. EDUCATIONAL ATTAINMENT IS SLIGHTLY HIGHER IN SUMMIT COUNTY THAN IN THE STATE OF OHIO, WITH 92.6% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 33.9% 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 ALMOST 1% LOWER THAN THAT OF THE STATE. TWO FEDERALLY DESIGNATED MUAS ARE PRESENT IN SUMMIT COUNTY: THE SOUTHEAST AKRON AND SUMMIT SERVICE AREAS.TRUMBULL COUNTY THERE ARE APPROXIMATELY 200,643 PEOPLE LIVING IN TRUMBULL COUNTY, A SLIGHT DECLINE FROM 2020. 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, 8.8% OF THE POPULATION IS BLACK OR AFRICAN-AMERICAN AND 2.1% IS HISPANIC OR LATINO, COMPARED TO 13.2% AND 4.3%, RESPECTIVELY, IN THE STATE OF OHIO. EDUCATIONAL ATTAINMENT IN TRUMBULL COUNTY IS LOWER THAN THE STATE AVERAGE, WITH 89.4% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 19.2% 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 RESIDENTS LIVING IN POVERTY IS HIGHER. IN ADDITION, TRUMBULL COUNTY IS FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). TUSCARAWAS COUNTY THERE ARE APPROXIMATELY 91,937 PEOPLE LIVING IN TUSCARAWAS COUNTY, WITH THE POPULATION DECREASING BY ABOUT 1.4% SINCE 2020. THERE ARE ONLY 3 CITIES, THE COUNTY SEAT BEING NEW PHILADELPHIA, AND ALMOST 40 VILLAGES AND TOWNSHIPS IN THE COUNTY. THE PROPORTION OF CHILDREN AND OLDER ADULTS ARE BOTH HIGHER THAN THE STATE OF OHIO'S. IN TUSCARAWAS COUNTY, 3.8% OF THE POPULATION NON-WHITE. EDUCATIONAL ATTAINMENT IS LOWER THAN THE STATE, AS IS MEDIAN HOUSEHOLD INCOME. HOWEVER, THE PERCENT OF PERSONS LIVING IN POVERTY IS BELOW THE STATE AVERAGE. WAYNE COUNTY THERE ARE APPROXIMATELY 116,559 PEOPLE LIVING IN WAYNE COUNTY, WITH THE POPULATION DECREASING BY LESS THAN 0.5% SINCE 2020. 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 AND OLDER ADULTS. IN WAYNE COUNTY, 4.7% OF THE POPULATION IS NON-WHITE, COMPARED TO 18.8% IN THE STATE. EDUCATIONAL ATTAINMENT IS LOWER IN WAYNE COUNTY COMPARED TO THE STATE OF OHIO, WITH 86.8% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 22.5% HAVING A BACHELOR'S DEGREE OR HIGHER. THE ANNUAL PER CAPITA INCOME IN WAYNE COUNTY IS 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 UNINSURED BECAUSE THEY DO NOT PARTICIPATE IN TRADITIONAL HEALTH INSURANCE PROGRAMS.
PART VI, LINE 5:	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 OUR COMMUNITY. WITHIN OUR DOORS, THIS MEANS TREATING ALL CHILDREN AS IF THEY WERE OUR OWN, TURNING NO CHILD OR FAMILY AWAY BASED ON THEIR ABILITY TO PAY. CHMCA'S GOVERNING BOARD OF DIRECTORS IS COMPRISED OF MEMBERS OF THE COMMUNITY THAT MAKES UP THE HOSPITAL'S PRIMARY SERVICE AREA. THEY ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. 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 CHILDREN. CHMCA BRINGS PEDIATRIC PRIMARY CARE FOR BABIES, CHILDREN AND TEENS TO MANY NORTHEAST OHIO NEIGHBORHOODS THROUGH OUR NETWORK OF PEDIATRICIAN OFFICES. EACH OFFICE IS STAFFED WITH BOARD-CERTIFIED PEDIATRICIANS AND EXPERIENCED STAFF. CHMCA ALSO OPERATES REGIONAL HEALTH CENTERS THAT BRING PRIMARY CARE, A RANGE OF SPECIALTY CARE SERVICES, AND AT SOME LOCATIONS, URGENT CARE, UNDER THE SAME ROOF. WE 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 ANNUALLY. IN ADDITION, WE ENGAGE IN COMMUNITY BUILDING ACTIVITIES, AS DEPICTED IN PART II OF THIS SCHEDULE. IN 2022, CHMCA HAD ONE HOSPITAL WITH TWO CAMPUSES, 39 PEDIATRICIAN OFFICES, AND 4 URGENT CARES. THERE WERE 98,621 EMERGENCY DEPARTMENT VISITS, 10,946 INPATIENT ADMISSIONS, 17,898 SURGERIES, AND MORE THAN 1.3 MILLION TOTAL OUTPATIENT VISITS. WE SERVICED MORE THAN 280,000 INDIVIDUAL PATIENTS. 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 DOZENS OF OUTREACH AND EDUCATION ACTIVITIES ON FIRE SAFETY, IN ADDITION TO BURN SURVIVORSHIP SUPPORT GROUPS AND CAMPS. THE REBECCA D. CONSIDINE RESEARCH INSTITUTE IS THE HUB FOR RESEARCH ACTIVITY. IN 2022, CHMCA NAMED A NEW CHIEF ACADEMIC OFFICER TO ELEVATE THE HOSPITAL'S ACADEMIC PROFILE. THE INSTITUTE FACILITATES SPONSORED CLINICAL STUDIES AS WELL AS INTERNAL INVESTIGATOR-INITIATED RESEARCH PROGRAMS ACROSS A SPECTRUM OF RESEARCH SUBJECTS. IT ALSO OFFERS RESEARCH-ORIENTED EDUCATIONAL OPPORTUNITIES FOR FELLOWS, STUDENTS AND FACULTY FROM AROUND THE GLOBE. OUR ADULT CONGENITAL HEART SERVICE PROVIDES ONGOING MONITORING AND SPECIALIZED CARE FOR ADULTS WITH CONGENITAL HEART DISEASE. AS CHILDREN WITH CONGENITAL HEART DISEASE (CHD) BECOME ADULTS, THEY CAN ACCESS LIFETIME CARE THROUGH OUR CENTER. THE CYSTIC FIBROSIS CENTER PROVIDES DIAGNOSIS AND TREATMENT TO CHILDREN AND ADULTS WITH CYSTIC FIBROSIS (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. 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. OUR MATERNAL FETAL TREATMENT CENTER PROVIDES GENETIC COUNSELING AND OBSTETRIC/DELIVERY SERVICES TO HIGH-RISK PREGNANT WOMEN IN THE REGION. CHMCA BECAME A LEVEL I PEDIATRIC TRAUMA CENTER IN 2022. OUR TRAUMA SERVICES DEPARTMENT PARTICIPATES IN SEVERAL RESEARCH AND QUALITY/PERFORMANCE IMPROVEMENT 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. IN JULY 2022, CHMCA APPOINTED ITS FIRST CHIEF DIVERSITY, EQUITY AND INCLUSION (DEI) OFFICER TO BUILD THE ORGANIZATION'S DEI CAPACITY. PRIMARY DELIVERABLES IN THE MONTHS FOLLOWING THIS APPOINTMENT INCLUDED: INVENTORYING INTERNAL COMMITTEES WITH A DEI PURPOSE OR COMPONENT TO REDUCE DUPLICATION AND PROMOTE ALIGNMENT OF EFFORTS; ESTABLISHING JOB DESCRIPTIONS AND BEGINNING THE HIRING PROCESS TO EXPAND THE DEI TEAM; AND DEVELOPING A DEI SCORECARD FOR MEASURING PROGRESS ON KEY METRICS RELATED TO CLINICAL OUTCOMES, PATIENT SATISFACTION, HUMAN RESOURCES, SUPPLY CHAIN AND OTHER DOMAINS. UNDER THE DEI UMBRELLA, THE HEALTH EQUITY STEERING COMMITTEE (HESC) AIMS TO ENSURE THAT ALL OF OUR PATIENTS AND FAMILIES RECEIVE HIGH QUALITY, EVIDENCE-BASED AND EQUITABLE CARE. THE HESC WILL MAKE RECOMMENDATIONS TO THE DEI STEERING COMMITTEE AND IMPLEMENT INITIATIVES TO SUPPORT KEY EQUITABLE OUTCOMES. THE BEHAVIORAL HEALTH CENTER LEADS SEVERAL EFFORTS ALIGNED WITH THE CHNA IDENTIFIED NEED OF MENTAL/BEHAVIORAL HEALTH AND ADVERSE CHILDHOOD EXPERIENCES, OR ACES. CHMCA HAS EMBEDDED BEHAVIORAL HEALTH SERVICES WITHIN OUR NETWORK OF PRIMARY CARE OFFICES, THROUGH A COMBINATION OF INTERNAL STAFFING AND FORMAL RELATIONSHIPS WITH COMMUNITY AGENCIES PROVIDING BEHAVIORAL HEALTH SERVICES. FURTHER, IN 2022, CHMCA CONTINUED ITS ENGAGEMENT IN THE ZERO SUICIDE INITIATIVE, A PUBLIC-PRIVATE PARTNERSHIP AMONG OHIO MENTAL HEALTH & ADDICTION SERVICES, THE OHIO CHILDREN'S HOSPITAL ASSOCIATION, CARDINAL HEALTH FOUNDATION, AND THE ZERO SUICIDE INSTITUTE. THE PURPOSE IS TO BUILD A COORDINATED FRAMEWORK AMONG PRIMARY CARE PROVIDERS, BEHAVIORAL HEALTH ORGANIZATIONS, SCHOOLS, PARENTS/CAREGIVERS AND OTHER COMMUNITY PARTNERS WITH THE GOAL OF INCREASING THE AWARENESS OF EFFECTIVE SUICIDE PREVENTION STRATEGIES AND INTERVENTIONS. CHMCA OPENED A BEHAVIORAL HEALTH CENTER AT THE MAHONING VALLEY CAMPUS IN 2019 TO BETTER SERVE A GROWING NEED FOR PEDIATRIC MENTAL AND BEHAVIORAL HEALTH SERVICES IN THE AREA. THE 9,000 SQUARE FOOT BUILDING HAS NINE INDIVIDUAL THERAPY ROOMS AND OPEN SPACES FOR GROUP AND FAMILY THERAPY. THE CENTER PROVIDES A RANGE OF MENTAL AND BEHAVIORAL HEALTH SERVICES PREVIOUSLY UNAVAILABLE IN THIS COMMUNITY, INCLUDING A PARTIAL HOSPITALIZATION PROGRAM THAT OFFERS TWO WEEKS OF INTENSIVE INDIVIDUAL AND GROUP THERAPY BUT DOES NOT REQUIRE INPATIENT ADMISSION. IN ADDITION, OUTPATIENT BEHAVIORAL HEALTH SERVICES CAN BE ACCESSED THROUGH CHMCA'S PRIMARY CARE OFFICES THROUGHOUT THE MAHONING VALLEY. OUR CRISIS CARE SERVICE LINE, PSYCHIATRIC INTAKE RESPONSE CENTER (PIRC) OPERATES A 24/7 TELEPHONE TRIAGE SERVICE FOR HIGH-ACUITY BEHAVIORAL HEALTH CONCERNS, AND IS HOUSED IN THE EMERGENCY DEPARTMENTS AT OUR AKRON AND BOARDMAN CAMPUSES. PIRC IS STAFFED BY MASTER'S LEVEL MENTAL HEALTH THERAPISTS WHO PERFORM RISK ASSESSMENTS USING EVIDENCED BASED SCREENING AND ASSESSMENT TOOLS TO DETERMINE PATIENTS' OVERALL LEVEL OF RISK OF HARM TO SELF OR OTHERS ALONG WITH THE APPROPRIATE TREATMENT DISPOSITION. THESE RECOMMENDATIONS ARE THEN SHARED WITH THE ATTENDING PHYSICIAN AND THE PSYCHIATRIST ON CALL IF AN INPATIENT ADMISSION IS INDICATED. SAFETY PLANNING IS FACILITATED WITH THE PATIENT AND PARENT OR LEGAL GUARDIAN, AND REFERRALS MAY BE MADE TO AKRON CHILDREN'S SERVICES OR THOSE AVAILABLE IN THE COMMUNITY AS APPROPRIATE. AS PART OF THE 2020-2022 CHNA IMPLEMENTATION STRATEGY AROUND MENTAL HEALTH AND TRAUMA, CHMCA INCORPORATED ADVERSE CHILDHOOD EXPERIENCES (ACES) SCREENING INTO ALL MAHONING VALLEY BEHAVIORAL HEALTH SERVICE LINES. STAFF THROUGHOUT MAHONING VALLEY'S BEHAVIORAL HEALTH PRACTICES WERE TRAINED IN TRAUMA INFORMED CARE TO BE MORE RESPONSIVE TO PATIENTS AND FAMILIES WITH GREATER ACE EXPOSURE.
LINE 5, PROMOTION OF COMMUNITY HEALTH CONTINUED:	CHMCA'S PUBLIC SAFETY DEPARTMENT SUPPORTS OUR FOCUS ON MENTAL HEALTH BY PROMOTING CRISIS INTERVENTION TRAINING (CIT) FOR ITS OFFICERS AND OTHER LOCAL LAW ENFORCEMENT. WE ESTABLISHED A SPECIALIZED UNIT CALLED BEHAVIORAL RESPONSE AGAINST VIOLENCE ESCALATION (B.R.A.V.E.) WHICH INCORPORATES CIT CORE PRINCIPLES AND UTILIZES COLLABORATION, DE-ESCALATION, EDUCATION, AND UNDERSTANDING, WHILE TAKING A TRAUMA INFORMED APPROACH. AS A RESULT OF THIS PROGRAM, THE COMMUNITY IN WHICH THESE OFFICERS SERVE HAS SEEN A REDUCTION OF VIOLENT BEHAVIOR IN THE MENTALLY ILL POPULATION, SPECIFICALLY JUVENILES, AND REDUCTION IN USE OF FORCE ENCOUNTERS ACROSS ALL DEMOGRAPHICS. CHMCA'S NEONATOLOGY DEPARTMENTS IN AKRON AND BOARDMAN OFFER INTENSIVE CARE TO SICK AND PREMATURE NEWBORNS. 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'SNEONATAL TEAMIS 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 MORE THAN 1200 NICUS AROUND THE WORLD WHO FOCUS ON RESEARCH, EDUCATION ANDPROJECTS 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 HEALTH'S AKRON CITY HOSPITAL IN AKRON; AULTMAN HOSPITAL IN CANTON; MERCY HEALTH LORAIN; WOOSTER COMMUNITY HOSPITAL; CHMCA'S BEEGHLY CAMPUS IN BOARDMAN; ST. ELIZABETH BOARDMAN HOSPITAL, AND ST. JOSEPH WARREN HOSPITAL. A SPECIALLY EQUIPPED AMBULANCE AND PEDIATRIC TRANSPORT TEAM HANDLES THE TRANSFER OF THE NEWBORNS REQUIRING THE LEVEL III NEONATAL INTENSIVE CARE PROVIDED AT CHMCAIN DOWNTOWN AKRON. CHMCA'S POPULATION HEALTH DEPARTMENT PROVIDES CASE MANAGEMENT AND CARE COORDINATION SERVICES THROUGHOUT THE HOSPITAL'S SERVICE AREA, WORKING WITH PATIENTS ON A "HIGH RISK" REGISTRY TO IMPROVE HEALTH OUTCOMES AND ENHANCE 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. LOCATED AT CHMCA'S MAHONING VALLEY CAMPUS IS THE CHRONIC CARE EDUCATION AND SUPPORT CENTER (CCESC), WHICH DELIVERS CHRONIC DISEASE PREVENTION AND SELF-MANAGEMENT PROGRAMMING TO CHILDREN AND THEIR FAMILIES. THE DEPARTMENT DOES NOT GENERATE ANY REVENUE FOR THESE SERVICES, AND PROGRAMS MEET SPECIFIED CRITERIA OF NATIONALLY ACCREDITED DISEASE MANAGEMENT PROGRAMS, AS WELL AS CHMCA CRITERIA AND MONITORING REQUIREMENTS. IN 2022, THE CCESC RECEIVED 1160 REFERRALS FOR ASTHMA AND/OR ANAPHYLAXIS EDUCATION. OF THOSE, 746 CHILDREN/FAMILIES WERE PROVIDED PERSONALIZED ASTHMA AND ANAPHYLAXIS EDUCATION BY CCESC CERTIFIED ASTHMA EDUCATORS. THE CHILD AND ADOLESCENT DIABETES PREVENTION PROGRAM RECEIVED 230 REFERRALS FROM VARIOUS PEDIATRIC PROVIDERS ACROSS THE MAHONING VALLEY AND COMPLETED 396 INITIAL AND FOLLOW-UP APPOINTMENTS. THROUGH POPULATION HEALTH, CHMCA SERVES AS A CONTRACTED COORDINATING AGENCY COLLABORATING WITH LOCAL PATHWAYS COMMUNITY HUBS. FOR OUR AKRON FACILITY, THIS INCLUDES AKRON-SUMMIT COMMUNITY ACTION, STARK COMMUNITY ACTION COALITION, AND COMMUNITY HEALTH ACTION PROJECT. THESE HUBS SERVE SUMMIT, STARK, PORTAGE, MEDINA, WAYNE, RICHLAND, ASHLAND, KNOX, HURON, CRAWFORD, AND MORROW COUNTIES. WE ALSO WORK WITH MAHONING VALLEY HUB, WHICH SERVES MAHONING AND TRUMBULL COUNTIES. CHMCA AND THE HUBS PROVIDE BIDIRECTIONAL REFERRALS OF WOMEN WHO ARE PREGNANT AND UP TO ONE YEAR POSTPARTUM, INCREASING THEIR ACCESS TO RESOURCES SUCH AS PRENATAL CARE, FOOD AND HOUSING ASSISTANCE, ADULT EDUCATION, TOBACCO CESSATION SERVICES, AND OTHERS. COMMUNITY HEALTH WORKERS (CHWS), INCLUDING THOSE EMPLOYED BY CHMCA, HELP TO NAVIGATE THESE WOMEN THROUGH SYSTEMS, ENSURING THEY RECEIVE THE RESOURCES NEEDED TO PROVIDE A HEALTHY ENVIRONMENT FOR THEMSELVES AND THEIR CHILDREN.CHMCA ALSO EMPLOYES CHWS WHO WORK WITH PATIENT FAMILIES OUTSIDE OF THE HUBS. IN ADDITION, CHMCA IS A NURSE-FAMILY PARTNERSHIP SERVICE PROVIDER, WITH CHILDREN'S HOME CARE GROUP NURSES PROVIDING HOME VISITS TO PREGNANT WOMEN AND THEIR BABIES UP TO TWO YEARS POSTPARTUM. IN ADDITION, CHMCA PARTNERS WITH THE LOCAL NONPROFIT, COMMUNITY LEGAL AID SERVICES, ON THE HEALTH, EDUCATION, ADVOCACY AND LAW (HEAL) PROJECT, A MEDICAL-LEGAL PARTNERSHIP THAT PROVIDES PRIORITY LEGAL ASSISTANCE TO FAMILIES MEETING ELIGIBILITY REQUIREMENTS. FAMILIES ARE ASSISTED WITH LANDLORD/TENANT RELATIONS, STUDENT INDIVIDUALIZED EDUCATION PROGRAM (IEP) SUPPORT, PUBLIC BENEFITS NAVIGATION, DOMESTIC VIOLENCE SITUATIONS, AND OTHER LEGAL MATTERS. IN 2022, THE SOCIAL DETERMINANTS OF HEALTH (SDOH) COMMITTEE FORMED A WORKGROUP TO TACKLE TRANSPORTATION BARRIERS IN THE MAHONING VALLEY. IN REVIEWING DATA ON INCREASED NO-SHOWS TO APPOINTMENTS, STAFF DETERMINED LACK OF TRANSPORTATION TO BE A CONTRIBUTING FACTOR. CHMCA PARTNERED WITH THE THIRD-PARTY VENDOR ROUNDTRIP TO ADDRESS PATIENT FAMILIES' NON-URGENT TRANSPORTATION NEEDS. FROM JUNE 1, 2022 DEC. 31, 2022 ROUNDTRIP COMPLETED 1,390 RIDES FOR CHMCA FAMILIES, WITH 1,264 RIDES THROUGH RIDESHARE (UBER, LYFT) AND 126 RIDES THROUGH TAXICAB SERVICES. CHMCA'S EXTERNAL AFFAIRS DEPARTMENT OFFERS A VARIETY OF COMMUNITY HEALTH EDUCATION AND OUTREACH PROGRAMS TO CHILDREN AND FAMILIES THROUGHOUT THE SERVICE AREA. THESE INCLUDE INJURY PREVENTION PROGRAMS ON CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, TEEN SAFE DRIVING AND SAFE SLEEP, AND REACH OUT AND READ, A PROGRAM THAT PROMOTES EARLY CHILDHOOD LITERACY BY DISTRIBUTING BOOKS TO CHMCA PRIMARY CARE OFFICES TO PROVIDE CHILDREN DURING WELL VISITS. WE ALSO COORDINATE OUTREACH EVENTS AND OUTREACH KIT DISTRIBUTIONS IN OUR COMMUNITIES BASED ON IDENTIFIED NEEDS AND ALIGNMENT WITH STRATEGIC PRIORITIES. IN 2022, EXTERNAL AFFAIRS ENGAGED HOSPITAL AND COMMUNITY PARTNERS IN TWO SUMMER HEALTH AND WELLNESS DAY EVENTS, REACHING OVER 300 CHILDREN. AT THIS EVENT, CLINICIANS PROVIDED WELL VISITS, IMMUNIZATIONS AND SPORTS PHYSICALS TO STUDENTS HAVING LITTLE OTHER OPPORTUNITY TO ACCESS THEM ELSEWHERE. IN ADDITION, WE PROVIDED EDUCATION ON A VARIETY OF TOPICS RELATING TO CHILD HEALTH AND WELLBEING, AS WELL AS SCHOOL SUPPLIES, GUN CABLE LOCKS AND LOCK BOXES, AND NUMEROUS PROMOTIONAL ITEMS. WE DISTRIBUTED HYGIENE KITS FILLED WITH PERSONAL CARE ITEMS TO EVERY CHILD IN ATTENDANCE. EXTERNAL AFFAIRS CONTINUED YOUTH SUICIDE PREVENTION INITIATIVES IN 2022, COORDINATING AND CO-CHAIRING THE SUMMIT COUNTY YOUTH SUICIDE PREVENTION SUBCOMMITTEE AND PARTICIPATING ALONGSIDE OUR BEHAVIORAL HEALTH DIVISION IN AKRON CHILDREN'S HOSPITAL'S ZERO SUICIDE PEDIATRIC INITIATIVE. WE WORKED WITH NATIONALLY KNOWN EDUCATION AND TRAINING PROGRAMS ON YOUTH SUICIDE PREVENTION AND SHARED THESE RESOURCES THROUGHOUT THE HOSPITAL AND WITH COMMUNITY AGENCIES SERVING YOUTH AND FAMILIES, PARTICULARLY THOSE AT INCREASED RISK.
LINE 5, PROMOTION OF COMMUNITY HEALTH CONTINUED:	CHMCA'S SCHOOL HEALTH SERVICES SUPPORTSTHE ACADEMIC SUCCESS OF CHILDREN THROUGH HEALTH PROMOTION, EDUCATION AND CHILD ADVOCACY.SCHOOL HEALTHSERVES AS A LIAISON AMONG SCHOOL STAFF, FAMILY, AND PROVIDERS, WORKING CLOSELY WITH SCHOOL STAFF TO ENSURE A COMPREHENSIVE SCHOOL HEALTH PROGRAM IS IN PLACE. WITH IMMEDIATE ACCESS TOPEDIATRIC HEALTH CARE PROFESSIONALS AT CHMCA, SCHOOL HEALTH SERVICES LETS SCHOOLS FOCUS ON EDUCATING STUDENTS, WHILE WE MANAGE THEIR DISTRICT'S MEDICAL NEEDS. IN 2022, WE MANAGED CARE FOR 92,286 STUDENTS IN 205 BUILDINGS THROUGHOUT 43 DISTRICTS, AND WE PROVIDED 721,464 CLINIC VISITS. SCHOOL HEALTH SERVICES EXPANDED INTO FIVE NEW DISTRICTS IN 2022, AND BROUGHT SERVICES INTO TWO SHELTER SITES IN AKRON. STAFF COMPLETED 1,070 WELL CHILD VISITS AND 1,206 NURSE VISITS WHICH INCLUDED VACCINATIONS, BLOOD PRESSURE CHECKS, AND/OR HEARING/VISION CHECKS. IN ADDITION, THERE WERE MULTIPLE WELLNESS DAYS HELD AT SCHOOLS DURING THE SUMMER WHERE FAMILIES COULD TAKE THEIR CHILDREN FOR PREVENTIVE CARE SERVICES. CHMCA ALSO OPERATES A SCHOOL-BASED HEALTH CENTER WITHIN WARREN CITY SCHOOLS. SERVICES INCLUDE WELL-CHILD EXAMS (IN PERSON) AND EVALUATION FOR ILLNESS (BY TELEHEALTH TECHNOLOGY) WITH A NURSE PRACTITIONER; AS WELL AS VARIOUS SCREENINGS, WELLNESS ADVICE AND SPORTS PHYSICALS. PARENTS AND MEMBERS OF CHMCA'S FAMILY-CENTERED CARE COMMITTEE ESTABLISHED THE PARENT ADVISORY COUNCIL IN 1995. 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 WORK WITH HOSPITAL LIAISONS TO REPRESENT THE VOICE OF FAMILIES AS WE WORK TOGETHER TO ENHANCE THE DELIVERY OF FAMILY-CENTERED CARE.

Schedule H (Form 990) 2022

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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

2022

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) AMERICAN RED CROSS P O BOX 73013 CHICAGO,IL606737013	53-0196605	501(C)(3)	17,000	GENERAL SUPPORT
(2) AMERICAN HEART ASSOCIATION GREAT RIVERS AFFILIATE CHICAGO,IL60693	31-4409976	501(C)(3)	22,500	GENERAL SUPPORT
(3) AKRON COMMUNITY FOUNDATION 345 WEST CEDAR ST AKRON,OH44307	34-1087615	501(C)(3)	15,450	GENERAL SUPPORT
(4) RONALD MCDONALD HOUSE CHARITIES OF NORTHEAST OHIO INC 10415 EUCLID AVENUE CLEVELAND,OH44106	34-1269123	501(C)(3)	7,800	GENERAL SUPPORT
(5) AKRON ZOOLOGICAL PARK 500 EDGEWOOD AVENUE AKRON OHIO,AK44307	34-6003866	501(C)(3)	19,200	GENERAL SUPPORT
(6) MARCH OF DIMES 5425 WARNER RD STE 10 CLEVELAND,OH44125	13-1846366		8,000	GENERAL SUPPORT
(7) CHILD NEUROLOGY SOCIETY 1000 W COUNTY RD E STE 290 ST PAUL,MN55126	23-7359775		10,000	GENERAL SUPPORT
(8) AKRON AREA YMCA 50 S MAIN ST STE LL100 AKRON,OH44308	34-0714727		7,500	GENERAL SUPPORT
(9) CANTON REGIONAL CHAMBER OF COMMERCE 222 MARKET AVENUE N CANTON,OH44702	34-0129930	501(C)(3)	8,000	GENERAL SUPPORT
(10) YOUNGSTOWNWARREN REG CHAMBER 100 E FEDERAL STREET YOUNGSTOWN,OH44503	34-1731411		19,675	GENERAL SUPPORT
(11) GREATER AKRON CHAMBER OF COMMERCE AKRON,OH44311	34-1156576	501(C)(3)	15,920	GENERAL SUPPORT
(12) YOUNGSTOWN STATE UNIVERSITY OFFICE OF THE UNIV BURSAR YOUNGSTOWN,OH44555	94-3305461	501(C)(3)	27,400	GENERAL SUPPORT
(13) AKRON MARATHON CHARITABLE CORP 155 E VORIS STREET AKRON,OH443111513	43-1531773		12,500	GENERAL SUPPORT
(14) YOUNGSTOWN PHANTOMS 229 E FRONT STREET YOUNGSTOWN,OH44503	54-2117655		12,200	GENERAL SUPPORT
(15) COVELLI CENTRE 229 E FRONT STREET YOUNGSTOWN,OH44503	26-1299078		10,000	GENERAL SUPPORT
(16) HWS BASEBALL VI LLC 111 EASTWOOD MALL BLVD NILES,OH44446	26-1918633	501(C)(3)	19,000	GENERAL SUPPORT
(17) MILL CREEK METROPARKS ATTN LYNN YOUNGSTOWN,OH44509	34-6003205		5,060	GENERAL SUPPORT
(18) AKRON BASEBALL LLC 300 SOUTH MAIN ST AKRON,OH44308	99-0379765	501(C)(3)	50,500	GENERAL SUPPORT
(19) SIGHT FOR ALL UNITED INC 966 FIFTH STREET STRUTHERS,OH44471	81-1468439	501(C)(3)	15,800	GENERAL SUPPORT
(20) CITY OF NORTH CANTON 145 N MAIN ST NORTH CANTON,OH44720	34-6002037	501(C)(3)	56,719	GENERAL SUPPORT
(21) THE CHILDREN'S HEART FOUNDATION 5 REVERE DR NORTHBROOK,IL60062	36-4077528	501(C)(3)	7,500	GENERAL SUPPORT
(22) CANAPI 759 W MARKET ST AKRON,OH44303	31-1506671		5,360	GENERAL SUPPORT
(23) MAHONING COUNTY AGRICULTURAL SOCIETY 7265 COLUMBIANA CANFIELD ROAD CANFIELD,OH44406	34-0764399	501(C)(3)	15,000	GENERAL SUPPORT
(24) FELLOWSHIP OF CHRISTIAN ATHLETES ATTN PAM MATEJKA BEREA,OH44017	44-0610626	501(C)(3)	10,500	GENERAL SUPPORT
(25) NORTHERN OHIO GOLF CHARITIES FOUNDATION INC 440 EAST WARNER ROAD AKRON,OH44319	34-1712857	501(C)(3)	15,000	GENERAL SUPPORT
(26) WENTZ FAMILY FOUNDATION 5790 HUDSON DR HUDSON,OH44236	46-1066495	501(C)(3)	10,000	GENERAL SUPPORT
(27) INTERNATIONALS SOCCER CLUB LLC 313 MEDINA RD MEDINA,OH44256	45-3187875	501(C)(3)	25,000	GENERAL SUPPORT
(28) TOPNOTCH EVENTS LLC 12410 LARCHMERE BLVD CLEVELAND,OH44120	86-3225566	501(C)(3)	6,256	GENERAL SUPPORT
(29) 33 FOREVER INC ONE MARION AVE MANSFIELD,OH44903	83-3606336	501(C)(3)	5,333	GENERAL SUPPORT
(30) BRIDGESTONE SENIOR PLAYERS CHAMPIONSHIP - FIRESTONE CC 452 E WARNER RD AKRON,OH44319	75-1744518	501(C)(3)	21,289	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) 2022

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

Schedule I (Form 990) 2022

Additional Data

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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

2022

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 on 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 on 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? .............

Yes

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) 2022

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1GRACE WAKULCHIK FORMER PRESIDENT	(i) (ii)	531,652 ------------- 0	400,000 ------------- 0	951,624 ------------- 0	0 ------------- 0	0 ------------- 0	1,883,276 ------------- 0	894,384 ------------- 0
2CHRISTOPHER GESSNER PRESIDENT & CEO	(i) (ii)	1,000,002 ------------- 0	0 ------------- 0	15,690 ------------- 0	214,796 ------------- 0	33,414 ------------- 0	1,263,902 ------------- 0	0 ------------- 0
3KATHERINE WOLFE MD CHIEF MATERIAL FETAL MED SVS	(i) (ii)	827,920 ------------- 0	225,446 ------------- 0	646 ------------- 0	18,300 ------------- 0	32,117 ------------- 0	1,104,429 ------------- 0	0 ------------- 0
4MARK WULKAN MD CHAIR OF SURGERY	(i) (ii)	802,006 ------------- 0	233,000 ------------- 0	3,612 ------------- 0	21,350 ------------- 0	22,007 ------------- 0	1,081,975 ------------- 0	0 ------------- 0
5ROBERT STEWART MD DIRECTOR CARDIOTHORACIC SURGERY	(i) (ii)	812,314 ------------- 0	200,000 ------------- 0	3,354 ------------- 0	21,350 ------------- 0	32,672 ------------- 0	1,069,690 ------------- 0	0 ------------- 0
6ABDELAZIZ SALEH MD PERINATOLOGIST	(i) (ii)	857,007 ------------- 0	153,330 ------------- 0	6,096 ------------- 0	20,105 ------------- 0	29,881 ------------- 0	1,066,419 ------------- 0	0 ------------- 0
7LISA AURILIO CHIEF OPERATING OFFICER	(i) (ii)	584,994 ------------- 0	164,629 ------------- 0	332,740 ------------- 0	-64,180 ------------- 0	13,074 ------------- 0	1,031,257 ------------- 0	308,045 ------------- 0
8TSULEE CHEN MD NEUROSURGEON	(i) (ii)	868,613 ------------- 0	110,000 ------------- 0	840 ------------- 0	18,300 ------------- 0	20,570 ------------- 0	1,018,323 ------------- 0	0 ------------- 0
9SHAWN LYDEN CHIEF STRATEGY OFFICER	(i) (ii)	671,235 ------------- 0	145,699 ------------- 0	32,431 ------------- 0	117,065 ------------- 0	24,525 ------------- 0	990,955 ------------- 0	0 ------------- 0
10JODI REGAN MD PERINATOLOGIST	(i) (ii)	816,270 ------------- 0	153,330 ------------- 0	1,488 ------------- 0	0 ------------- 0	0 ------------- 0	971,088 ------------- 0	0 ------------- 0
11ROBERT MCGREGOR MD DIRECTOR / CHIEF MEDICAL OFFICER	(i) (ii)	588,092 ------------- 0	145,355 ------------- 0	29,989 ------------- 0	103,850 ------------- 0	24,057 ------------- 0	891,343 ------------- 0	0 ------------- 0
12CHRSTINE YOUNG CHIEF NURSING OFFICER	(i) (ii)	373,578 ------------- 0	106,650 ------------- 0	187,096 ------------- 0	81,847 ------------- 0	30,278 ------------- 0	779,449 ------------- 0	185,600 ------------- 0
13MICHAEL BIGHAM MD CHIEF QUALITY OFFICER	(i) (ii)	448,240 ------------- 0	116,876 ------------- 0	1,962 ------------- 0	103,894 ------------- 0	24,327 ------------- 0	695,299 ------------- 0	0 ------------- 0
14HARUN RASHID CHIEF INFORMATION OFFICER	(i) (ii)	410,622 ------------- 0	107,602 ------------- 0	45,602 ------------- 0	94,761 ------------- 0	30,794 ------------- 0	689,381 ------------- 0	0 ------------- 0
15ANTHEA DANIELS ASST SEC /CHIEF LEGAL OFFICER	(i) (ii)	439,997 ------------- 0	116,853 ------------- 0	1,914 ------------- 0	100,069 ------------- 0	3,609 ------------- 0	662,442 ------------- 0	0 ------------- 0
16RHONDA LARIMORE CHIEF HUMAN RESOURCES OFFICER	(i) (ii)	367,460 ------------- 0	106,202 ------------- 0	4,497 ------------- 0	89,414 ------------- 0	30,625 ------------- 0	598,198 ------------- 0	0 ------------- 0
17SHEFALI MAHESH MD DEPARTMENT CHAIR OF PEDIATRICS	(i) (ii)	309,153 ------------- 0	148,678 ------------- 0	428 ------------- 0	21,350 ------------- 0	18,860 ------------- 0	498,469 ------------- 0	0 ------------- 0
18MICHELE BROWN CHIEF DEVELOPMENT OFFICER	(i) (ii)	0 ------------- 328,004	0 ------------- 82,675	0 ------------- 7,427	0 ------------- 55,026	0 ------------- 19,393	0 ------------- 492,525	0 ------------- 0
19ALICIA LAMANCUSA TREASURER - PART YEAR	(i) (ii)	375,003 ------------- 0	231,875 ------------- 0	8,489 ------------- 0	-208,698 ------------- 0	23,241 ------------- 0	429,910 ------------- 0	0 ------------- 0
20BERNETT WILLIAMS CHIEF DIVERSITY, EQUITY, INCLUSION O	(i) (ii)	292,409 ------------- 0	47,500 ------------- 0	5,977 ------------- 0	66,076 ------------- 0	16,719 ------------- 0	428,681 ------------- 0	0 ------------- 0
21CRAIG MCGHEE CHIEF NON HOSPITAL SVS OFFICER	(i) (ii)	287,083 ------------- 0	81,510 ------------- 0	13,398 ------------- 0	4,846 ------------- 0	13,847 ------------- 0	400,684 ------------- 0	0 ------------- 0
22MICHAEL FORBES MD INTERIM CHAIR OF PEDIATRICS	(i) (ii)	391,892 ------------- 0	56,154 ------------- 0	5,243 ------------- 0	-86,807 ------------- 0	22,578 ------------- 0	389,060 ------------- 0	0 ------------- 0
23GORDON EDWARDS CFO AND TREASURER - PART YEAR	(i) (ii)	156,433 ------------- 0	20,000 ------------- 0	43,686 ------------- 0	0 ------------- 0	6,508 ------------- 0	226,627 ------------- 0	0 ------------- 0
24KRISTENE GRAYEM CHIEF POPULATION HEALTH OFFICER	(i) (ii)	341,062 ------------- 0	41,825 ------------- 0	1,249 ------------- 0	-222,371 ------------- 0	3,024 ------------- 0	164,789 ------------- 0	0 ------------- 0
25WILLIAM CONSIDINE CEO EMERITUS	(i) (ii)	0 ------------- 0	0 ------------- 0	72,856 ------------- 0	0 ------------- 0	0 ------------- 0	72,856 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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	THE FOLLOWING INDIVIDUALS HAD A 2022 COUNTRY CLUB MEMBERSHIP THAT WAS USED BY THEM FOR BUSINESS PURPOSES: CHRISTOPHER GESSNER ROBERT MCGREGOR M.D. AN UPGRADE TO THE NEXT AVAILABLE CLASS, E.G., BUSINESS CLASS, MAY BE PERMITTED WHEN THE FLIGHT IS OUTSIDE THE CONTINENTAL UNITED STATES OR THE FLIGHT DURATION IS IN EXCESS OF FIVE HOURS; OR AN UPGRADE TO THE NEXT AVAILABLE CLASS MAY BE PERMITTED WHEN AN OVERNIGHT ACCOMMODATION CAN BE AVOIDED. AS PART OF THE RECRUITMENT PACKAGE FOR AN EXECUTIVE, HOTEL AND MOVING REIMBURSEMENT IS MADE AVAILABLE AND TAXED ACCORDINGLY.
PART I, LINES 4A-B	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. DISTRIBUTIONS WERE MADE IN 2022 IN THE FOLLOWING AMOUNTS: GRACE WAKULCHIK - $894,384 CHRISTOPHER GESSNER - $0 MICHELE E. BROWN - $0 MICHAEL T. BIGHAM - $0 ANTHEA R. DANIELS - $0 HARUN A. RASHID - $0 CHRISTINE G. YOUNG - $185,000 RHONDA L. LARIMORE - $0 LISA AURILIO - $308,045 ROBERT MCGREGOR - $0 SHAWN LYDEN - $0 BERNETT WILLIAMS - $0 CHMCA HAS A SUPPLEMENTAL NONQUALIFIED PLAN OPEN TO SELECTED EMPLOYEES WHEN WAGES EXCEED THE MAXIMUM THRESHOLD FOR THE QUALIFIED RETIREMENT PLANS. THE AMOUNTS ARE CALCULATED IN THE FOLLOWING YEAR OF EARNINGS AND EITHER PAID TO THE EMPLOYEE IF THEY ARE VESTED AS TAXABLE INCOME OR PUT INTO THE PLAN UNTIL VESTED AND THEN PAID. MS. GRACE WAKULCHIK RECEIVED $315,839 AS SEVERANCE IN THE FIRST PAY OF 2022 IN ACCORDANCE WITH THE AGREEMENT SIGNED APRIL 28, 2021.
PART I, LINE 7	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. BONUSES ARE BASED ON PERFORMANCE AND OTHER METRICS BUT FINAL DECISIONS ARE DISCRETIONARY BY THE BOARD. THE CEO'S BONUS IS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD. CEO RECOMMENDS FOR APPROVAL THE EXECUTIVES BONUSES TO THE BOARD AND THEY APPROVE THEM. THE CEO APPROVES THE VICE PRESIDENTS BONUSES.

Schedule J (Form 990) 2022

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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 instructions and the latest information.

OMB No. 1545-0047

2021

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	009730QS4	05-12-2022	83,892,426	2022A - REFUND PRIOR ISSUE		X		X		X
B	AKRON BATH AND COPLEY JOINT TWSP HOSP DISTRICT	34-1448680	009730NB4	05-15-2013	101,377,818	CONSTRUCTION OF CRITICAL CARE TOWE	X			X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................			6,440,000
2 Amount of bonds legally defeased ..............			90,905,000
3 Total proceeds of issue ..................	83,892,426		101,377,818
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............			10,229,217
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	196,856		1,148,601
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............	932,000
10 Capital expenditures from proceeds .............			90,000,000
11 Other spent proceeds .............	82,763,570
12 Other unspent proceeds .............
13 Year of substantial completion .............	2013		2015
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X			X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X
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 %
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 .........	0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		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
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? .............
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

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
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........	X			X
c No rebate due? .........		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

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X
b Name of provider ..........
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
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

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

Return Reference	Explanation
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

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

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 instructions and the latest information.

OMB No. 1545-0047

2021

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 section 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 the 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) 2021

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) BWK ENGINEERING	FAMILY OF BOARD MEMBER, LISA BANDWEN OWNS MORE THAN 35% OF BWK ENGINEERING	138,406	ENGINEERING DESIGN SERVICES		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

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 1, DESCRIPTION OF ORGANIZATION MISSION:	CHILDREN'S HOSPITAL MEDICAL CENTER OF AKRON (CHMCA) IS COMMITTED TO REMAINING AN INDEPENDENT, COMMUNITY GOVERNED, INTEGRATED PEDIATRIC HEALTH CARE SYSTEM. CHMCA IS DEDICATED TO IMPROVING THE HEALTH OF CHILDREN THROUGH OUTSTANDING QUALITY CARE, EDUCATION, ADVOCACY, COMMUNITY SERVICE AND RESEARCH. CHMCA IS AN INDISPENSABLE, INTEGRATED PEDIATRIC HEALTHCARE DELIVERY SYSTEM SERVING INFANTS, CHILDREN AND ADOLESCENTS, AS WELL AS ADULTS IN THE REGIONAL BURN CENTER IN AKRON AND NORTHEAST OHIO. ESTABLISHED IN 1890 BY A GROUP OF WOMEN AFFILIATED WITH A LOCAL CHURCH, CHMCA HAS GROWN FROM A TWO-ROOM DAY NURSERY TO INCLUDE TWO HOSPITAL CAMPUSES, SIX REGIONAL HEALTH CENTERS AND MORE THAN 50 PRIMARY AND SPECIALTY CARE LOCATIONS. CHMCA IS A NOT-FOR PROFIT FACILITY WHICH OPERATES TWENTY-FOUR (24) HOURS A DAY, SEVEN (7) DAYS A WEEK. CHMCA ACCEPTS ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY WHILE ALSO PROMISING 1) TO TREAT EVERY CHILD AS WE WOULD OUR OWN; 2) TO TREAT OTHERS AS THEY WOULD LIKE TO BE TREATED; AND 3) TO TURN NO CHILD AWAY FOR ANY REASON.
FORM 990, PART VI, SECTION A, LINE 6	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, SECTION A, LINE 7A	ACCORDING TO THE CODE OF REGULATIONS OF CHMCA, FIVE OF THE MEMBERS SHALL CONSIST OF THE WOMEN'S BOARD OF CHMCA AND SHALL HOLD SUCH POSITION FOR A PERIOD OF TWO YEARS OR UNTIL THEIR SUCCESSORS ARE ELECTED AND QUALIFIED. THE HOSPITAL'S CHIEF EXECUTIVE OFFICER AND PRESIDENT, CHIEF MEDICAL OFFICER, CHAIRMAN OF THE DEPARTMENT OF SURGERY, AND THE CURRENTLY SERVING NOAH MILLER CHAIR FOR PEDIATRICS SHALL EACH BE A MEMBER OF THE BOARD OF DIRECTORS. IN ADDITION, THE ELECTED PRESIDENT OF THE MEDICAL STAFF WILL BE A MEMBER OF THE BOARD OF DIRECTORS AND CHAIR OF THE FOUNDATION BOARD. THE REMAINING MEMBERS OF THE BOARD OF DIRECTORS AND CHAIR OF THE FOUNDATION BOARD SHALL BE ELECTED BY THE MEMBERS OF CHMCA. A DIRECTOR SHALL BE ELECTED FOR A THREE-YEAR TERM. EACH DIRECTOR SHALL SERVE UNTIL THEIR SUCCESSOR IS ELECTED AND QUALIFIED. A DIRECTOR MAY RENEW UP TO THREE (3) THREE YEAR TERMS. UPON UNANIMOUS RESOLUTION OF THE MEMBERS, A FORMER CHAIR WHO AFTER SUCH TERM EXPIRES, SHALL BECOME A DIRECTOR EMERITUS. THE DIRECTOR'S RESPONSIBILITIES INCLUDE: ENSURING THAT CHMCA FULFILLS ITS DUTY TO SERVE THE COMMUNITY BENEFIT PURPOSE, INCLUDING THE HOSPITAL'S MISSION OF IMPROVING THE HEALTH OF CHILDREN THROUGH OUTSTANDING QUALITY PATIENT CARE, EDUCATION, ADVOCACY, COMMUNITY SERVICE, AND RESEARCH BY CONTINUING TO SATISFY THE FEDERAL TAX LAWS AROUND MAINTAINING CHARITABLE AND PUBLIC BENEFIT STATUS WHILE NOT ENGAGING IN PRIVATE INUREMENTS. THE BOARD SHALL GOVERN THE AFFAIRS OF CHMCA AND ITS PROPERTY. THE CORPORATE POWERS, PROPERTY, AND AFFAIRS OF CHMCA SHALL BE EXERCISED, CONDUCTED, AND CONTROLLED BY THE DIRECTORS. THE EXECUTIVE COMMITTEE MEMBERSHIP IS DELINEATED IN THE CODE OF REGULATIONS.
FORM 990, PART VI, SECTION A, LINE 7B	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, REPRESENT THE BOARD OF DIRECTORS AND SHALL BE RESPONSIBLE TO THEM RESPECTIVELY FOR THE PROPER PERFORMANCE OF DUTIES. IT SHALL BE THE DUTY OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER TO MAKE KNOWN AND ENFORCE ALL RULES AND REGULATIONS WHICH SHALL BE MADE BY AND UNDER THE AUTHORITY OF THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE OF THE BOARD. IN ALL CASES OF DISPUTED AUTHORITY OR UNCERTAINTY AS TO THE MEANING OF THE REGULATIONS, THE DECISION OF THE CHIEF EXECUTIVE OFFICER IS ABSOLUTE UNTIL A RULING IS RENDERED BY THE BOARD OF DIRECTORS, PRESIDENT, AND THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11B	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, SECTION B, LINE 12C	IT IS CHMCA'S POLICY THAT ALL EMPLOYEES, BOARD MEMBERS, AND OFFICERS DISCLOSE REAL AND APPARENT CONFLICTS OF INTEREST AS A CONDITION OF EMPLOYMENT WITH CHMCA. CHMCA ALSO REQUIRES THAT EACH EMPLOYEE, BOARD MEMBER, AND OFFICER DISCLOSE IN WRITING, ANNUALLY, A LIST OF ALL BUSINESSES OR OTHER ORGANIZATIONSIN WHICH HE/SHE (OR AN IMMEDIATE FAMILY MEMBER) 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 RESPONSIBILITYOF 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 CHIEF HUMAN RESOURCES OFFICER WHO WILL PRESENT IT TO THE PRESIDENT AND CEO OR THEIR DESIGNEE. IT IS THE RESPONSIBILITYOF THE PRESIDENT AND CEO OR THE 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 RESPONSIBILITYOR OTHER DISCIPLINARY ACTION UP TO AND INCLUDING DISCHARGE.
FORM 990, PART VI, SECTION B, LINE 15	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. AN INDEPENDENT SALARY SURVEY WAS COMPLETED IN 2022 AND RECOMMENDATIONS WERE PROVIDED AND PRESENTED BY THE INDEPENDENT CONSULTANT TO THE COMMITTEE FOR APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19	CHMCA MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. IN ADDITION, CERTAIN 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 VI, LINE 16B:	CHMCA HAS MADE INVESTMENTS IN LIMITED LIABILITY OR LIMITED PARTNER ORGANIZATIONS ON A LIMITED BASIS TO SUPPORT THE DOWNTOWN AKRON AS WELL AS YOUNGSTOWN COMMUNITIES WITH THE GOAL OF ATTRACTING NEW BUSINESS TO THOSE AREAS. FURTHER, CHMCA HAS INVESTED IN A LIMITED BASIS ON INNOVATIVE IDEAS TO IMPROVE HEALTHCARE. ALL JOINT VENTURES ARE REVIEWED TO ENSURE EXEMPTION IS NOT AT RISK.
FORM 990, PART XI, LINE 9:	INVESTMENT IN FOUNDATION -33,865,915. OTHER CHANGES IN NET ASSETS -1,802,796. CHANGE IN PENSION PLAN REQUIREMENTS -22,557,754. CHANGE IN POSTRETIEMENT REQUIREMENTS 7,780,183. LOSS ON EXTINGUISHMENT OF DEBT 3,276,458.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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

2021

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)	LINE 7	CHMCA	Yes
(2)CHILD DIMENSIONS INSURANCE COMPANY ONE PERKINS SQUARE AKRON,OH44308 03-0317160	INSURANCE	VT	501(C)(3)	LINE 12A, I	CHMCA	Yes
(3)AKRON CHILDREN'S HEALTH COLLABORATIVE ONE PERKINS SQUARE AKRON,OH44308 87-0853487	ACCOUNTABLE CARE ORGANIZATION	OH	501(C)(4)	LINE 12A, I	CHMCA	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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	(k) Percentage ownership
(1) GAMUT QUALITY IMPROVEMENT COLLABORATIVE LLC 68 RAVENNA STREET 463 HUDSON,OH44236 87-1832345	CONTRACT MANAGEMENT	OH	CHILDREN'S HOSPITAL MED CENTER OF AKRON	RELATED	61,189	178,827		No			No	60.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2021

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) ............................

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) .....................

Yes

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) AKRONS CHILDRENS HOSPITAL FOUNDATION	Q	1,241,440	ACTUAL PER GL
(2) AKRONS CHILDRENS HOSPITAL FOUNDATION	C	14,368,908	ACTUAL PER GL
(3) AKRONS CHILDRENS HOSPITAL FOUNDATION	O	3,788,579	ACTUAL PER GL
(4) AKRONS CHILDRENS HOSPITAL FOUNDATION	B	614,331	ACTUAL PER GL
(5) AKRON CHILDREN'S HEALTH COLLABORATIVE	Q	6,382,673	ACTUAL PER GL
(6) AKRON CHILDREN'S HEALTH COLLABORATIVE	L	113,232,195	ACTUAL PER GL
(7) CHILD DIMENSIONS INSURANCE COMPANY	Q	3,771,269	ACTUAL PER GL

Schedule R (Form 990) 2021

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2021

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) 2021

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, AND CHILD ADVOCACY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	30
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	25
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	8,223
6	Total number of volunteers (estimate if necessary) .............	6	912
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	276,861
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	16,021,034	20,114,563
9	Program service revenue (Part VIII, line 2g) .........	1,123,755,021	1,176,233,927
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	39,875,247	5,361,953
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,715,151	6,361,331
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,186,366,453	1,208,071,774
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,064,040	1,166,285
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)	642,828,864	703,156,319
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)....	376,634,243	421,608,258
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,022,527,147	1,125,930,862
19	Revenue less expenses. Subtract line 18 from line 12.......	163,839,306	82,140,912
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,008,652,850	1,981,794,990
21	Total liabilities (Part X, line 26).............	564,707,101	565,331,293
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,443,945,749	1,416,463,697

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 897,661,689 including grants of $ 1,166,285 ) (Revenue $ 1,176,233,927 )
	CHMCA IS THE LARGEST PEDIATRIC HEALTHCARE SYSTEM IN NORTHEAST OHIO, OPERATING ONE HOSPITAL WITH TWO CAMPUSES IN NORTHEAST OHIO, INCLUDING INPATIENT AND OUTPATIENT SERVICES, 2 EMERGENCY DEPARTMENTS, 4 URGENT CARES, 35 PEDIATRICIAN OFFICES, AND MORE THAN 60 PRIMARY & SPECIALTY LOCATIONS. DURING 2022, CHMCA SERVED OVER 1,200,000 PATIENT VISITS THROUGH ALL OF ITS PROGRAMS.INPATIENT SERVICES INCLUDE AREAS OF ROUTINE CARE, NEONATAL INTENSIVE CARE, PEDIATRIC INTENSIVE CARE, BEHAVIORAL HEALTH, REGIONAL BURN CENTER, HEMATOLOGY/ONCOLOGY, AND EMERGENCY/TRAUMA SERVICES. OUTPATIENT SERVICES OFFERS UNIQUE SERVICES IN A BROAD RANGE OF PEDIATRIC SUBSPECIALTIES SUCH AS NEONATOLOGY, BEHAVIORAL HEALTH,REHABILITATION SERVICES, CARDIOLOGY, PLASTIC SURGERY, GENETICS, MATERNAL FETAL MEDICINE, URGENT AND QUICK CARE, ADOLESCENT MEDICINE, PALLIATIVE CARE, PULMONARY MEDICINE, UROLOGY, OPHTHALMOLOGY, ORTHOPEDICS, NEUROLOGY, ALLERGY, DENTAL, ADDICTION SERVICES, PHYSICAL AND OCCUPATIONAL THERAPY, AND INFECTIOUS DISEASE SERVICES.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses897,661,689

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	17,436,458	418,106	1,046,463

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	677,963
d	Related organizations		1d	14,368,908
e	Government grants (contributions)		1e	4,188,992

f	All other contributions, gifts, grants, and similar amounts not included above		1f	878,700

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		20,114,563

		Business Code
2a	NET PATIENT SERVICE REVENUE	621110	1,052,571,654	1,052,571,654
b	OTHER PROGRAM SERVICE REVENUE	621110	123,662,273	123,662,273
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,176,233,927

3 Investment income (including dividends, interest, and othersimilar amounts) ......			12,530,547		-14,093	12,544,640
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	30,000	553,692,785	7a
b	Less: cost or other basis and sales expenses	0	560,891,379	7b
c	Gain or (loss)	30,000	-7,198,594	7c
d	Net gain or (loss).........			-7,168,594			-7,168,594
8a	Gross income from fundraising events (not including $ 677,963of contributions reported on line 1c). See Part IV, line 18 ....
			8a	225,989
b	Less: direct expenses ...		8b	1,056,252
c	Net income or (loss) from fundraising events..			-830,263			-830,263
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA		722514	3,185,098			3,185,098
b	OUTSIDE LAB SERVICES		621500	206,398		206,398
c	RETAIL PHARMACY		445100	84,556		84,556
d	All other revenue ....			3,715,542			3,715,542
e	Total. Add lines 11a–11d ......			7,191,594
12	Total revenue. See instructions.....			1,208,071,774	1,176,233,927	276,861	11,446,423

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,166,285	1,166,285
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	11,437,040		11,437,040
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	541,501,225	472,797,588	68,703,637
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	32,026,053	27,911,570	4,114,483
9	Other employee benefits .......	83,292,300	68,827,813	14,464,487
10	Payroll taxes ...........	34,899,701	30,534,798	4,364,903
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	987,237		987,237
c	Accounting ...........	517,530		517,530
d	Lobbying ...........	196,713		196,713
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,148,154		1,148,154
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	86,366,585	58,427,161	27,939,424
12	Advertising and promotion ....	11,832,033	207,885	11,624,148
13	Office expenses .......	13,776,272	11,482,145	2,294,127
14	Information technology ......	4,936,671		4,936,671
15	Royalties ..
16	Occupancy ...........	7,614,002	7,163,663	450,339
17	Travel ............	2,900,199	2,370,894	529,305
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	9,863,344	3,019,642	6,843,702
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	64,604,859	36,968,422	27,636,437
23	Insurance ...	6,540,833	58,665	6,482,168
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 SUPPLI	141,224,915	141,107,631	117,284
b	PROVISION FOR FRANCHISE	31,794,746		31,794,746
c	EQUIPMENT RENTAL/MAINTE	25,333,885	19,885,734	5,448,151
d	PROVISION FOR BAD DEBT	12,084,177	12,084,177
e	All other expenses	-113,897	3,647,616	-3,761,513
25	Total functional expenses. Add lines 1 through 24e	1,125,930,862	897,661,689	228,269,173	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 ........			17,632	1	17,632
2	Savings and temporary cash investments .........			167,338,564	2	218,750,878
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			164,695,454	4	169,576,332
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			32,031,800	7	45,521,438
8	Inventories for sale or use ............			13,042,057	8	10,993,922
9	Prepaid expenses and deferred charges ......			10,147,610	9	13,969,696
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,440,698,440
b	Less: accumulated depreciation	10b	826,352,140	619,241,051	10c	614,346,300
11	Investments—publicly traded securities .			709,042,037	11	641,163,622
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			21,719,788	13	30,561,299
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			271,376,857	15	236,893,871
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,008,652,850	16	1,981,794,990

17	Accounts payable and accrued expenses .....	146,980,967	17	186,021,060
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	188,447,856	20	83,892,426
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23	81,216,504
24	Unsecured notes and loans payable to unrelated third parties ..	80,963,920	24	79,522,641
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	148,314,358	25	134,678,662
26	Total liabilities. Add lines 17 through 25..	564,707,101	26	565,331,293

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,320,265,716	27	1,307,787,533
28	Net assets with donor restrictions ...........	123,680,033	28	108,676,164
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	1,443,945,749	32	1,416,463,697
33	Total liabilities and net assets/fund balances ........	2,008,652,850	33	1,981,794,990