4A (Expenses $ 520493213 including grants of $ 0) (Revenue $ 613978885)
OUTPATIENT SERVICES FOR 2021: SUMMA HEALTH SYSTEM, AND SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP, PROVIDED OVER 1.9 MILLION OCCASIONS OF SERVICE, INCLUDING 136,836 EMERGENCY DEPARTMENT VISITS, 9,128 OBSERVATION PATIENTS, 15,980 SURGICAL OPERATIONS, AND OVER 1.7 MILLION OTHER OUTPATIENT VISITS.

4B (Expenses $ 466096914 including grants of $ 0) (Revenue $ 549812479)
INPATIENT SERVICES FOR 2021: SUMMA HEALTH SYSTEM HAD APPROXIMATELY 662 BEDS IN SERVICE, ADMITTED 34,852 ADULT PATIENTS, AND DELIVERED 4,545 NEWBORNS. THE ADULT PATIENTS RECEIVED 179,868 DAYS OF CARE, INPATIENT SURGERIES TOTALED 6,882, EMERGENCY ADMISSIONS TOTALED 25,636 AND THE AVERAGE LENGTH OF STAY WAS 5.16 DAYS.

4C (Expenses $ 44568831 including grants of $ 0) (Revenue $ 11825897)
RESEARCH/EDUCATION FOR 2021: SUMMA HEALTH HAS A HISTORY OF SPONSORING AND SUPPORTING BASIC AND CLINICAL RESEARCH TO UNDERSTAND DISEASES AND TREATMENT. CENTERS, PROGRAMS AND LABS FACILITATE RESEARCH IN A NUMBER OF MEDICAL FIELDS. SUMMA HEALTH FOSTERS A LEARNING ENVIRONMENT FOR THE NEXT GENERATION OF CAREGIVERS. AT SUMMA HEALTH'S HOSPITALS, APPROXIMATELY 270 MEDICAL SCHOOL GRADUATES TRAIN IN 14 ACCREDITED RESIDENCY PROGRAMS, EIGHT ACCREDITED FELLOWSHIP TRAINING PROGRAMS AND ONE NON-ACCREDITED FELLOWSHIP PROGRAM. SUMMA HEALTH PROVIDES CLINICAL LEARNING EXPERIENCES TO NEARLY 2,300 NURSING, MEDICAL, PHARMACY, EMERGENCY MEDICAL TECHNICIAN, PARAMEDIC, AND ALLIED HEALTH STUDENTS.

4D (Expenses $ 153305176 including grants of $ 13212281) (Revenue $ 180840285)
SUMMARYALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF SUMMA HEALTH, NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. SUMMA HEALTH PROVIDED SERVICES TO ALL PATIENTS ON A NON-DISCRIMINATORY BASIS AND WITHOUT REGARD TO ANY PATIENT'S ABILITY TO PAY FOR SUCH SERVICES OR THE INDIVIDUAL'S PARTICIPATION IN A GOVERNMENT-SPONSORED OR SUBSIDIZED HEALTHCARE SYSTEM.PATIENTS WERE ENCOURAGED TO APPLY FOR UNCOMPENSATED CARE AND, DEPENDING ON THEIR LEVEL OF INCOME AND NUMBER OF DEPENDENTS, ALL (OR A PORTION) OF THEIR BILL WAS REDUCED. GROSS ANNUAL FAMILY INCOME WAS COMPARED USING A SLIDING SCALE BASED ON THE FEDERAL POVERTY INCOME GUIDELINES TO DETERMINE THE CHARITY DISCOUNT FOR WHICH THE PATIENT MAY BE ELIGIBLE. IN 2021, SUMMA HEALTH PROVIDED CHARITY CARE TO THE INDIGENT (INCLUDING UNREIMBURSED MEDICAID) AT THE COST OF MORE THAN $81.9 MILLION. THIS AMOUNT DOES NOT INCLUDE SERVICES PROVIDED WRITTEN OFF AS BAD DEBT.IN ADDITION TO UNCOMPENSATED MEDICAL CARE, SUMMA HEALTH PROVIDED WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS AND SPECIAL PROGRAMS FOR THE ELDERLY, PERSONS WITH DISABILITIES AND THE MEDICALLY UNDERSERVED. SUMMA HEALTH ALSO OPERATED A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THESE PROGRAMS WERE OFFERED AT A REDUCED PRICE OR PROVIDED TO THE COMMUNITY FREE OF CHARGE. SUMMA HEALTH OPERATES ITS FACILITIES IN A MANNER CONSISTENT WITH THE COMMUNITY BENEFIT REQUIREMENTS OF REV. RULE 69-545 AND SUBSEQUENT CASE LAW AND IRS GUIDELINES. SUMMA HEALTH'S HOSPITALS PROVIDE EMERGENCY SERVICES WHICH ARE OPEN AND AVAILABLE TO ALL PERSONS OF THE COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY. THE BOARD OF DIRECTORS CONSISTS OF PERSONS WHO ARE BROADLY REPRESENTATIVE OF THE COMMUNITY AND MEDICAL STAFF.SUMMA HEALTH MEDICAL GROUP- PROGRAM SERVICE ACCOMPLISHMENTS:SUMMA HEALTH MEDICAL GROUP, A SUMMA HEALTH ENTITY, IS A MULTI-SPECIALTY GROUP OF PHYSICIANS, ADVANCED PRACTICE PROVIDERS AND CARE TEAMS IN MEDICAL PRACTICES LOCATED IN THE COMMUNITIES WE SERVE. IN TOTAL, SUMMA HEALTH MEDICAL GROUP EMPLOYS MORE THAN 300 PHYSICIANS, 150 ADVANCED PRACTICE PROVIDERS AND MORE THAN 1,200 SUPPORT STAFF IN MORE THAN 35 SPECIALTIES AND SUB-SPECIALTIES. SUMMA HEALTH MEDICAL GROUP PROMOTES STRONG AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIAN SERVICES ARE MET. AS MEMBERS OF NEWHEALTH COLLABORATIVE, A CLINICIAN-LED ACCOUNTABLE CARE ORGANIZATION, SUMMA HEALTH MEDICAL GROUP PHYSICIANS ARE LEADING THE WAY TOWARD VALUE-BASED HEALTHCARE WITH INITIATIVES SUCH AS THE PATIENT-CENTERED MEDICAL HOME (PCMH) AND MEANINGFUL USE OF HEALTH INFORMATION TECHNOLOGY. SUMMA FOUNDATION - PROGRAM SERVICE ACCOMPLISHMENTS:SUMMA FOUNDATION SUPPORTS PATIENT CARE, MEDICAL EDUCATION AND RESEARCH THROUGH PHILANTHROPY. GENEROUS CONTRIBUTIONS TOTALED $23.2 MILLION IN 2021 HELPING SUMMA HEALTH FULFILL ITS MISSION TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE AND CONTRIBUTE TO A HEALTHIER COMMUNITY. SUMMA FOUNDATION LINKS COMMUNITY SUPPORTERS WITH PHILANTHROPIC PRIORITIES THAT ENHANCE THE DELIVERY OF PATIENT CARE AND EMPOWER CLINICAL EXCELLENCE ACROSS THE ENTIRE SYSTEM. GIFTS SUPPORT PHYSICIAN RESIDENCY PROGRAMS, ADVANCED CERTIFICATIONS FOR NURSES, BEHAVIORAL HEALTH PROGRAMS, GROUNDBREAKING RESEARCH, THE LATEST TECHNOLOGIES FOR DIAGNOSIS AND TREATMENT, CANCER SUPPORT SERVICES, AND HELP RECRUIT AND RETAIN THE REGION'S BEST PHYSICIANS, ASSURING PATIENTS AND FAMILIES A CONTINUUM OF QUALITY CARE FAR INTO THE FUTURE. SUMMA FOUNDATION ALSO COLLABORATES WITH SYSTEM AND CLINICAL LEADERS TO DOCUMENT THE IMPACT OF PHILANTHROPIC INVESTMENTS AND TO SHARE THAT IMPACT WITH DONORS.COMMUNITY BENEFIT AND DIVERSITY:THIS DEPARTMENT LEADS EFFORTS TO ADDRESS HEALTH DISPARITIES AND OTHER IMPORTANT COMMUNITY NEEDS AND RAISE AWARENESS OF HEALTH AND HEALTHCARE ISSUES AFFECTING THE COMMUNITIES SERVED BY SUMMA HEALTH. COMMUNITY BENEFIT AND DIVERSITY PROVIDE WELLNESS AND EDUCATIONAL TOOLS, FACILITATE ECONOMIC DEVELOPMENT PROGRAMS, DEVELOP COMMUNITY PARTNERSHIPS, COMMUNICATE SUMMA HEALTH'S BENEFIT TO THE COMMUNITY AND ENGAGE THE COMMUNITY AND ITS WORKFORCE WITHIN THE SYSTEM AND THROUGHOUT THE REGION.GOVERNMENT RELATIONS: THIS DEPARTMENT IS DEDICATED TO ELEVATING SUMMA HEALTH AS A CREDIBLE LEADER AND PARTNER IN THE HEALTH POLICY PLANNING PROCESS. THIS DEPARTMENT COLLABORATES WITH NUMEROUS DEPARTMENTS TO BEST POSITION SUMMA EDUCATION, RESEARCH AND CLINICAL INNOVATION PRIORITIES WITH PUBLIC SECTOR FUNDING OPPORTUNITIES.

SUMMA HEALTH SYSTEM
PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT BROAD INTERESTS OF COMMUNITY SERVED:SUMMA HEALTH SYSTEM:IN 2019 SUMMA HEALTH PARTNERED WITH SUMMIT COUNTY PUBLIC HEALTH (SCPH) AND THE SUMMIT COALITION FOR COMMUNITY HEALTH IMPROVEMENT (SCCHI) TO CONDUCT THE 2019 CHNA. DURING THE PROCESS, OVER 200 INDICATORS WERE REVIEWED, AND COMMUNITY LEADERS AND RESIDENTS WERE CONSULTED. THE 2019 CHNA WAS COMPLETED USING THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) MODIFIED-MOBILIZING ACTION THROUGH PARTNERSHIP AND PLANNING (MAPP) PROCESS. THIS PROCESS WAS FACILITATED BY SCPH AND CONDUCTED WITH THE SCCHI. SCCHI IS A 40+ MEMBER COLLABORATIVE WITH THE MISSION OF IDENTIFYING KEY HEALTH PRIORITIES IN SUMMIT COUNTY AND COORDINATING ACTION TO IMPROVE POPULATION HEALTH AND PROMOTE HEALTH EQUITY FOR ALL. THESE COMMUNITY LEADERS PROVIDE A PERSPECTIVE ON THE BROAD INTERESTS OF THE GROUPS SERVED BY THE HOSPITAL FACILITY, INCLUDING THE MEDICALLY UNDERSERVED, LOW-INCOME PERSONS, MINORITY GROUPS. SCPH EPIDEMIOLOGY GATHERED DATA FROM A VARIETY OF SOURCES INCLUDING COUNTY HEALTH RANKINGS, AMERICAN COMMUNITY SURVEY, AND COMMUNITY HEALTH STATUS INDICATORS. SCPH ALSO UTILIZED THE 2018 YOUTH RISK BEHAVIORAL SURVEY, THE OHIO DEPARTMENTS OF HEALTH BIRTH AND DEATH DATA, AND EPICENTER. QUALITATIVE DATA COLLECTED THROUGH SURVEYS, FOCUS GROUPS AND COMMUNITY MEETINGS WERE ALSO UTILIZED TO GATHER INFORMATION ABOUT HOW SUMMIT COUNTY LEADERS AND RESIDENTS EXPERIENCE THE HEALTH OUTCOMES AND COMMUNITY CONDITIONS THAT AFFECT QUALITY OF LIFE. THIS INFORMATION CAN PROVIDE ADDITIONAL CONTEXT TO QUANTITATIVE DATA AND HEALTH TO STRATEGICALLY INFORM IMPROVEMENTS. SCCHI AND SCPH ALSO COMPLETED TWO QUALITATIVE MAPP ASSESSMENTS: COMMUNITY THEMES, STRENGTHS, AND THE FORCES OF CHANGE. FOCUS GROUPS AND SURVEYS WERE CONDUCTED AND DISTRIBUTED THROUGHOUT THE COMMUNITY IN 2019 TO IDENTIFY BARRIERS AND OPPORTUNITIES THROUGH THE LENS OF THE COMMUNITY MEMBER. LEADERS FROM THE FOLLOWING COMMUNITY ORGANIZATIONS WERE CONSULTED DURING THIS CHNA: AKRON AREA YMCAAKRON CANTON REGIONAL FOODBANKAKRON CHILDREN'S HOSPITALAKRON METROPOLITAN AREA TRANSPORTATION STUDYAKRON METROPOLITAN HOUSING AUTHORITY AKRON PUBLIC SCHOOLSAKRON REGION INTERPROFESSIONAL AREA HEALTH EDUCATION CENTERAKRON SUMMIT COMMUNITY ACTION, INCAKRON SUMMIT COUNTY PUBLIC LIBRARYAMERICAN CANCER SOCIETYASIAN SERVICES IN ACTION, INCAXESSPOINTE COMMUNITY HEALTH CENTERCHILD GUIDANCE AND FAMILY SOLUTIONSCITY OF AKRONCLEVELAND CLINIC AKRON GENERALCOMMUNITY HEALTH CENTERCOMMUNITY LEGAL AIDCOUNTY OF SUMMITCOUNTY OF SUMMIT ALCOHOL DRUG ADDICTION AND MENTAL HEALTH SERVICES BOARDGREATER AKRON CHAMBER OF COMMERCE HATTIE LARLHAMHAVEN OF REST MINISTRIESINFOLINE, INCINTERNATIONAL INSTITUTE OF AKRONLOVE AKRONMATURE SERVICESMUSTARD SEED MARKET AND CAFNOTHEAST OHIO MEDICAL UNIVERSITYOHIO GUIDESTONEOPEN M MINISTRIESOSU EXTENSIONPROJECT LEARN OF SUMMIT COUNTYSUMMIT COUNTY DD BOARDSUMMIT COUNTY PUBLIC HEALTH THE BLICK CENTERTHE OHIO AFFILIATE OF PREVENT BLINDNESSU.S. REPRESENTATIVE MARCIA FUDGEU.S. SENATOR SHERROD BROWNUNITED WAY OF SUMMIT COUNTYADDITIONAL DETAIL CAN BE FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2019.

SUMMA REHAB HOSPITAL, LLC
PART V, SECTION B, LINE 5: INPUT FROM PERSONS WHO REPRESENT BROAD INTERESTS OF COMMUNITY SERVED:SUMMA REHABILITATION HOSPITAL:IN 2019 SUMMA HEALTH PARTNERED WITH SUMMIT COUNTY PUBLIC HEALTH (SCPH) AND THE SUMMIT COALITION FOR COMMUNITY HEALTH IMPROVEMENT (SCCHI) TO CONDUCT THE 2019 CHNA. DURING THE PROCESS, OVER 200 INDICATORS WERE REVIEWED, AND COMMUNITY LEADERS AND RESIDENTS WERE CONSULTED. THE 2019 CHNA WAS COMPLETED USING THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO) MODIFIED-MOBILIZING ACTION THROUGH PARTNERSHIP AND PLANNING (MAPP) PROCESS. THIS PROCESS WAS FACILITATED BY SCPH AND CONDUCTED WITH THE SCCHI. SCCHI IS A 40+ MEMBER COLLABORATIVE WITH THE MISSION OF IDENTIFYING KEY HEALTH PRIORITIES IN SUMMIT COUNTY AND COORDINATING ACTION TO IMPROVE POPULATION HEALTH AND PROMOTE HEALTH EQUITY FOR ALL. THESE COMMUNITY LEADERS PROVIDE A PERSPECTIVE ON THE BROAD INTERESTS OF THE GROUPS SERVED BY THE HOSPITAL FACILITY, INCLUDING THE MEDICALLY UNDERSERVED, LOW-INCOME PERSONS, MINORITY GROUPS. SCPH EPIDEMIOLOGY GATHERED DATA FROM A VARIETY OF SOURCES INCLUDING COUNTY HEALTH RANKINGS, AMERICAN COMMUNITY SURVEY, AND COMMUNITY HEALTH STATUS INDICATORS. SCPH ALSO UTILIZED THE 2018 YOUTH RISK BEHAVIORAL SURVEY, THE OHIO DEPARTMENTS OF HEALTH BIRTH AND DEATH DATA, AND EPICENTER. QUALITATIVE DATA COLLECTED THROUGH SURVEYS, FOCUS GROUPS AND COMMUNITY MEETINGS WERE ALSO UTILIZED TO GATHER INFORMATION ABOUT HOW SUMMIT COUNTY LEADERS AND RESIDENTS EXPERIENCE THE HEALTH OUTCOMES AND COMMUNITY CONDITIONS THAT AFFECT QUALITY OF LIFE. THIS INFORMATION CAN PROVIDE ADDITIONAL CONTEXT TO QUANTITATIVE DATA AND HEALTH TO STRATEGICALLY INFORM IMPROVEMENTS. SCCHI AND SCPH ALSO COMPLETED TWO QUALITATIVE MAPP ASSESSMENTS: COMMUNITY THEMES, STRENGTHS, AND THE FORCES OF CHANGE. FOCUS GROUPS AND SURVEYS WERE CONDUCTED AND DISTRIBUTED THROUGHOUT THE COMMUNITY IN 2019 TO IDENTIFY BARRIERS AND OPPORTUNITIES THROUGH THE LENS OF THE COMMUNITY MEMBER. LEADERS FROM THE FOLLOWING COMMUNITY ORGANIZATIONS WERE CONSULTED DURING THIS CHNA: AKRON AREA YMCAAKRON CANTON REGIONAL FOODBANKAKRON CHILDREN'S HOSPITALAKRON METROPOLITAN AREA TRANSPORTATION STUDYAKRON METROPOLITAN HOUSING AUTHORITY AKRON PUBLIC SCHOOLSAKRON REGION INTERPROFESSIONAL AREA HEALTH EDUCATION CENTERAKRON SUMMIT COMMUNITY ACTION, INCAKRON SUMMIT COUNTY PUBLIC LIBRARYAMERICAN CANCER SOCIETYASIAN SERVICES IN ACTION, INCAXESSPOINTE COMMUNITY HEALTH CENTERCHILD GUIDANCE AND FAMILY SOLUTIONSCITY OF AKRONCLEVELAND CLINIC AKRON GENERALCOMMUNITY HEALTH CENTERCOMMUNITY LEGAL AIDCOUNTY OF SUMMITCOUNTY OF SUMMIT ALCOHOL DRUG ADDICTION AND MENTAL HEALTH SERVICES BOARDGREATER AKRON CHAMBER OF COMMERCE HATTIE LARLHAMHAVEN OF REST MINISTRIESINFOLINE, INCINTERNATIONAL INSTITUTE OF AKRONLOVE AKRONMATURE SERVICESMUSTARD SEED MARKET AND CAFNOTHEAST OHIO MEDICAL UNIVERSITYOHIO GUIDESTONEOPEN M MINISTRIESOSU EXTENSIONPROJECT LEARN OF SUMMIT COUNTYSUMMIT COUNTY DD BOARDSUMMIT COUNTY PUBLIC HEALTH THE BLICK CENTERTHE OHIO AFFILIATE OF PREVENT BLINDNESSU.S. REPRESENTATIVE MARCIA FUDGEU.S. SENATOR SHERROD BROWNUNITED WAY OF SUMMIT COUNTYADDITIONAL DETAIL CAN BE FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2019.

SUMMA HEALTH SYSTEM
PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE OTHER HOSPITAL FACILITIES:SUMMA HEALTH SYSTEM: SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF EACH OF ITS HOSPITAL FACILITIES LISTED IN PART V, SECTION A, WHICH ARE, SUMMA HEALTH SYSTEM AND SUMMA REHAB HOSPITAL, LLC

SUMMA REHAB HOSPITAL, LLC
PART V, SECTION B, LINE 6A: CHNA CONDUCTED WITH ONE OR MORE OTHER HOSPITAL FACILITIES:SUMMA REHABILITATION HOSPITAL:SUMMA HEALTH CONDUCTED THE CHNA ON BEHALF OF EACH OF ITS HOSPITAL FACILITIES LISTED IN PART V, SECTION A, WHICH ARE SUMMA HEALTH SYSTEM AND SUMMA REHAB HOSPITAL, LLC

SUMMA HEALTH SYSTEM
PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:SUMMA HEALTH SYSTEM:SUMMIT COUNTY PUBLIC HEALTH SUMMIT COALITION FOR COMMUNITY HEALTH IMPROVEMENT

SUMMA REHAB HOSPITAL, LLC
PART V, SECTION B, LINE 6B: CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:SUMMA REHABILITATION HOSPITAL:SUMMIT COUNTY PUBLIC HEALTH SUMMIT COALITION FOR COMMUNITY HEALTH IMPROVEMENT

SUMMA HEALTH SYSTEM
"PART V, SECTION B, LINE 11: HOW THE HOSPITAL FACILITY IS ADDRESSING NEEDS IDENTIFIED IN ITS CHNA:SUMMA HEALTH SYSTEM:IN 2019 SUMMA HEALTH PARTNERED WITH SUMMIT COUNTY PUBLIC HEALTH (SCPH) AND THE SUMMIT COALITION FOR COMMUNITY HEALTH IMPROVEMENT (SCCHI) TO CONDUCT THE 2019 CHNA THAT WAS APPROVED BY THE SUMMA HEALTH BOARD OF DIRECTORS ON DECEMBER 12, 2019. DURING THIS PROCESS OVER 200 INDICATORS WERE REVIEWED, COMMUNITY LEADERS AND RESIDENTS WERE CONSULTED, AND SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED USING THE MAPP PROCESS. TO RESPOND TO THE NEEDS IDENTIFIED IN THE 2019 CHNA, IN COLLABORATION WITH SUMMA HEALTH'S INTERNAL LEADERSHIP AND DEPARTMENTS, ASSISTANCE FROM THE SUMMA COMMUNITY ENGAGEMENT COMMITTEE AND MANY EXTERNAL PARTNERS, SUMMA ENTERED INTO THE ACTION PHASE OF THE MAPP PROCESS. THIS PHASE INCLUDED THE PLANNING, IMPLEMENTATION, AND EVALUTION OF THE OBJECTIVES AND STRATEGIES FOR EACH OF THE IDENTIFIED PRIORITY AREAS. EACH PRIORITIZED HEALTH NEED ARE DETERMINED TO BE WIHTIN THE SCOPE OF SERVICES AND ALIGNED WITH THE MISSION OF THE SYSTEM. THE PLAN IS BUILT UPON THE EFFORTS OF THE PREVIOUS IMPLEMENTATION PLAN, UTLIZING LESSONS LEARNED AND CURRENT OPPORTUNITIES. THE MAPP PROCESS AND COUNTY HEALTH RANKINGS MODEL PROVIDED THE GUIDING PRINCIPLES AND FRAMEWORK FOR DEVELOPING THE PLAN AND CREATING EVIDENCE BASED STRATEGIES TO MOBILIZE COMMUNITY ACTION TOWARD HEALTH IMPROVEMENT. THE PRIORITY AREAS ARE AS FOLLOWS: CHRONIC DISEASE MANAGEMENT, ACCESS AND BARRIERS TO HEALTH CARE, HEALTH DISPARITIES, PREVENTION AND WELLNESS. ON MARCH 12, 2020, THE IMPLEMENTATION PLAN WAS APPROVED BY THE SUMMA HEALTH BOARD OF DIRECTORS. THE PRIORITIES ARE IN ALIGNMENT WITH CURRENT COMMUNITY HEALTH NEEDS IDENTIFIED BY THE SUMMIT COUNTY PUBLIC HEALTH 2019 COMMUNITY HEALTH ASSESSMENT AND THE OHIO DEPARTMENT OF HEALTH'S 2019 STATE HEALTH ASSESSMENT. THERE IS STRONG ALIGNMENT BETWEEN THE SELECTED HEALTH PRIORITIES AND THE PRIORITIES IN THE 2020-2022 OHIO STATE HEALTH IMPROVEMENT PLAN (SHIP)PRIORITY HEALTH NEEDS IDENTIFIED IN THE 2019 SUMMA CHNA:PRIORITY HEALTH ISSUE, PLAN TO ADDRESSACCESS TO HEALTH CARE, YESCHRONIC DISEASE, YESENVIRONMENTAL FACTORS, NOHEALTH DISPARITIES, YESINJURY AND ACCIDENTS, NOQUALITY OF HEALTH CARE, YESMATERNAL AND CHILD HEALTH, YESMENTAL HEALTH, YESPREVENTION AND WELLNESS, YESSUBSTANCE ABUSE, YESSIGNIFICANT HEALTH NEEDS ADDRESSED:PRIORITY HEALTH OUTCOME: IMPROVING PREVENTION AND WELLNESSAT SUMMA HEALTH, OUR POPULATION HEALTH STRATEGY IS EVOLVING THE WAY WE DELIVER CARE. OUR VISION FOR CARE PUTS THE PATIENT AT THE CENTER OF THIS MODEL BY CREATING A COLLABORATION BETWEEN THE PATIENT AND THEIR CAREGIVERS THAT IS FOCUSED ON PREVENTION AND WELLNESS (P&W). P&W FOCUSES ON IMPROVING THE WHOLE PERSON, BODY AND MIND AND REDUCING LIFESTYLE RISK FACTORS AND ""EVERYDAY"" BEHAVIORS THAT CAN NEGATIVELY IMPACT HEALTH. P&W STRATEGIES CROSS ALL THE PRIORITY HEALTH OUTCOMES, AND ARE EMBEDDED IN EACH OBJECTIVE.PRIORITY HEALTH OUTCOME: IMPROVING ACCESS TO HEALTH CARETHE HEALTH NEEDS PERTAINING TO ACCESS ARE BEING ADDRESSED BY INCORPORATING COMMUNITY HEALTH WORKERS IN COMMUNITY BASED SETTINGS, AND INCREASING THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES AND COMPREHENSIVE PRIMARY CARE PLUS PRACTICES THEREBY INCREASING THE OPPORTUNITIES FOR PREVENTATIVE AND EARLY INTERVENTIONS FOR INDIVIDUALS REQUIRING PRIMARY CARE, DENTAL, AND BEHAVIORAL HEALTH PROVIDERS.PRIORITY HEALTH OUTCOME: PROVIDING CHRONIC DISEASE MANAGEMENTTHE HEALTH NEEDS PERTAINING TO CHRONIC DISEASE ARE BEING ADDRESSED THROUGH INCREASING CONSUMER KNOWLEDGE BASE OF RISK FACTORS, RISK BEHAVIORS, AND GENETIC CONSIDERATIONS, WHICH LEAD TO CANCER, CARDIOVASCULAR DISEASE AND DIABETES (P&W). THE HEALTH NEEDS PERTAINING TO SUBSTANCE ABUSE ARE BEING ADDRESSED BY DECREASING ALCOHOL AND OPIATE RELATED OVERDOSES AND DEATHS (P&W). THE HEALTH NEEDS PERTAINING TO LIFESTYLE FACTORS ARE BEING ADDRESSED BY DECREASING SMOKING AND TOBACCO USE IN ADULTS. PRIORITY HEALTH OUTCOME: REDUCING HEALTH DISPARITIESTHE HEALTH NEEDS PERTAINING TO HEALTH DISPARITIES ARE BEING ADDRESSED THROUGH REDUCING INFANT MORTALITY BY PROVIDING PROGRAMS AND SERVICES THAT PROVIDE OUTREACH, EDUCATION, COORDINATION AND FOCUS ON REDUCING THE IMPACTS OF THE SOCIAL DETERMINANTS OF HEALTH FOR LOW INCOME MOTHERS(P&W). PRIORITY HEALTH OUTCOME: IMPROVING QUALITY OF HEALTH CARETHE HEALTH NEEDS PERTAINING TO QUALITY OF CARE FACTORS ARE BEING ADDRESSED BY DECREASING HOSPITAL READMISSIONS AND INCREASING CONSUMER KNOWLEDGE OF PREOPERATIVE CARE. SIGNIFICANT HEALTH NEEDS NOT ADDRESSEDTHE LIST ABOVE INDICATES SEVERAL PRIORITIZED HEALTH NEEDS IDENTIFIED IN THE 2019 CHNA THAT SUMMA WILL NOT ADDRESS IN THE PLAN. REASONS FOR NOT TARGETING THESE AREAS INCLUDE THEY ARE ADDRESSED DURING CLINCIAL VISITS, GO BEYOND THE CURRENT SCOPE OF THE HOSPITAL, RESOURCE CONSTRAINTS, AVAILABLE EXPERTISE, OR BEING MORE APPRORIATE FOR OTHER COMMUNITY AGENCIES TO ADDRESS. POOR HEALTH STATUS CAN RESULT THROUGH A COMPLEX INTERACTION OF CHALLENGING SOCIAL, ECONOMIC, ENVIRONMENTAL AND BEHAVIORAL FACTORS, COMBINED WITH LACK OF ACCESS TO CARE. ADDRESSING THE MORE COMMON ""ROOT"" CAUSES OF POOR COMMUNITY HEALTH CAN SERVE TO IMPROVE A COMMUNITY'S QUALITY OF LIFE AND TO REDUCE MORTALITY AND MORBIDITY. HOWEVER, SUMMA RECOGNIZES THAT NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE ROOT CAUSES AND HEALTH NEEDS PRESENT IN ITS COMMUNITY. THEREFORE, IT WAS DETERMINED THAT THE HEALTH SYSTEM WILL COLLABORATE WITH OTHER ORGANIZATIONS AS NEEDED TO ADDRESS THE HEALTH NEEDS NOT SELECTED. INJURIES, ACCIDENTS AND ENVIRONMENTAL FACTORS INCLUDING VIOLENCE, CRIME, AND POVERTY WILL NOT BE ADDRESSED DIRECTLY THROUGH OUR PLAN. SUMMA HEALTH WILL, LOOK FOR OPPORTUNITIES TO COLLABORATE WITH SAFE COMMUNITIES OF SUMMIT COUNTY, SUMMIT COUNTY SAFE KIDS COALITION, COMMUNITY DEVELOPMENT CORPORATIONS, LOCAL SERVICES AGENCIES AND OTHER ORGANIZATIONS TO ADDRESS THESE IMPORTANT HEALTH ISSUES WHENEVER POSSIBLE. THE PLAN IS ALSO IN ALIGNMENT WITH CURRENT COMMUNITY HEALTH NEEDS AND PRIORITIES IDENTIFIED BY THE SUMMIT COUNTY PUBLIC HEALTH 2019 COMMUNITY HEALTH ASSESSMENT AND THE OHIO DEPARTMENT OF HEALTH'S 2020-2022 STATE HEALTH IMPROVEMENT PLAN.A DETAILED DESCRIPTION OF THE ACTIONS BEING TAKEN TO ADDRESS THE HEALTH NEEDS IDENTIFIED ABOVE CAN BE FOUND ON THE 2020-2022 SUMMA HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2019.A SUMMARY OF THE GOALS AND OBJECTIVES ARE AS FOLLOWS:PRIORITY HEALTH GOAL: INCREASE ACCESS TO QULITY HEALTHCARE OBJECTIVE 1: THE NUMBER OF INDIVUDALS WHO HAVE ACCESS TO PRIMARY CARE MEDICAL HOMES (PCMH) AND COMPREHENSIVE CARE PLUS (CPC+) PRACTICES HEREBY INCREASE THE OPPORTUNITIES FOR PREVENTATIVE AND EARLY INTERVENTIONS FOR INDIVIDUALS REQUIRING PRIMARY CARE, DENTAL AND BEHAVIORAL HEALTH PROVIDERS. OBJECTIVE 2: INCREASE ACCESS TO PRIMARY CARE PROVIDERS AND SPECIALISTS AS NEEDED ALONG THE CONTINUUM OF CARE. OBJECTIVE 3: PARTICPATE IN THE CMS ONCOLOTY CARE MODEL. OBJECTIVE 4: REDUCE FINANCIAL STRESS. PRIORITY HEALTH GOAL: CHRONIC DISEASE PREVENTION AND MANAGEMENT OBJECTIVE 1: DECREASE RATES OF CHRONIC DISEASE IN ADULTS. OBJECTIVE 2: INCREASE CONSUMER KNOWLEDGE BASE OF RISK FACTORS, RISK BEHAVIORS, AND GENETIC CONSIDERATIONS, WHICH LEAD TO CARDIOVASCULAR DISEASE DEVELOPMENT. OBJECTIVE 3: INCREASE CONSUMER KNOWLEDGE BASE OF RISK FACTORS, RISK BEHAVIORS, AND GENETIC CONSIDERATIONS, WHICH LEAD TO CANCER. OBJECTIVE 4: PROVIDE DIABETES PREVENTION PROGRAMS AND DIABETES EDUCATION SERVICES. OBJECTIVE 5: PROMOTE MENTAL WELLBEING AND PREVENT ALCOHOL AND OTHER DRUG DEPENDENCE FOR RESIDENTS OF SUMMIT COUNTY. OBJECTIVE 6: DECREASE SMOKING, TOBACCO AND VAPING USE IN ADULTS.PRIORITY HEALTH GOAL: REDUCE HEALTH DISPARITIES OBJECTIVE 1: IMPROVE ACCESS TO HEALTH CARE AND CARE COORINATION TO THE LGBTQ COMMUNITY THROUGH THE SUMMA HEALTH PRIDE CLINIC. OBJECTIVE 2: IMPROVE CARE COORDINATION AND REDUCE HEALTH DISPARITIES BY UTILIZING COMMUNITY HEALTH WORKERS (CHW) IN COMMUNITY-BASED SETTINGS. OBJECTIVE 3: REDUCE INFANT MORTALITY. OBJECTIVE 4: INCREASE ACADEMIC ACHIEVEMENT BY PARTNERING WITH AKRON PUBLIC SCHOOLS AS THE SUMMA HEALTH ACADEMY OF LEADERSHIP AND INNOVATION AT BUCHTEL HIGH SCHOOL."

SUMMA REHAB HOSPITAL, LLC
PART V, SECTION B, LINE 11: HOW THE HOSPITAL FACILITY IS ADDRESSING NEEDS IDENTIFIED IN ITS CHNA:SUMMA REHABILITATION HOSPITAL:DUE TO THE NATURE OF THE ADULT REHABILITATION SPECIALTY SERVICES PROVIDED BY SUMMA REHAB HOSPITAL, LLC, THE IDENTIFIED HEALTH NEED IN WHICH THEY HAVE THE OPPORTUNITY TO ADDRESS IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE GREATEST IMPACT IS ACCESS TO HEALTH CARE. THE COMMUNITY RESOURCES PROVIDED BY A VARIETY OF INSTITUTIONS AND AGENCIES, INCLUDING SHS LED TO THE DETERMINATION BY SUMMA REHAB HOSPITAL, LLC TO NOT ADDRESS ANY OTHER IDENTIFIED HEALTH NEEDS AS DESCRIBED IN THE CHNA. PRIORITY HEALTH OUTCOME: IMPROVING ACCESS TO HEALTH CARETHE HEALTH NEEDS PERTAINING TO ACCESS ARE BEING ADDRESSED BY ENHANCING ACCESS TO APPROPRIATE MEDICATIONS AND IMPROVE COMPLIANCE WITH MEDICATION PRESCRIPTIONS FOR PATIENTS THAT ARE DISCHARGED FROM SUMMA REHABILITATION HOSPITAL(SRH). SRH IS ALSO IMPROVING ACCESS BY ENHANCING ACCESS TO DIAGNOSIS SPECIFIC SUPPORT GROUPS FOR COMMUNITY MEMBERS TO INCREASE PATIENT KNOWLEDGE. SUPPORT GROUPS FOCUS ON STROKE, AMPUTEE, PARKINSON'S AND TRAMATIC BRAIN INJURY(TBI). IN ADDITION, SRH WILL ALSO PARTICIPATE IN ADVOCACY AND SUPPORT GROUP ACTIVITIES THROUGH NORTHEAST OHIO BRAIN INJURY FOUNDATION/ SUMMIT COUNTY TBI COLLABORATION. A DETAILED DESCRIPTION OF THE ACTIONS BEING TAKEN TO ADDRESS THE HEALTH NEEDS IDENTIFIED ABOVE CAN BE FOUND ON THE 2020-2022 SUMMA HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN FOUND ON THE SUMMA HEALTH WEBSITE AT HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2019.

PART V, SECTION B, LINE 7A FACILITY REPORTING SUMMA HEALTH & SUMMA REHAB
SUMMA HEALTH SYSTEM: HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2019SUMMA REHAB HOSPITAL:HTTP://WWW.SUMMAREHABHOSPITAL.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/

PART V, SECTION B, LINE 10A FACILITY REPORTING SUMMA HEALTH AND SUMMA REHAB
SUMMA HEALTH SYSTEM:HTTPS://WWW.SUMMAHEALTH.ORG/ABOUT-US/ABOUT-SUMMA/COMMUNITY-BENEFIT-AND-DIVERSITY/COMMUNITYNEEDSASSESSMENTS/COMMUNITYNEEDSASSESSMENT2019SUMMA REHAB HOSPITAL:HTTPS://WWW.SUMMAREHABHOSPITAL.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDSASSESSMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-2019/

PART V SECTION B LINE 16A: FACILITY REPORTING SUMMA HEALTH & SUMMA REHAB
SUMMA HEALTH SYSTEM: HTTPS://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/FINANCIALASSISTANCESUMMA REHAB HOSPITAL: HTTPS://WWW.SUMMAREHABHOSPITAL.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE-POLICY-FOR-SUMMA-REHAB-HOSPITAL/

PART V SECTION B LINE 16B FACILITY REPORTING SUMMA HEALTH & SUMMA REHAB
SUMMA HEALTH SYSTEM: HTTPS://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/FINANCIALASSISTANCESUMMA REHAB HOSPITAL: HTTPS://WWW.SUMMAREHABHOSPITAL.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE-POLICY-FOR-SUMMA-REHAB-HOSPITAL/

PART V SECTION B LINE 16C FACILITY REPORTING SUMMA HEALTH & SUMMA REHAB
SUMMA HEALTH SYSTEM: HTTPS://WWW.SUMMAHEALTH.ORG/PATIENTVISITOR/INSURANCEANDBILLING/FINANCIALASSISTANCESUMMA REHAB HOSPITAL: HTTPS://WWW.SUMMAREHABHOSPITAL.COM/PATIENT-RESOURCES/FINANCIAL-ASSISTANCE-POLICY-FOR-SUMMA-REHAB-HOSPITAL/

PART V SECTION B LINE 20A: EXTRAORDINARY COLLECTION ACTION
SUMMA REHAB HOSPITAL:SUMMA REHAB HOSPITAL DOES NOT TAKE ECAS AND THEREFORE WRITTEN NOTICES ARE NOT NECESSARY

PART I, LINE 3C:
SUMMA HEALTH SYSTEM RESERVES THE RIGHT TO CONSIDER A DISCOUNT OR DISCOUNTED CARE TO ANY INDIVIDUAL WHO MAY FALL OUTSIDE THE PARAMETERS SET FORTH IN THE HOSPITAL FINANCIAL ASSISTANCE PROGRAM POLICY, WHERE SUCH INDIVIDUAL WHO HAS BEEN IDENTIFIED, IN THE SOLE DISCRETION OF HOSPITAL FACILITY AND APPROVED BY THE SYSTEM DIRECTOR HAVING EXCEPTIONAL MEDICAL CIRCUMSTANCES (I.E. TERMINAL ILLNESS, EXCESSIVE MEDICAL BILLS AND/OR MEDICATIONS, ETC.)

PART I, LINE 6A:
NAME OF RELATED ORGANIZATION THAT PREPARED THE COMMUNITY BENEFIT REPORT:SUMMA HEALTH

PART I, LINE 7:
EXPLANATION OF COST METHODOLOGY USED FOR CALCULATING LINE 7 TABLE:COST OF FINANCIAL ASSISTANCE AT COST WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. THE COST RELATED TO MEDICAID PATIENTS WAS CALCULATED WITH A COST TO CHARGE RATIO USING WORKSHEET 2. FOR SUBSIDIZED SERVICES SUMMA HEALTH'S COST ACCOUNTING SYSTEM IS USED TO DETERMINE COST RELATED TO SPECIFIC SERVICES EXCLUDING TRADITIONAL MEDICAID AND MEDICAID MANAGED CARE PATIENTS. COSTS FOR CHARITY AND BAD DEBT ACCOUNTS ARE DEDUCTED USING A RATIO OF COST TO CHARGE SPECIFIC TO THAT SUBSIDIZED SERVICE. COSTS FOR OTHER PROGRAMS REFLECT THE DIRECT AND INDIRECT COSTS OF PROVIDING THOSE PROGRAMS.

PART I, LINE 7G:
DESCRIBE SUBSIDIZED HEALTH SERVICE COSTS FROM PHYSICIAN CLINIC ON LINE 7G:THE AMOUNT OF SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7(G) ATTRIBUTABLE TO SUMMA PHYSICIANS, INC. DBA SUMMA HEALTH MEDICAL GROUP IS $39,621,564.

PART II, COMMUNITY BUILDING ACTIVITIES:
DESCRIBE HOW COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY:GUIDED BY OUR COMMUNITY HEALTH NEEDS ASSESSMENT, SUMMA HEALTH ADDRESSES VARIOUS COMMUNITY NEEDS, INCLUDING ECONOMIC DEVELOPMENT OPPORTUNITIES, HEALTH IMPROVEMENT, POVERTY, FOOD INSECURITY, WORKFORCE DEVELOPMENT AND ACCESS TO HEALTH CARE. SUMMA HEALTH HOSPITALS CONDUCT COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS, HEALTH FAIRS AND SCREENINGS FOR THE COMMUNITIES SERVED. SUMMA HEALTH HOSPITALS WORK WITH STATE AND LOCAL LEADERSHIP TO ADDRESS COMMUNITY NEEDS AND PROVIDE HEALTHCARE SERVICES TO THE POOR AND UNDERSERVED.SUMMA HEALTH HOSPITALS PROVIDE PROGRAMS TO IMPROVE THE PHYSICAL SURROUNDINGS IN THE COMMUNITIES SERVED. A ROBUST ECONOMY POSITIVELY IMPACTS RESIDENTS COVERED BY HEALTH INSURANCE AND IMPROVES THE CAPACITY OF THE COMMUNITY TO SUPPORT HEALTH SERVICES. SUMMA IS PROUD TO CONTRIBUTE TO THE ECONOMIC GROWTH OF THE COMMUNITIES WE SERVE. SUMMA HEALTH PROVIDES EMPLOYMENT TO OVER 8,100 EMPLOYEES AND PHYSICIANS, AND IS THE LARGEST EMPLOYER IN SUMMIT COUNTY. SUMMA'S CAPITAL INVESTMENTS IN OUR FACILITIES WITHIN OUR REGION, PROVIDE CONSTRUCTION AND HOSPITAL BASED JOBS. NEW STATE OF THE ART OUTPATIENT HEALTH CENTERS IN THE REGION HAVE SPURRED ECONOMIC GROWTH WHILE GIVING PEOPLE ACCESS TO THE CARE THEY NEED CLOSE TO HOME AND EXPANDING OUR COMMUNITY BENEFIT PROGRAMS.

PART III, LINE 2:
AN ESTIMATED PROVISION FOR DOUBTFUL ACCOUNTS IS RECORDED THAT RESULTS IN NET PATIENT SERVICE REVENUE BEING REPORTED AT THE NET AMOUNT EXPECTED TO BE RECEIVED. SUMMA HAS DETERMINED, BASED ON AN ASSESSMENT AT THE CONSOLIDATED LEVEL, THAT PATIENT SERVICE REVENUE IS PRIMARILY RECORDED PRIOR TO ASSESSING THE PATIENT'S ABILITY TO PAY AND AS SUCH, THE ENTIRE PROVISION FOR DOUBTFUL ACCOUNTS RELATED TO PATIENT REVENUE IS RECORDED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. AT THE POINT IN TIME THAT A CHARGE IS BELIEVED TO BE UNCOLLECTIBLE, THE RELATED RECEIVABLE IS WRITTEN OFF AS A DOUBTFUL ACCOUNT.SUMMA MAINTAINS AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON THE EXPECTED COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE. THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGES, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGH THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR THE UNCOLLECTIBLE RECEIVABLES.

PART III, LINE 4:
FOOTNOTE IN ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBING BAD DEBT EXPENSE:SUMMA HEALTH'S AUDITED FINANCIAL STATEMENTS NOTES TO CONSOLIDATED FINANCIAL STATEMENTS, 13. PATIENT SERVICE REVENUE, PAGE 37.

PART III, LINE 8:
DESCRIBE EXTENT ANY SHORTFALL FROM LINE 7 IS TREATED AS COMMUNITY BENEFIT AND COSTING METHODOLOGY OR SOURCE USED TO DETERMINE AMOUNT ON LINE 6:INCLUSION OF ALL COSTS ASSOCIATED WITH THE ORGANIZATION'S PARTICIPATION IN MEDICARE PROGRAMS WOULD SIGNIFICANTLY INCREASE THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H, PART III, LINE 7. THE ORGANIZATION'S MEDICARE SHORTFALL IS ATTRIBUTABLE TO REIMBURSEMENTS THAT ARE LESS THAN THE COST OF PROVIDING PATIENT CARE AND SERVICES TO MEDICARE BENEFICIARIES AND DOES NOT INCLUDE ANY AMOUNTS THAT RESULT FROM INEFFICIENCIES OR POOR MANAGEMENT. THE ORGANIZATION ACCEPTS ALL MEDICARE PATIENTS KNOWING THAT THERE MAY BE SHORTFALLS, THEREFORE IT HAS TAKEN THE POSITION THAT ANY SHORTFALL SHOULD BE COUNTED AS PART OF ITS COMMUNITY BENEFIT.COSTING METHOD USED WAS TOTAL ALLOWABLE COST LESS ALL COSTS DEEMED NON-ALLOWABLE BY MEDICARE REGULATIONS. MEDICARE ALLOWABLE COST ARE BASED ON INFORMATION PROVIDED ON WORKSHEET B, PART I, COLUMN 26, LINE 118 FROM THE VARIOUS HOSPITALS' MEDICARE COST REPORTS.

PART III, LINE 9B:
DID COLLECTION POLICY CONTAIN PROVISIONS ON COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR ASSISTANCE:SUMMA WILL NOT PURSUE LEGAL ACTION FOR NON-PAYMENT OF BILLS AGAINST ANY PATIENT WHO IS WITHOUT ACCESS TO HEALTH INSURANCE AND WITHOUT OTHER SIGNIFICANT INCOME OR NET WORTH. BEFORE INITIATING LEGAL ACTION FOR NON-PAYMENT, OUR HOSPITALS WILL, IN CONJUNCTION WITH THE PATIENT, MAKE SURE THAT THE PATIENT IS NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM AND DOES NOT QUALIFY UNDER THE HOSPITALS' CHARITY CARE POLICY.

PART VI, LINE 2:
NEEDS ASSESSMENT:IN ADDITION TO THE CHNA DESCRIBED IN PART V, SECTION B, THE HEALTH CARE NEEDS OF THE COMMUNITY ARE COLLABORATIVELY ASSESSED BY SURVEY PROCESSES CONDUCTED BY SUMMA HEALTH, SUMMIT COUNTY PUBLIC HEALTH, AND SUMMIT COALITION FOR COMMUNITY HEALTH IMPROVEMENT.

SCHEDULE H, PART VI, LINE 7 FACILITY REPORTING SUMMA HEALTH & SUMMA REHAB
STATE FILING OF COMMUNITY BENEFIT REPORT:THE STATE OF OHIO DOES NOT REQUIRE THE FILING OF THE COMMUNITY BENEFIT REPORT. HOWEVER, OHIO REQUIRES ALL TAX-EXEMPT HOSPITALS TO SUBMIT TO THE OHIO DEPARTMENT OF HEALTH (ODH)EXISTING COMMUNITY HEALTH NEEDS ASSESSMENTS AND PLANS. ADDITIONALLY, HOSPITALS ARE REQUIRED TO SUBMIT TO ODH A COPY OF THE HOSPITAL'S SCHEDULE H (FORM 990), CORRESPONDING ATTACHMENTS AND REPORTING ON FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS AND COMMUNITY BUILDING ACTIVITIES IN PARTS I AND II OF SCHEDULE H.

PART VI, LINE 3:
PATIENT EDUCATION:IN ACCORDANCE WITH THE RULES SET FORTH BY OHIO ADMINISTRATIVE CODE SECTION 2101:3-2-07.17 NOTICES, SUMMA HEALTH SYSTEM'S HOSPITALS HAVE NOTICES POSTED IN THE EMERGENCY ROOMS, ADMISSION AREAS, CASHIER'S OFFICE, AND OTHER PATIENT AREAS. THE NOTICES SPECIFY THE RIGHTS OF INDIVIDUALS TO RECEIVE WITHOUT CHARGE, MEDICALLY NECESSARY HOSPITAL-LEVEL SERVICES. A FINANCIAL ADVOCATE IS AVAILABLE TO PATIENTS AT THE POINT OF ADMISSION AND PRIOR TO SCHEDULED OUTPATIENT SERVICE. FINANCIAL ADVOCATE REVIEWS THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS AND ASSISTS WITH APPLICATION COMPLETION. THE SUMMA WEBSITE PROVIDES DETAILED INFORMATION REGARDING FINANCIAL ASSISTANCE ALONG WITH THE FINANCIAL ASSISTANCE APPLICATION. CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO PROVIDE FINANCIAL COUNSELING TO PATIENTS WHO CALL. CUSTOMER SERVICE REPRESENTATIVES ASSIST THE PATIENT IN COMPLETING THE FINANCIAL ASSISTANCE APPLICATION. CUSTOMER SERVICE REPRESENTATIVES MAKE OUTGOING CALLS TO DISCUSS AND EDUCATE PATIENT ON FINANCIAL ASSISTANCE. PATIENT BILLING STATEMENTS CONTAIN CONTACT INFORMATION AND INFORMATION ABOUT FINANCIAL ASSISTANCE. THE STATEMENT INCLUDES AN APPLICATION FOR FINANCIAL ASSISTANCE. SUMMA HEALTH CONTRACTS WITH CORPORATE PARTNERS WHO MEET WITH INHOUSE PATIENTS. AVAILABILITY OF COUNTY AND FEDERAL ASSISTANCE PROGRAMS IS REVIEWED. A FINANCIAL ASSISTANCE APPLICATION IS COMPLETED DURING THIS MEETING. THIS CORPORATE PARTNER ALSO MAKES OUTGOING CALLS AND SENDS LETTERS TO PATIENTS WHO HAD OUTPATIENT PROCEDURES INFORMING THEM OF FINANCIAL ASSISTANCE.

PART VI, LINE 4:
COMMUNITY INFORMATION: BASED ON 2021 PATIENT ADMISSION DATA, SUMMA HEALTH CARE DELIVERY IS PRIMARILY IN SUMMIT COUNTY. SUMMIT COUNTY IS AN URBAN COUNTY AND REPRESENTS 69.6% OF THE 2021 ADMISSIONS FROM SUMMA HEALTH. WHILE SUMMA ALSO TREATS PATIENTS FROM MEDINA, NORTHERN STARK, AND WAYNE COUNTIES, MOST PATIENTS COME FROM SUMMIT COUNTY. THERE WERE 537,633 PEOPLE LIVING IN SUMMIT COUNTY IN 2021. THERE ARE 31 CITIES, VILLAGES, AND TOWNSHIPS IN SUMMIT COUNTY, WITH THE LARGEST BEING THE CITY OF AKRON. COMPARED TO THE STATE OF OHIO, SUMMIT COUNTY HAS A SLIGHTLY SMALLER PROPORTION OF CHILDREN (UNDER 18 YEARS OLD) AND A SLIGHTLY HIGHER 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 THE STATE OF OHIO, WITH 92.1% HAVING A HIGH SCHOOL DIPLOMA OR HIGHER AND 32.8% HAVING A BACHELOR'S DEGREE OR HIGHER. SIMILARLY, ANNUAL PER CAPITA INCOME IN SUMMIT COUNTY IS SLIGHLTY HIGHER THAN THE STATE OF OHIO AT $34,684; THE MEDIAN HOUSEHOLD INCOME IS $59,253; THE PERCENT OF SUMMIT COUNTY RESIDENTS LIVING IN POVERTY IS 12.1%. OF THE HOUSEHOLDS IN SUMMIT COUNTY, 47.7% MAKE LESS THAN $50,000 ANNUALLY. HOWEVER, THE CITY OF AKRON, WHICH IS THE LARGEST CITY IN SUMMIT COUNTY HAS A MEDIAN HOUSEHOLD INCOME IS $40,281 WITH A POVERTY RATE OF 23% FOR THE CALENDAR YEAR 2021. THE UNEMPLOYMENT RATE IN SUMMIT COUNTY REBOUNDED AFTER BEING IMPACTED BY COVID-19. IN 2020, THE HIGHEST RATE WAS IN APRIL AT 14.7%, THE RATE AT THE CLOSE OF 2021 WAS 3.7%. THE CURRENT UNEMPLOYMENT RATE IS UP SLIGHTLY IN JUNE OF 2022 AT 4.4% FOR SUMMIT COUNTY. THERE ARE TWO MEDICALLY UNDERSERVED AREAS (MUAS) PRESENT IN SUMMIT COUNTY: THE SOUTHEAST AKRON AND SUMMIT SERVICE AREAS. LOW INCOMES AND AN INCREASING UNEMPLOYMENT RATE ADD TO SUMMA'S BURDEN FOR CHARITY CARE. DESPITE THESE CHALLENGES, DEMAND FOR SUMMA'S SERVICES IN THESE COMMUNITIES IS PROJECTED TO GROW. MORE IMPORTANTLY, THE AGE GROUP THAT DEMAND HEALTHCARE SERVICES THE MOST (AGE 65 AND OLDER) IS EXPECTED TO GROW SIGNIFICANTLY. THIS AGE GROUP IS EXPECTED TO INCREASE 16.0% IN SUMMIT COUNTY OVER THE FIVE YEAR PERIOD.

PART VI, LINE 5:
PROMOTION OF COMMUNITY HEALTH:SUMMA PROPOSES THAT ALL OF ITS ACTIONS EITHER DIRECTLY PROVIDE CARE TO OUR PATIENTS, OR CONTRIBUTE TO A HEALTHIER COMMUNITY, BOTH BY THE DIRECT INVESTMENTS IN THE DELIVERY OF HEALTHCARE AND IN PROVIDING SPECIALIZED INPATIENT AND OUTPATIENT CARE FOR PATIENTS OF ALL AGES THROUGHOUT NORTHEAST OHIO. AMONG THE WAYS THE HOSPITALS WITHIN SUMMA HEALTH PROMOTE THE HEALTH OF THE COMMUNITY ARE BY MAINTAINING AN INDEPENDENT MEDICAL STAFF AND A COMMUNITY ENGAGEMENT COMMITTEE (CEC). SUMMA IS COMPRISED OF AN INDEPENDENT MEDICAL STAFF AND EXTENDS THE OPPORTUNITY FOR ALL QUALIFIED PHYSICIANS TO APPLY FOR MEDICAL STAFF MEMBERSHIP AND HOSPITAL PRIVLEGES. THE CEC OF THE SUMMA HEALTH BOARD OF DIRECTORS IS RESPONSIBLE FOR THE OVERSIGHT AND IMPLEMENTATION OF SUMMA HEALTH'S COMMUNITY BENEFIT, COMMUNITY OUTREACH, AND COMMUNITY RELATIONS ACTIVITIES AND STRATEGIES, AS DIRECTED BY THE SUMMA HEALTH BOARD. THE CEC IS COMPRISED OF 17 DIVERSE COMMUNITY LEADERS, 100% OF THEM RESIDE OR WORK IN SUMMA'S PRIMARY AREA. IN ADDITION, A MAJORITY OF SUMMA'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN SUMMA'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF SUMMA, NOR FAMILY MEMBERS THEREOF. SUMMA CONTINUES TO INVEST IN ITSELF AND THE COMMUNITY THROUGH ENHANCED CLINICAL SERVICES, RESEARCH, EDUCATIONAL PROGRAMS, AND CAPITAL IMPROVEMENTS THAT MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES AND PATIENTS WE SERVE. SUMMA HAS MADE SIGNIFICANT MULTI-MILLION DOLLAR INVESTMENT TO EXPAND AND ENHANCE SERVICES AT THE AKRON AND BARBERTON CAMPUS IMPACTING BOTH INPATIENT AND OUTPATIENT SERVICES AND ADDRESSING THE GREATEST NEEDS IN OUR COMMUNITY. IN FEBRUARY OF 2021, SUMMA BEGAN PHASE TWO OF THE MASTER FACILITY PLAN WITH A GROUND BREAKING OF THE NEW BEHAVIORAL HEALTH PAVILION ON THE AKRON CAMPUS. THIS INVESTMENT WILL PROVIDE THE MOST ADVANCED BEHAVIORAL HEALTH FACILITY IN THE AKRON AREA AND WILL SERVE AS A HOME FOR ALL LEVELS OF BEHAVIORAL HEALTHCARE. IN JUNE OF 2021, SUMMA OPENED A COMPREHENSIVE MEDICAL CENTER IN STOW-KENT TO PROVIDE BETTER ACCESS TO HEALTHCARE SERVICES. WITH A FOCUS ON HEALTH AND WELLNESS, IT OFFERS ACCESS TO PRIMARY CARE, HEALTH SCREENINGS AND SPECIALITY CARE. THE STOW-KENT CENTER HONORS THE FARRIS, MCNEIL AND RIDDLE FAMILIES, THE FIRST BLACK FAMILIES TO PURCHASE PROPERTY IN THE CITY OF STOW. SUMMA HEALTH HONORS THESE FAMILIES FOR THEIR MOMENTOUS ACHIEVEMENTS IN THE FIELD OF MEDICINE AND EDUCATION, COURAGEOUS EFFORTS TO EXPAND RACIAL UNDERSTANDING, AND COMMITMENT TO ENGAGE OTHERS IN PRACTICING EQUALITY. IN SEPTEMBER OF 2021, PARTNERING WITH NORTHEAST OHIO MEDICAL UNIVERSITY, SUMMA OPENED A MEDICAL CENTER IN ROOTSTOWN TO NOT ONLY FILL A NEED FOR MEDICAL SERVICES, IT WILL GIVE MEDICAL STUDENTS ADDITIONAL OPPORTUNTIES TO LEARN AND GROW. SUMMA'S HOSPITALS ADDRESS HEALTH DISPARITIES THROUGH PRACTICE, RESEARCH, EDUCATION AND COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS. CONTRIBUTIONS, BOTH FINANCIAL AND IN-KIND, ARE MADE TO INITIATIVES AND PROGRAMMING (I.E. FEDERALLY QUALIFIED HEALTH CENTER, OPEN M, CENTER FOR COMMUNITY HEALTH IMPROVEMENT) THAT ARE DEEMED TO PROMOTE THE HEALTH, WELLNESS AND IMPROVED QUALITY OF LIFE FOR THE COMMUNITIES SUMMA HEALTH SERVES. ONE SPECIFIC WAY SUMMA PROMOTED THE HEALTH OF OUR COMMUNITY WAS BY UTILIZING ITS MOBILE VACCINATION UNIT. IN APRIL OF 2021, SUMMA LAUNCHED COMMUNITY VACCINATION CLINICS AT SUMMA'S CORPORATE OFFICE. WE SERVED THOUSANDS OF INDIVIDUALS WITH THE DRIVE-THRU CLINIC MODEL. UNDERSTANDING TRANSPORTATION IS A BARRIER TO CARE, WE DECIDED TO TAKE VACCINES DIRECTLY TO THE COMMUNITY. IN JUNE OF 2021, SUMMA HEALTH STARTED THE VITAL VAX AND GO PROGRAM, WHICH DEPLOYED A NEW STRATEGY TO VACCINATE UNDERSERVED COMMUNITIES. THE VITAL VAX AND GO UNIT PROVIDED COVID-19 VACCINE CLINICS TO DIFFERENT LOCATIONS IN NORTHEAST OHIO REDUCING THE TRANSPORTATION BARRIER THAT MANY COMMUNITIES FACE. SUMMA SERVED OVER 25,000 INDIVIDUALS WITH THE DRIVE-THRU VACCINE CLINIC AND VITAL VAX AND GO PROGRAM. THE PANDEMIC ADVERSELY AFFECTED SUMMA HEALTH'S OPERATIONS, INCLUDING A DECLINE IN PATIENT VOLUMES AND PATIENT SERVICE REVENUE AS COVID-19 SURGES AND STAFF SHORTAGES TEMPORARILY SHUT DOWN ELECTIVE SURGERIES AND OTHER PROCEDURES THROUGHOUT VARIOUS TIMES IN 2021. SUMMA ALSO HAS INCURRED, AND WILL CONTINUE TO INCUR, SIGNIFICANT COSTS TO ADDRESS COVID-19, WHICH INCLUDE INCREASED SUPPLY COSTS, INCLUDING FOR PERSONAL PROTECTIVE EQUIPMENT, AND ADDITIONAL LABOR COSTS. FURTHERMORE, TO SUPPORT OUR COMMUNITY DURING THE PANDEMIC, SUMMA INVESTED HEAVILY IN IT INFRASTRUCTURE AND TELEMEDICINE TO ALLOW FOR A REMOTE WORKFORCE AS WELL AS CONTINUITY OF CARE DESPITE CLOSURES.

PART VI, LINE 6:
"DESCRIPTION OF AFFILIATED GROUP:SUMMA HEALTH, EIN 34-1887844, IS THE PARENT ORGANIZATION OF SUMMA HEALTH SYSTEM. SUMMA HEALTH IS ONE OF THE LARGEST INTEGRATED DELIVERY SYSTEMS IN OHIO, ENCOMPASSING A NETWORK OF HOSPITALS, COMMUNITY-BASED HEALTH CENTERS, A HEALTH PLAN, A PHYSICIAN-HOSPITAL ORGANIZATION, RESEARCH AND MEDICAL EDUCATION AND A FOUNDATION. SUMMA HEALTH IS RENOWNED FOR EXCELLENCE IN PATIENT CARE AND FOR EXCEPTIONAL APPROACHES TO HEALTHCARE DELIVERY. DURING 2020, SUMMA HEALTH PROVIDED INPATIENT CARE THROUGH FACILITIES LOCATED ON THREE MAIN CAMPUSES AND IN ADDITION, OUTPATIENT CARE IS EXTENDED THROUGHOUT THE REGION IN A NUMBER OF OUTPATIENT CENTERS, BOTH HOSPITAL-BASED AND FREESTANDING. SUMMA HEALTH SYSTEM'S AKRON TERTIARY CAMPUS IS LOCATED IN DOWNTOWN AKRON, OHIO AND HAS SERVED, TOGETHER WITH SUMMA HEALTH, AS THE LARGEST SAFETY-NET HOSPITAL IN THE COMMUNITY FOR MANY YEARS. THE BARBERTON CAMPUS IS A 271-BED HOSPITAL FACILITY THAT OFFERS INPATIENT SERVICES, OUTPATIENT SERVICES AND COMMUNITY OUTREACH PROGRAMS. THE BARBERTON CAMPUS IS LOCATED IN THE CITY OF BARBERTON IN SOUTHERN SUMMIT COUNTY. SUMMA REHAB HOSPITAL, LLC, A JOINT VENTURE BETWEEN SUMMA HEALTH SYSTEM AND VIBRA HEALTHCARE, OPENED ON THE CAMPUS OF SUMMA AKRON CITY HOSPITAL IN 2012. THIS 60-BED FREE STANDING FACILITY PROVIDES INPATIENT REHABILITATION CARE AND SERVICES AND ADHERES TO SUMMA'S CHARITY CARE POLICY. ESTABLISHED IN 1993, SUMMACARE OFFERS HEALTH CARE COVERAGE TO MEMBERS INCLUDING MEMBERS INSURED THROUGH ITS STATUS AS A MEDICARE ADVANTAGE ORGANIZATION. SUMMACARE IS RECOGNIZED BY THE HEALTH INDUSTRY RESEARCH COMPANY AS A HEALTH PLAN WITH EFFECTIVE DISEASE MANAGEMENT PROGRAMS FOR ASTHMA, HEALTH FAILURE AND DIABETES. SUMMACARE, ALONG WITH ITS THIRD PARTY ADMINISTRATIVE SERVICES PRODUCTS COVERS NEARLY 57,000 MEMBERS. SUMMA FOUNDATION IS A NONPROFIT ORGANIZATION ADVANCING TRANSFORMATIONAL PHILANTHROPY, COMMUNITY UNDERSTANDING AND GOODWILL FOR THE PROGRAMS AND PRIORITIES OF SUMMA HEALTH. SUMMA HEALTH NETWORK, LLC IS THE INTEGRATED PHYSICIAN-HOSPITAL ORGANIZATION AFFILIATED WITH SUMMA HEALTH. WITH MORE THAN 2,300 PHYSICIANS PARTICIPATING, SUMMA HEALTH NETWORK OVERSEES MUTUALLY BENEFICIAL CONTRACTS WITH INSURANCE COMPANIES, PREFERRED PROVIDER ORGANIZATIONS, THIRD-PARTY ADMINISTRATORS AND OTHER PAYORS ON BEHALF OF ITS PHYSICIANS AND HOSPITAL MEMBERS. SUMMA ACCOUNTABLE CARE ORGANIZATION (D/B/A NEWHEALTH COLLABORATIVE (""NHC"")) IS A CLINICIAN-LED COLLABORATIVE, ORGANIZED TO COMPASSIONATELY CARE FOR AND SERVE PATIENTS IN AN ACCOUNTABLE, VALUE AND EVIDENCE-BASED MANNER. IN ACCORDANCE WITH THE AFFORDABLE CARE ACT, NHC CREATES INCENTIVES FOR PROVIDERS TO FURTHER ENHANCE THE QUALITY OF CARE. OHIO HEALTH CHOICE, INC. (OHC) IS OHIO'S OLDEST PREFERRED PROVIDER ORGANIZATION (PPO) NETWORK IN THE STATE. OHC IS CO-OWNED BY SUMMA HEALTH AND MERCY MEDICAL CENTER, AND IS COMPRISED OF APPROXIMATELY 200 HOSPITALS, 9,400 PRIMARY CARE PROVIDERS, 31,300 SPECIALISTS, COVERING MEMBERS ACROSS ALL 88 COUNTIES IN OHIO. SUMMA PHYSICIANS, INC. (D/B/A SUMMA HEALTH MEDICAL GROUP (""SHMG"")) IS A MULTI-SPECIALTY PHYSICIAN PRACTICE EMPLOYING OVER 350 PHYSICIANS IN MULTIPLE SPECIALTIES. SHMG PROMOTES STRONGER AFFILIATION AND EMPLOYMENT OF PHYSICIANS TO ENSURE COMMUNITY AND HOSPITAL NEEDS FOR PHYSICIANS SERVICES ARE MET."