Summa Health is undergoing a major top leadership shake-up following months of upheaval and disappointing financial results.

The positions of the second-highest executive and the chief medical officer — both of whom had roles in the abrupt changeover of Summa’s longtime ER physician group after last-minute negotiations fell through — have been eliminated, according to a memo issued Thursday morning to staff by Dr. Cliff Deveny, interim chief executive officer.

Chief Operating Officer Valerie Gibson and Chief Medical Officer Dr. Vivian von Gruenigen are leaving the organization.

The changes, made effective immediately, Deveny said, “remove layers of management, increase efficiency and maintain high standards of accountability for quality, safety and operations.”

Deveny took over Summa’s leadership about eight weeks ago amid uproar over the ER physician staffing changeover and the subsequent loss of national accreditation for the hospital’s emergency medicine residency program. Hundreds of doctors demanded the former CEO’s ouster before he agreed to step down.

In a wide-ranging and exclusive interview with the Beacon Journal after the memo was sent, Deveny said the leadership changes, including the elimination of Gibson and von Gruenigen’s positions, were not connected to the ER issues.

“The innuendo that people will say, ‘This is retribution. These people were part of the team.’ I think that’s totally inaccurate,” Deveny said. “People are going to have to make their own judgment.”

Instead, it’s a financial decision to flatten the organization to keep it viable, he said.

While official first-quarter financial numbers have not yet been released, Deveny said they were “pretty disappointing.”

Summa officials are estimating the health system had an operating loss of $15 million for the first three months of this year after several successful quarters. However, with investment income included, Summa says it netted $5.5 million during that time period.

Deveny said hospital admissions overall were down about 5 percent and outpatient visits fell 9 percent during the first three months of this year.

However, Deveny said, ER visits, arrivals via ambulance, surgeries and newborn deliveries were at projected levels or better than last year.

‘Our biggest issue’

But Deveny said it would be naive to think the ripple effects of the hospital’s ER and leadership problems didn’t have an impact on the hospital’s financial performance.

“What you see today is our biggest issue is the viability of this organization going forward and the performance,” he said. “Akron has an expectation there is going to be a free-standing, locally run health care system.”

Deveny said he cannot say there will not be layoffs as a result of the poor first-quarter results, but he had nothing to announce.

Budget concerns

The health system needs to improve its financial performance by $40 million, by cutting costs and/or boosting revenue, Deveny said. A review of departments will include looking for improvements, reductions in expenses, lower supply costs and opportunities to expand services to grow revenue.

Deveny said he hadn’t broken out how much the elimination of the two top administrative positions will save the organization.

Gibson came to Summa in 2015. She had worked previously with former hospital President and CEO Dr. Thomas Malone, who resigned under pressure earlier this year. Gibson began the negotiations with Summa Emergency Associates (SEA) physicians, the company that had staffed the ERs for nearly 40 years. Malone took over the negotiations days before the contract expired on New Year’s Eve when Gibson left for the holiday.

Gibson has decided not to stay at Summa, Deveny said.

Von Gruenigen, who had one of the most powerful positions at Summa, came under fire from fellow physicians for what some perceived as a conflict of interest because she is married to CEO Dr. Dominic Bagnoli, whose US Acute Care Solutions was awarded the replacement ER contract.

Hospital officials said von Gruenigen had minimal involvement in the negotiations.

Deveny said he was unsure of von Gruenigen’s plans.

Later in the day, in an email to the Beacon Journal, von Gruenigen said she would not be practicing gynecologic oncology at Summa, “at least for now, and I’m taking time to evaluate other opportunities locally.”

In a statement, von Gruenigen said she was grateful to have served the Akron community and for “the opportunity to leave a positive mark on thousands of women, babies and families in the community that I live.”

“As I leave Summa, my home for 15 years, I know it is in good hands,” she said.

Other changes

Deveny also announced several other leadership changes:

•?Separate positions of president for the Summa Health System-Akron Campus and Summa Health System-Barberton Campus have been created. Dr. David Custodio, vice president, hospital chief medical officer/interim of the chair department of emergency medicine, will serve at the Akron Campus, which includes the flagship Akron City Hospital. Dr. Michael Hughes, currently the senior vice president of hospital operations in Barberton, will assume the role of president at that location. Both positions report directly to Deveny.

•?Bob Paskowski will leave his role as interim president of SummaCare and will be replaced by Dennis Pijor. Pijor will report to Summa Health Chief Financial Officer Brian Derrick.

•?Tammy Scarborough, vice president for ambulatory services and chief operating officer for Summa Health Medical Group, has been promoted to senior vice president and will report directly to Deveny. She, along with Custodio and Hughes, will assume many of the responsibilities currently under the eliminated COO position.

•?Chief Nursing Officer Lanie Ward and Senior Vice President for Human Resources Lorraine Washington will now report directly to Deveny.

Deveny, an Akron native, returned to Summa as interim CEO. He began on March 13, leading Summit County’s largest employer, with about 8,000 workers.

The hospital and its ER also faced other devastating challenges, including losing its ability to train future emergency room doctors on July 1 after the Accreditation Council for Graduate Medical Education suspended the program.

The hospital system was also placed on probation, prohibiting it from starting new residency programs or increasing the size of those that already exist.

Betty Lin-Fisher can be reached at 330-996-3724 or Follow her @blinfisherABJ  on Twitter or