It’s usually one of the first items you’ll see after you enter a hospital room: a small, clear plastic bag filled with a saline or sugar-water solution, hanging above a patient’s bed.

But a serious shortage of the bags used to inject drugs intravenously is now alarming many hospitals after Hurricane Maria in September slammed into Puerto Rico and shut down production at three plants owned by Baxter International, which makes a large percentage of the IV bags used in the United States.

In the Akron area and across Northeast Ohio, hospitals are watching their supplies of IV bags and in some cases, making some changes.

At all Cleveland Clinic facilities, including Cleveland Clinic Akron General, the IV bag shortage means more work for pharmacists and nurses, who are administering some drugs by IV push, or in a syringe, instead of via an IV bag, said Scott Knoer, chief pharmacy officer for the Cleveland Clinic. Administering IV drugs via a syringe takes longer than via a bag, he said.

“This is the worst shortage nationally I’ve come across that’s impacted every hospital,” said Knoer. The shortage is in three types of IV bags: what are called piggy-back bags, often filled with saline and hung on a pole; empty IV bags that pharmacists use to mix and fill with medications; and pre-made IV bags with medications, he said.

“We’ve got the drugs, but we do not have the most convenient way to give it,” Knoer said.

Western Reserve Hospital is not experiencing any shortages in IV bags, said spokesman Mark Bosko.

Summa Health and Akron Children’s Hospital both released statements when asked about the shortage.

Summa said it had changed vendors for a large portion of its IV bag supply.

“Patient care has not changed in any way. In addition, we are dealing with the national IV bag shortage through a number of other means, including maximizing allocations with all of our suppliers and working collaboratively with our physicians to conserve the products we have while maximizing our utilization efficiencies,” said Summa spokesman Jim Gosky.

John Lepto, director of pharmacy for Children’s, said the hospital is still getting shipments from its major supplier, Baxter, and is closely watching its inventories.

“IV bags of dextrose and saline are perhaps our most pressing concern but shortages have not affected patient care in any way,” said Lepto. “We have learned of efforts by the FDA to direct ship — rather than use standard distribution methods — to bring product from approved countries such as Spain, Ireland, Australia, Canada and Mexico. We are also encouraged to learn that Baxter is bringing on line a new plant in Mexico as recovery efforts continue in Puerto Rico.”

Last week, the American Hospital Association and five prominent medical societies wrote a congressional subcommittee and partially blamed the current shortage on the fact that pharmaceutical companies are not required under federal or state laws to disclose where they manufacture different products.

“This lack of transparency puts health care systems at a significant disadvantage when trying to take a proactive approach to handling a potential drug shortage,” the groups wrote.

Even before Maria hit Puerto Rico as a Category 4 hurricane Sept. 20, IV bags were often hard to get, hospital industry officials say.

Dr. Scott Gottlieb, the U.S. commissioner of food and drugs, acknowledged as much in an Oct. 13 statement that noted that the bags have been in short supply since 2014.

Because of consolidation in the pharmaceutical industry, experts say, there are fewer IV bag producers, while FDA-ordered upgrades to certain manufacturing facilities have sometimes temporarily halted production of the bags in the mainland United States.

Even though there are other manufacturing plants, Gottlieb said, “the agency and Baxter recognized that further shortage of this product could potentially put U.S. health care at risk.”

While the FDA has approved importing the IV bags from manufacturing plants in Ireland, Australia, Mexico and Canada to reduce some of the shortage, the hospital industry believes that will only meet 10 to 15 percent of current demand.

In the meantime, hospitals across the U.S. are being allocated just enough IV bags based on what they have used in the past, said Roslyne Schulman, director for policy development at the Washington-based American Hospital Association.

But, she said, the rationing doesn’t take into account the possibility of a severe U.S. flu season this year — or an even worse scenario such as a pandemic. An unexpected rise in seriously ill flu patients, she said, would require hospitalization and IV fluids to help treat patients, further challenging suppliers.

Last week, the hospital association issued a strongly worded letter to Gottlieb, calling the shortage of IV bags “unacceptable.”

In its letter, the hospital association said it “is concerned that patients could face harm” if the severe shortages — predicted to last at least through March — are not resolved quickly.

“There is a huge concentration of drug manufacturers in Puerto Rico, but we don’t know what they make or in what amounts or where because it’s proprietary information,” the association’s Schulman said. “The only time we find out is when a plant goes down.”

Medical writer Betty Lin-Fisher and the San Jose Mercury News contributed to this report. Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ

Twinkling lights and beautifully decorated trees and wreaths are once again filling the John S. Knight Center for the 36th annual Akron Children’s Hospital Holiday Tree Festival.

“This is Akron Children’s gift to the community,” said Heather Jalbert of West Akron, a longtime volunteer who is co-chairing the event with Liz Lenke of Copley.

The free event is a holiday tradition for many families, who come to stroll the hall and admire the trees, all donated by individuals, families, groups and companies. Since its beginning, the Holiday Tree Festival has raised more than $5.3 million to benefit medical research, education and patient care programs at Children’s.

The festival opens this Saturday and runs through Nov. 26. A preview gala will be held Friday. Two Breakfasts with Santa will also be held this Saturday and Nov. 25.

Tickets are sold out for the first breakfast, but still available for the second event.

The decorated trees, wreaths and other Christmas decorations are for sale and available for pickup after the event. The trees are wrapped as is and delivered to buyers’ homes, complete with two “fluffers” who follow the truck and make sure the tree looks exactly as it did at the festival once delivered, Lenke said.

This year’s offering is the most trees in the festival’s history, Jalbert said. There are 165 decorated trees and 85 wreaths. Additionally, there’s a large number of trees and gifts and an elaborate train display in the festival’s raffle.

Earlier this week, the festival hall was buzzing as participants brought in their trees to decorate them.

Jamie Peterhoff, financial coordinator at Mellion Orthodontics in Fairlawn and Wadsworth, has been decorating festival trees in the office’s name for nine years. The orthodontists volunteer at the hospital’s craniofacial clinic and also have donated gifts to the palliative care center, Peterhoff said.

She said she starts planning her tree and shopping in July.

“This is my two days of loving every moment and getting myself ready for Christmas,” she said as she decorated a white tree with snowmen, trains and gift boxes.

While some tree decorators have been coming back year after year with new creations, this was the first year for other participants.

Jan Lonsdale, who has been decorating trees in the event for 35 years (she was a judge one year), chose to do a whimsical theme with elves this year.

“It makes me happy to look at it,” she said of the tree, which was sponsored by Harwick Standard Distribution Corp.

This year was the first for Donna Ezzie of Copley and Bonita Williams of Barberton. They were putting a tree together called “Heavenly Sounds” for their church, Mount Zwingli United Church of Christ in Wadsworth.

The tree, with angels and trumpets, is in honor of church member Dan Caskey, who died of cancer this year, they said.

But Williams said it was also an honor to do something to benefit the hospital, where two of her nephews were born as premature babies. They are now 28 and 29 years old.

“Anything I can do for Children’s, I’m happy to,” she said.

Dr. Robert Klein, retired director of the Children’s Hospital burn unit and a pediatric surgeon, returned this year with his wife, Karen, his grandson, Stuart, and friends Lori and Dave Weninger after a two-year hiatus to put together a tabletop Christmas train village set as part of the festival’s raffle.

Klein, a train enthusiast and collector for 72 years, said he has been providing train displays for the event for more than 30 years. Some previous themes have been circus and Western. He took a break a few years ago, but festival co-chair Jalbert convinced him that his beloved train displays were missed by festival-goers. This year, Jalbert’s donated Department 56 houses are used in Klein’s display. A handmade table for the Lionel train display was donated by 4 B Wood of Seville.

A tree decorated by Alex and Nichol Ellisen with cute mice, snowmen and ribbons is in memory of Alexander “Alex,” 3, and Nicholas “Zef,” 5, who died in July 2000. The boys died when a van their mother, Alex, was driving to take them to swimming lessons was struck by a man in a stolen pickup truck who was being chased by police. Another son, William “Willy,” was injured but survived after being cared for at Children’s.

Each year for the last 17 years, the family has placed a picture of the two boys next to the tree they donate. Hartville Hardware has donated the tree and decorations for the Ellisen family to decorate for the last five years, Alex said.

“Children’s Hospital was very, very good to our family and a big part of our healing process. It never goes away; it just gets different and this definitely helps,” she said, noting that Dr. Klein, who donates the train display, was Willy’s doctor.

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

A national credit rating agency has downgraded Summa Health’s credit worthiness and revised the health system’s financial outlook from stable to negative.

However, the downgrade comes amid news that “staggering losses” predicted by Summa’s leader for this year aren’t as large as initially expected.

In fact, the Akron-based health system took in more money than it spent the last three months, particularly in October, said Dr. Cliff Deveny, Summa’s interim president and CEO.

In a phone interview on Wednesday, Deveny said Summa cleared $2 million to $2.5 million in the last three months in clinical operations. With investments and gifts to the hospital included, the health system netted $4 million.

Moody’s Investors Service this week downgraded Summa’s rating for $350 million of debt from Baa1 to Baa2. The bond rating carries a “moderate risk” for investors, according to Moody’s.

In its report explaining the downgrade, Moody’s blamed a decline in patients seeking care at Summa as contributing to operating losses this year.

Moody’s also expressed concern about Summa’s increased borrowing to pay for ongoing construction of a $350 million addition to the Akron City Hospital campus.

Despite the challenges, Summa still has more than 50 percent of the market share and maintains a “strong liquidity position, which allow the system some time to execute turnaround initiatives and complete the project,” Moody’s analysts stated in the report.

The bond rating downgrade will cost Summa about $90,000 a year because of resulting higher interest rates, said Brian Derrick, Summa’s chief financial officer. Summa does not expect to be downgraded further and hopes to have its rating upgraded within 24 months “with the strength of our balance sheet and the focus we have on operating performance and our plans to continue to improve performance,” he said.

In late June, Deveny had warned of “staggering losses” of $60 million and announced the elimination of 300 positions, about half of which were filled at the time. He warned that if Summa couldn’t get back on solid financial footing, the hospital could be the target of a potential sale.

On Wednesday, Deveny said there have been “no discussions with any external organization about a sale, despite the rumors out there.”

In its report, Moody’s said Summa had a “large operating loss” of $37 million this year through September. Summa’s revenue also has declined by 5 percent.

Deveny told Summa employees in his memo that the health system now expects to end the year with a loss of $35 million, about $25 million less than expected.

“As a result of our efforts, patient volumes are rising; we’re making progress in improving our quality and patient experience; and our financial losses have slowed. In fact, we expect the second half of 2017 to reflect [break-even] performance,” he wrote.

While the health system will continuously look for ways to find “growth opportunities” and “right-size” the organization, Deveny said he does not anticipate any other large-scale layoff announcements.

Still, Deveny said there is a “rolling review” of employment. For example, he said, while there were 67 new hires at an orientation last week, there were also some eliminations.

The total employment at Summa is about 7,800, down from 8,000 earlier this year, he said.

“What we are constantly looking at is different areas and the expense structure appropriate for that area,” Deveny said. Some of the changes have included consolidation of units, expansion of hours in other areas and elimination of corporate positions.

Deveny was hired as Summa’s interim president and chief executive officer in March following the resignation of CEO Dr. Thomas Malone amid demands by hundreds of doctors for a change in leadership.

The situation was exacerbated with the abrupt changeover in Summa’s emergency room physician staffing in January and subsequent loss of accreditation to train emergency medicine resident physicians. The hospital’s overall probation of its residency programs was lifted by an accreditation agency last month and hospital officials say they are determined to get the emergency medicine residency program reinstated.

In the Moody’s report, the ratings agency acknowledged that “within the last year, Summa experienced several unexpected disruptions that exacerbated an already competitive market and contributed to accelerated volume losses. The system has addressed or is addressing some of these issues, but competitive challenges are likely to continue.”

Moody’s said Summa’s market share in the Akron area in 2014 was 58.3 percent and dropped to 52.9 percent as of June.

“Volume declines at Summa accelerated in 2017 as competitors benefitted from disruption in Summa’s ED (emergency department) following transition to a new ED provider,” Moody’s concluded.

Deveny said while Summa still enjoys the leading market share in Akron, it is being threatened by other health systems and “the fact that Akron is getting smaller, poorer and older. That’s revenue. We’ve either got to grow or right-size the organization.”

The Moody’s report also said Summa planned to hire a new CEO in the next couple of months. Deveny said the board began a national search about six to eight weeks ago and he is among the candidates. He did not know how many other candidates there were, but said he’s been told a decision should be made in the next month.

Deveny, an Akron native who spent 20 years of his career at Summa before moving away, said “the emotional part of being from here” is part of the reason he’s interested in the job.

“This is the place that gave me a lot of opportunities,” he said. “The fact that I’ve been part of the ongoing process of improvement, I feel like I have a responsibility to see it through.”

Deveny ended his memo by saying: “For all of us at Summa Health, these remain difficult times. But I still believe that we can successfully navigate these obstacles. To accomplish this, we must continue to work across the organization to ensure growth and a return to profitability — and secure our role as the area’s largest employer and only remaining independent adult healthcare system.”

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

An effort to get rival health systems and physicians to share data to improve patient care and reduce costs is coming to Summit County.

Better Health Partnership is a nonprofit organization based in Cuyahoga County. For the last 10 years, it has been collecting data from mostly Cleveland-area hospitals and primary care physician practices to improve quality of care, provide better health outcomes and reduce costs of care, said Rita Horowitz, president and CEO of the collaborative.

Non-identifying, aggregate data is collected from participating partners — more than 1,000 primary care providers from 10 different health systems, including MetroHealth, Cleveland Clinic’s main Cleveland campus and, in recent years, Akron Children’s Hospital and its network of primary care offices.

“They share their electronic health record data with us, and we look for bright spots in the data to find out what health systems are doing exceptionally well,” Horowitz said.

For instance, after finding a best practice with the former Northeast Ohio operations of Kaiser Health for high-blood pressure after tracking data for 10 years, the partnership shared the data and methods with other health systems, and more than 75,000 people have their high-blood pressure under better control, she said.

The partnership was also able to close the gap in disparities in diabetes care management among Hispanics, African-Americans and Caucasian populations after seeing MetroHealth’s protocols — including making sure patients got an eye exam — and that all patients received a pneumonia vaccine. After finding out that MetroHealth’s nurses had standing orders to give a pneumonia vaccine to all diabetes patients, and once other health systems “got more comfortable with that, we saw everybody get better,” Horowitz said. “As a result, we did an analysis and saved $7 million in avoided hospitalizations due to pneumonia.”

On Tuesday, the organization will have its first Summit County event, a learning collaborative with 125 attendees, including representatives from Children’s, Summa Health System and Cleveland Clinic Akron General and other local health care workers. The event will have several public-health related breakout sessions for participants.

“We know Summit County is a big piece of Northeast Ohio, and we haven’t built the relationships in that space,” said Horowitz. “It’s about bringing our well-established infrastructure and our model and some of our quality-improvement expertise to help support the region’s unique needs in a good way.”

The conference, which is being held at the Summit County Public Health Department in partnership with Children’s Hospital, will also have a keynote address by Summit County Executive Ilene Shapiro and Akron Mayor Dan Horrigan, discussing what they are doing to address important public health issues.

Having a neutral third party like the Better Health Partnership to gather data to analyze and help improve health is something the county hasn’t had, said Summit County Health Commissioner Donna Skoda.

“We’ve been looking at ways to bring it to Summit County to have reliable clinical data. We know who’s dead, we know who’s born. We don’t have that good in-between data as to what’s happening to folks in between,” she said.

Having that neutral party collecting data also makes it easier for rival health systems to know “nobody’s at risk for their market share,” Skoda said.

Hospitals and physicians are only a small part of a person’s health, said Dr. Norman Christopher, chair of pediatrics at Akron Children’s.

“The rest of one’s health is their environment and their habits, those things hospitals don’t necessarily influence,” he said. “We need to improve the health of populations and do that through partnerships and through community agencies and with schools and partnerships with universities.”

Skoda and Horowitz said they are encouraged that representatives from both Cleveland Clinic Akron General and Summa are attending Tuesday’s conference, and they hope to get both organizations to work with the collaborative.

“The ultimate benefit down the road is to patients. It’s less out-of-pocket costs and reduces the claim experience, which hopefully ultimately reduces premiums,” Horowitz said.

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty.

A West Akron jewelry store with a long history is going out of business.

Lisa Ball Ponder, the fourth-generation owner of Henry B. Ball West, announced on Facebook and via email on Sunday that the store was closing.

The store opened in 1976, but has historical ties to a store that first opened 102 years ago.

Ponder returned to Akron two years ago from Florida to take over the store from her then 91-year old grandmother. Mary Gorman had retired after nearly 70 years as a jeweler and running the family business as a single mother of six.

The store was doing well, Ponder said in an interview Monday, but a recent loss in the family and family health problems are pulling her and her husband to want to return to Florida.

“The store has actually been great for the last two years. It’s been a real blessing to get to know my family up here. The community has been so welcoming,” Ponder said. “We’ve just had a lot of things happen to us in the last 12 months that we can’t ignore. It’s just pulling us back to Florida, where both of our parents are and the family is.”

Ponder said there weren’t any other family members who were able to take over the business from her.

“We tried,” she said.

Ponder hadn’t thought of returning to Akron to buy the business until she had heard an offhand remark about the business being on its last legs during a Christmas dinner the year before.

“It just triggered this inside of me to take on this honor,” Ponder said at the time of her grand opening in 2015. She gutted and renovated the store on West Market Street in Pilgrim Square, with the blessing and guidance of her “Nana” and other family members.

Gorman’s late first husband, Walter “Skip” Henry Ball, was the son of Henry B. Ball, who opened his first store in 1915 in downtown Akron. The couple joined the business in 1948 and Gorman took over the business after her husband died in 1971. In 1976, she opened Henry B. Ball West.

In 1983, the downtown store closed and was moved to Canton by Gorman’s son, Robert Ball. The Henry B. Ball Jewelers in Canton is a separate company and remains open.

At the West Market store, Ponder overhauled the inventory, keeping the fine jewelry and custom-made bridal sets, but also trying to appeal to a younger generation with spa products and other gifts.

Ponder said she has her Nana’s blessing to close the store and do what she needs to for her family.

“It breaks my heart to see the store close,” she said. “But our family traditions and legacy will be continued through our Canton store. My uncle is sole captain of the ship carrying it forward.”

Henry B. Ball Jewelers is located 5254 Dressler RD NW is in Jackson Township.

The Henry B. Ball West store is closed to prepare for a four-day going out of business sale. Hours are noon to 7 p.m Thursday, 10 a.m. to 7 p.m. Friday, 10 a.m. to 5 p.m. Saturday and noon to 4 p.m. Sunday. The store then will remain open through Christmas to sell off its remaining inventory and fixtures.

Ponder said she and her husband plan to move back to Florida in the spring. She doesn’t know what business will take over her spot, but “there’s been a lot of buzz about who is coming in next.”

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Christmas preparations came early on Friday as nearly $14,000 worth of toys were purchased for patients at Akron Children’s Hospital.

The main elf on Friday was Bobby Ina. It was the third year that he has coordinated a large toy drive involving his friends and clients that culminates with Santa arriving to deliver the gifts to patients in the hospital’s helicopter, AirBear.

Ina, 35, of Fairlawn, is managing director of Metropolis Consulting LLC, a company that does local government affairs work. As part of his work, Ina often interacts with politicians and labor unions.

Three years ago, Ina and his wife, Angela, wanted to do a toy drive for the hospital. He reached out to friends and clients and raised $6,000. Last year, he raised $12,000. This year, in a span of 3½ weeks since Ina said he got a late start because work was busy, he collected $13,500. They received an additional $840 in $10 Toys R Us gift cards since they were able to take advantage of the retailer’s promotion to get a gift card for every $75 purchased.

“What I found out was everybody wanted to do it, they just didn’t know how to do it. This was a great avenue for them to contribute $10 or $1,500,” Ina said. “We put everything together as a big group of friends and created something big.”

On Friday, Ina and several of his clients, mostly representatives of labor unions, were at the Toys R Us in the Montrose area at 7:30 a.m. to do their shopping. The store opened early for the group.

In past years, a few politicians have done some of the shopping off the toy wish lists, but several had Veterans Day commitments this year, Ina said.

Last year, Akron Mayor Dan Horrigan was among the shoppers. This year, Horrigan donated, along with other politicians, such as U.S. Rep. Tim Ryan and state Sen. Frank LaRose, who met up with Ina at the hospital after the shopping to drop off some toys.

Thankful for donors

The toys, gift cards and additional donations by check will be used mainly to provide Christmas gifts to patients on Dec. 22, said Helen Aberegg, volunteer training specialist. The hospital is lucky to have donors like Ina and his friends, as well as many other donors who donate throughout the year to provide gifts at the holidays, as well as year round for hospital patients.

For instance, one donor has provided a teddy bear for every patient at Christmas for years, she said. Children and families often bring in donations in lieu of their own birthday or Christmas gifts, Aberegg said.

“It’s incredible how the community supports the hospital,” she said. “It literally takes a village to raise a sick child.”

The hospital tries to provide at least four gifts to patients when Santa comes, which includes a teddy bear, a blanket made by Project Linus and toys, said Wendy Sawyer, volunteer recruiter. Donations also help provide coloring books for siblings and toys for the prize boxes in the outpatient areas.

“Everyone who leaves the hospital [in December] usually gets something because they were brave,” Sawyer said.

Ina also gave about $1,500 in cash that will be used to help families in the pediatric ICU and hematology/oncology floors with bus fares or parking fees, Aberegg said. It will also be used for meals for families, she said.

Shopping trip

At the Toys R Us, Tom Wiant, financial secretary/treasurer of Sheetmetal Workers Local 33 of Northern Ohio admitted he was not normally a shopper.

Wiant had just finished spending $900 on boxes of Star Wars and Batman Legos. The shoppers were going off lists of popular toys provided by child life specialists at Children’s Hospital. Ina gave each shopper an area to load up their carts to bring up to the registers and then head back to the aisles for more.

“It’s a good feeling when you’re picking out toys and you know this is more than just toys,” Wiant said.

John Sindyla, CEO of Sheet Metal Air Conditional Contractors National Association’s Cleveland chapter, was a bit lost when he was sent to the display area for the popular TV show Paw Patrol to fill up his cart.

“My son is 10, so he’s past this. I haven’t heard of Paw Patrol,” Sindyla said.

Still, Sindyla, filled his cart with toys he knew would brighten patient’s days.

Sindyla said he and his members were happy to help “to make a kid’s Christmas a little brighter when they’re going through tough times. Every child loves to get something from Santa.” Thomas Martin, owner of T.H. Martin Inc. and president of Sindyla’s union, rented a box truck to transport the toys from Toys R Us to the hospital.

Greg Daniels, business manager and financial secretary for Akron-based Plaster and Cement Masons Local 109, had $2,000 in funds personally donated by him and his members to spend at the store.

Daniels said if he can take a morning to shop and bring smiles to kids’ faces, it’s a good thing.

When asked about being part of an effort that brings together people who may sometimes be at odds in their professional lives, Daniels said “we don’t have to today. It’s not about our fights. It’s about the kids today.”

When the box truck arrived at the hospital, volunteers were ready with five carts to load the bags of toys and take them up to the volunteer offices’ toy closet. Ina had also worked with Acme Fresh Markets to have pastries delivered for hospital staffers.

Ina and his friends aren’t able to witness the toys getting delivered to patients, but Ina said that’s not important.

“The hospital is a hospital. It’s not a zoo. You don’t get to go and watch people. I don’t need to have accolades for it. As long as they come back and say ‘You put smiles on kids’ faces for Christmas, that’s all I care about.’ ”

Beacon Journal medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Summa Health and Western Reserve Hospital Partners have taken the first steps toward becoming amicable exes in what has been Summit County’s ugliest health care divorce.

Summa and the physician-owned Western Reserve Hospital Partners (WRHP) entered into a 40/60 partnership to run the 57-bed Cuyahoga Falls hospital in 2009. But the hospital has been in limbo since the relationship began to fail in 2014 and ended up in court.

Now, a letter of intent has been signed by officials at the Akron-based health system, Western Reserve Hospital and its parent group, WRHP, to allow the 3-year-old battle to come to an end.

In a joint statement released Wednesday, both partners outlined some of the agreement. Details are still being worked out, they said, and Summa spokesman Mike Bernstein and Western Reserve spokesman Mark Bosko said no additional comment would be made. The heads of both organizations were not available Wednesday.

In the letter of intent, the sides agreed to the following items, according to the statement:

• Summa will sell its 40 percent interest in Western Reserve Hospital to a third-party investor.

• Summa will sell the facility currently housing Western Reserve Hospital at 1900 23rd St. in the Falls to Western Reserve.

• All outstanding litigation will be resolved.

In the statement, Bernstein and Bosko said: “All parties are committed to working together to achieve a definitive agreement to finalize details of the [letter of intent] that will be in the best interests of the community and the patients collectively served. It is expected that the definitive agreement will be completed by the end of 2017, but no date has been set.”

Bosko and Bernstein declined to name the third-party investor or the Falls building’s selling price.

New hospital

The partnership between Summa and WRHP, a group of about 200 area doctors, had included an intent to develop or build a new hospital. But WRHP officials later said it became clear several years after the pact was formed that Summa didn’t want to build a new hospital.

Things went sour in 2014, after WRHP officials voted to strip Summa of its 40 percent ownership stake. Summa sued WRHP to regain access to information about hospital operations, information Summa said it needed before it could sell its interest in the hospital.

The legal battle between the two sides included accusations of name-calling, underhanded dealing and possible violations of federal regulations.

At one point, Summa threatened to evict Western Reserve from the hospital in Cuyahoga Falls.

Summa owns the building and leases it to the operating group. The doctors group has a purchase option to buy the hospital but hasn’t been able to agree on a price with Summa.

In July 2016, a Summit County Common Pleas jury found both Summa and the doctors group at fault for violating agreements in their joint ownership of the hospital, awarding each $10. The jury also awarded $906,464 in compensatory damages to Summa for breach of contract by the physician group.

The jury also issued a verdict requiring a third-party appraisal of the Summa-owned building in Cuyahoga Falls where the hospital is housed, which would have allowed Western Reserve to finally buy the facility.

At the time of the verdicts, both sides claimed victory.

Summa leadership

Earlier this year, both sides expressed hope that a resolution could result after a change in leadership at Summa.

Dr. Cliff Deveny returned in March to Summa, where he had spent about 20 years of his career, to help move it forward after former CEO and President Dr. Thomas Malone resigned under pressure following an emergency department physician staffing crisis at the start of the year.

In May, Deveny, Summa interim CEO, told the Beacon Journal that he had been meeting with Dr. Robert Kent, president and CEO of Western Reserve to see what they could work out together.

“I want to be friendly exes who are best friends,” Deveny said at the time. “There’s no reason the original vision can’t be realized of a physician-owned hospital that is part of a system of care.”

In response, Kent said: “I am encouraged from these early talks, and believe our organizations are now heading down a path that will allow for the development of a new and constructive relationship, one much different than what is now in place.”

Medical writer Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

The new 60-bed Cleveland Clinic Edwin Shaw Rehabilitation Hospital will officially open Tuesday morning in Bath Township.

The $30 million, 75,000-square- foot facility is a joint venture between Cleveland Clinic and Mechanicsburg, Pa.-based Select Medical.

Fifteen patients who were at the Edwin Shaw facility housed in rented space at the Falls Village Retirement Community — formerly Fallsview Psychiatric Hospital — in Cuyahoga Falls, will be transferred Tuesday to their new temporary home. Other patients were able to go home before the move, said Geoffrey Hall, chief executive officer of the new facility.

“We’ll have a celebration and a ribbon-cutting for every room” as patients arrive at the brand new facility on state Route 18, next to Cleveland Clinic Akron General’s Health and Wellness Center, he said.

“While the care has always been great [at the Falls facility], it’s a much older building. This gives us the opportunity to bring state-of-the-art equipment and state-of-the-art care,” he said.

The Falls space was a 33,000 square-foot, 34-bed unit in the former psychiatric hospital off state Route 8, which opened as a tuberculosis hospital in 1908.

Akron General first purchased Edwin Shaw Hospital from Summit County in 2005.

The new Edwin Shaw will care for patients recovering from stroke, spinal cord injury, brain injury, amputation, neurological disorders and orthopedic conditions.

Cleveland Clinic’s outpatient chemical dependency program will remain in a small portion of the rented space in the Falls. It will be renamed Cleveland Clinic Akron General Alcohol and Drug Recovery Center.

Outpatient rehab services which were at the Falls facility, have been moved to the wellness center in Stow and are being renamed the Cleveland Clinic Akron General Rehabilitation and Sports Therapy center.

During a celebration and tour of the Bath facility Monday evening, Akron General President Dr. Brian Harte said the transition of the new facility is not only a literal transition for the patients from the Falls, but a “transition for the Edwin Shaw name and legacy.”

The Bath facility will be the third rehabilitation hospital jointly operated in Northeast Ohio by Cleveland Clinic and Select Medical. Other facilities are in Avon Lake and Beachwood. The three facilities together have 180 rehabilitation beds available.

Select Medical is a health care company with more than 40,000 employees across the United States that specializes in rehab hospitals and long-term acute care.

All 135 Edwin Shaw employees earlier this year became Select Medical employees and an additional 75 were hired to work at the Bath Township facility, in addition to Cleveland Clinic physicians.

About 80 percent of Edwin Shaw patients come directly from Akron General, though the facility will also accept patients from other places, Hall said, adding that most patients stay an average of 14 to 18 days.

“We’re helping them learn how to navigate a wheelchair, we’re helping them learn how to regain some of their independence,” he said. “Our goal for every patient when they come to our hospital is to help them discharge home.

“We’re not a long-term hospital, we’re not a nursing home. What really makes us different is our intensity of service, with the ability of patients to do three hours of physical, occupational and speech therapy a day,” he said, adding that 76 percent of patients are able to leave the rehab hospital to go directly home. Others may return to a hospital or go to a skilled-nursing facility, Hall said.

The new Edwin Shaw has individual rooms that are all handicapped-accessible, two gyms for physical therapy and a room set up like an apartment, with laundry machines, a residential bathtub, bed and stove, so patients can learn how to re-adjust to life at home.

Harte said it’s exciting that “Edwin Shaw’s legacy of caring for patients in Northeast Ohio will continue in this world-class facility in Bath.”

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty.

When Homer Travis was discharged from the hospital after previous surgeries, he asked for narcotic painkillers “just in case” — and needed to use them.

But that changed last November, when he underwent colorectal surgery through a new approach at Cleveland Clinic Akron General in which no narcotics are used during or after some operations.

Travis never needed the strong painkillers after the surgery, which removed 14 inches of his colon and left him with a 12-inch incision from his sternum to his belly.

“I took nothing but Tylenol,” said Travis, 67, of Barberton, who was willing to go along with the new technique, but wasn’t sure it would work.

When Travis was invited earlier this year to talk about his surgery to a group of doctors and nurses, he brought his bottle of 20 unused Vicodin and handed it to his surgeon. Travis had asked for the painkillers “just in case” when he was discharged.

“If we can get rid of pain pills, that’s what I want. They always made me groggy and kind of in a fog,” said Travis, who has had two knee replacements, bariatric and hernia surgery and also had his appendix and gallbladder removed.

Doctors at Akron General and cross-town rival Summa Health are opting to forgo powerful and potentially addictive opiates for pain control during and after surgeries in favor of narcotic-free options.

The approach, known as Enhanced Recovery After Surgery, turns on its head what doctors and nurses had advised for years: Don’t eat or drink before surgery, use pain medications — including narcotics — for comfort and stay in bed to recover.

Proponents of the ERAS approach say it decreases hospital stays and gets patients back on their feet quicker. And an added bonus is it significantly reduces and in many cases eliminates the use of narcotics used during the hospital stay or after — a positive in the fight against the growing national opioid epidemic.

New anesthesia techniques and medications have become available, allowing nerve blocks that provide longer-lasting relief from pain during and after the surgery, said Dr. Mark Horattas, Akron General’s chairman of surgery. Patients using ERAS techniques also are instructed to drink a Gatorade several hours before their surgery to keep them hydrated — a switch from the typical orders to avoid liquids in the hours before surgery.

When Travis woke up from surgery, for example, he was encouraged to start chewing gum to increase his saliva and encourage the return of bowel functions.

Europe uses approach

ERAS protocols have been in use in different forms for about 20 years, but until more recent years have mostly been utilized in Europe, said Dr. Tonia Young-Fadok, a professor of surgery at Mayo Clinic Arizona and president of the board of the ERAS Society USA chapter.

“Adoption is still in its relative infancy in the U.S.,” said Young-Fadok, but it’s gaining traction. The society is holding its first conference next week in Dallas.

The reduction or elimination of narcotics is especially helpful for patients with colorectal problems because narcotics can slow bowel movement from returning after surgery, causing a longer recovery, she said.

To have two major hospital systems in one town both using ERAS techniques is “fantastic,” said Young-Fadok.

“There’s a fine balance when an institution is looking at doing this. If you’ve got just one interested person, it’s very hard to get this up and running. It’s also a balance between someone being young enough to be open-minded and senior enough to hold some sway in the hospitals so things actually get done,” said Young-Fadok.

Growth in protocol

Summa Health started using the Enhanced Recovery After Surgery protocol in 2013 and has been increasing its usage, said Dr. Tom Mark, chair of the department of anesthesiology.

At Summa, the non-narcotic ERAS options have been offered in a wide variety of surgeries, including mastectomies and other breast surgeries and hysterectomies, colorectal surgeries, all gastric-bypass patients, laparoscopic surgeries, liver and gallbladder surgeries and appendectomies. They also are used in thoracotomies and orthopedic cases, Mark said.

Akron General began using ERAS techniques in its colorectal surgeries in 2016 and found great successes, Horattas said.

It has been expanded to breast and bariatric surgery, with more departments exploring it, and the team has been working on developing the program to other parts of the Cleveland Clinic. The Clinic recently listed ERAS techniques as its No. 8 medical innovation for the health system. Horattas last week was at the American College of Surgeons meeting presenting the hospital’s ERAS results.

In 2016, 30 percent of colorectal surgical patients at Akron General didn’t receive any narcotics before, during or after their surgery or when they went home, said Horattas, who anticipates that the numbers have increased with the expansion of the program. Overall, the hospital also saw a 90 percent decrease in opioid administration for those patients using the ERAS protocols who did require some morphine during their stay, he said.

“The patients were easy to convince,” said Horattas. “It was tough to convince the other surgeons, anesthesiologists and nurses because it challenged their typical teachings.” After they saw results, “we have a great team that works together.”

Patient satisfied

Pat Clemas, 70, of Hudson, felt so good after she was released from Akron General following her colorectal surgery that she went to the store with her husband two days later to pick up her Tylenol.

“I didn’t feel I needed anything. I felt clearheaded and didn’t feel cloudy,” said Clemas, who is also no novice to surgery. She has had three Caesarean sections, a hysterectomy, surgery to remove a hernia, two knee-replacement surgeries and three rotator-cuff surgeries.

At Summa, a little more than 50 percent of surgeries now get no narcotics before or during surgery, Mark said. About one-third of Summa patients continue to get no narcotics after surgery.

“The benefit to the patient is immense. The majority of our complications come from narcotics and if we have virtually no pain or very low pain and no narcotics, it’s a win-win for the hospital and for everybody,” he said.

About 20 percent of patients get no narcotics during their hospital stay and as they go home, Mark said.

Weapon in drug fight

Both Horattas and Mark said their hospitals did not adopt the ERAS protocols because of the opioid epidemic, but recognize the approach helps eliminate the potential for addiction by patients and reduces the amount of unused narcotics in medicine cabinets, which may get used by others.

“Akron is ground zero,” Mark said.

The state of Ohio earlier this year also implemented new limits and rules for physicians on opiate prescriptions for acute pain.

Jerry Craig, executive director of the Summit County Alcohol, Drug Addiction and Mental Health Services Board, said he’s pleased to hear both local hospital systems are using methods to reduce or eliminate narcotic use in surgical procedures.

The ADM board often suggests that patients ask their doctors for opioid-alternatives.

“We have so many people who are in recovery who fear going under the knife because they fear returning to their addiction. If there’s an alternative, it gives them some peace of mind,” he said, adding that he recently spoke to a woman who needed a hysterectomy, but was worried about getting addicted to narcotics again from the pain pills.

“It’s neat to see that our hospital systems are looking at other creative ways of managing pain,” Craig said. “Certainly it’s for the right reasons, not just for the opioid epidemic, but because it’s the right thing to do.”

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter.

“The patients were easy to convince. It was tough to convince the other surgeons, anesthesiologists and nurses because it challenged their typical teachings.”

Mark Horattas

chairman of surgery

at Akron General

Help is available for people looking for health-insurance coverage options through the federal Health Insurance Marketplace.

The options were created through the Affordable Care Act, also called Obamacare.

This year, there is a shortened open-enrollment period from Nov. 1 through Dec. 15. Go to http://www.healthcare.gov for information and to enroll.

AxessPointe Community Health Center is holding free open-enrollment fairs at its various locations, in addition to weekly fairs from noon to 7 p.m. every Tuesday from Nov. 7 through Dec. 12 at the Ohio Means Jobs Center, 1040 E. Tallmadge Ave., Akron.

Certified application counselors will be available to offer free help; no appointment is necessary for any AxessPointe events.

Other AxessPointe fairs include:

• Nov. 4: Kent, 143 Gougler Ave. from 10 a.m. to 2 p.m.

• Nov. 6: Akron: 676 S. Broadway from 9 a.m. to 1 p.m.

• Nov. 11: Barberton: 390 Robinson Ave., Suite E from 10 a.m. to 2 p.m.

• Nov. 18: Akron: 1400 S. Arlington St., Suite 38 from 10 a.m. to 2 p.m.

• Dec. 6: Akron: 340 S. Broadway from 1 p.m. to 4 p.m.

For more information, help over the phone or to make an individual appointment with an AxessPointe counselor, call 888-975-9188.

Several local organizations that used to offer help had to stop their programs because federal funding was cut. There are a few other organizations offering limited assistance, via appointments, to the general public. They include:

• Summit County Health Department: 330-926-5660

• Asian Services in Action, Inc. (ASIA Inc.) Akron office: 330-535-3263.

• Lifecare Family Health & Dental Center in Canton: 330-454-2000

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Kaye Rootring says she and her college-age daughter won’t go without insurance.

But Rootring of Perry Township is unsure how much more her current $462.80 monthly premium costs will be when she starts shopping this week for plans available through the federal Health Insurance Marketplace. The plans were created through the Affordable Care Act, also known as ACA or Obama­care.

Rootring and other consumers are facing higher costs this year and other challenges as cuts to programming by the Trump administration and changes upheld as recently as last week will increase health-care costs for consumers.

About 12 million Americans, including 238,843 Ohioans, are enrolled in Affordable Care Act plans, which are available for those without health insurance through a job, Medicare, Medicaid or other source.

Under the ACA, most Americans are required to carry health insurance or face a potential financial penalty when they file their taxes.

The program has become a hot political issue while advocates say health-care needs for consumers are being lost in the shuffle.

In a study released last week by consulting firm Avalere Health, premiums for the most popular plans are going up an average of 34 percent, based on a review of plans for coverage beginning Jan. 1.

Rootring, 62, said her insurance costs for her family of three used to be $550 per month when she was still working.

Her husband now is covered by Medicare.

For Rootring, going without insurance is not an option.

“Whatever those people in Washington do, I have no control over it,” Rootring said. Without insurance, “you’re just tempting fate and something awful to happen.”

Open enrollment for the Affordable Care Act plans begins Wednesday, Nov. 1, and lasts through Dec. 15.

Changes in D.C.

The time frame for this year’s open-enrollment period has been cut in half, compared to the time allotted under President Barack Obama’s administration.

Sign-up season comes after President Donald Trump canceled federal payments that reimburse insurers for reduced copays and deductibles they’re required to provide to people of modest means.

The canceled payments, or subsidies, were upheld Wednesday by a federal judge, who denied a request by state attorneys general to order the payments immediately restored.

Some critics of the Affordable Care Act are glad about the changes.

Show of support

Tom Nunley, a self-employed sales broker from Springfield Township, blames the ACA for steady increases to his private insurance.

“I have watched my premiums go from the $400/month range to nearly $1200/month range for $5000/$10000 coverage from 2012 to 2017,” Nunley commented in a recent Beacon Journal Facebook post. “The ACA was the driver behind this increase. I am happy that the Trump administration has ended subsidies and opened up competition across state lines. Also allowing us to join or (form) groups will be a big help.”

Earlier in September, the Trump administration also announced sharp cuts, including cutting $90 million from the $100 million budget for advertising for open enrollment.

The website (http://www.healthcare.gov) to shop and enroll for plans will be shut down for maintenance for 12 hours nearly every Sunday — from midnight to noon — during the open-enrollment period.

The computerized system allows consumers to compare plans and determine whether they qualify for financial help to get insurance.

Ohio residents can also use the marketplace or a state-run website — https://benefits.ohio.gov — to apply for Medicaid coverage during open enrollment or year-round.

Adding to the uncertainty this open-enrollment period, about 40 percent of federal funding for “navigators” who helped consumers research and sign up for the plans, was cut.

As a result, many local organizations that had offered consumer assistance this year had to pull out or scrounge for other funds to offer limited unofficial helpers.

Politics criticized

The Ohio Association of Foodbanks, in a tersely worded news release, said it believed the nonprofit organizations that make up its Navigator program, including several in the Akron area, “have been held hostage by what we believe is a political maneuver to damage the viability and stability of the Affordable Care Act.”

Lori Jensen and Heather Gunnoe, certified application counselors at AxessPointe Community Health Centers, are bracing for an increase in consumers seeking help researching the ACA plans.

Jensen and Gunnoe believe AxessPointe is the only agency in Summit and Portage counties still receiving federal funds to continue their ACA programming.

AxessPointe has set up several free public fairs in coming weeks. Anyone can use their ACA counseling services, not just patients.

They also fear that many consumers will find that the premiums and costs for ACA plans will be too high, and they will have to opt out of insurance coverage.

Gunnoe said it is important for consumers to look at what’s available on the marketplace and not to assume the coverage they already have will be the same.

“If they roll over their same plan, they may not get the same advantage for their premium tax credit,” Gunnoe said. “Go in and see if there’s something better this year. I’m not sure there will be.”

The Affordable Care Act has been good, said Renee Lung, a certified application counselor at Lifecare Family Health & Dental Center in Canton, which like AxessPointe, is also a federally funded community health center.

“I just hate to see the road it’s taking now, especially since we’re a health center,” she said. “This has become political and not about people’s health.”

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Looking for enrollment aid for Affordable Care Act plans? See a list of places, times and events in the Akron area. A4

SummaCare’s big move down East Market Street to new headquarters will happen later than originally anticipated.

The Akron-based health insurance plan, originally created to provide managed care for Goodyear Tire & Rubber Co., announced earlier this year that it would be moving headquarters and more than 300 employees from downtown Akron to the former Goodyear campus now known as the East End.

The move was supposed to happen in November; it will now happen in March, a Summa Health spokesman said.

When asked about the move, Summa spokesman Jim Gosky said this in an email:

“In collaboration with the developer, we have made the decision to delay the move to Akron’s new East End neighborhood until March of next year. A move of this magnitude is complicated, and this decision will allow for additional time to ensure all details are completed to our satisfaction. This change also provides an opportunity to complete our current busy open enrollment season without the distraction of having to change locations.”

SummaCare has been in its present home, a five-story building put up on 6.9 acres that previously was the site of the former Portage Hotel, since December 2002.

Developer Signet Enterprises broke ground on that building at 10 N. Main St. in February 2001; the estimated construction cost was $12.5 million.

SummaCare officials have said its current headquarters at Main and Market streets is now too large. The health insurer said it signed a three-year lease for 65,000 square feet of space at the East End that will put all of its employees on one floor.

Delay confirmed

East End owner and developer Industrial Realty Group, also known as IRG, has said SummaCare would be the first significant business tenant in the complex off East Market Street.

IRG, which specializes in redeveloping aging industrial properties, purchased the former Goodyear campus and built Goodyear’s new headquarters just a short distance away in East Akron on Innovation Way.

In a statement, Carol Smith, IRG vice president, confirmed the delay.

Plans for the 1.4 million-square-foot East End Offices “involve the reconstruction of 65,000 square feet of space for SummaCare, an innovative and inviting lobby and cafe, creation of an internal courtyard, a 7,000-square-foot fitness center, and a covered bridge that will span the Little Cuyahoga while connecting our largest surface lot to the building.’’

Akron schools

There is interest in the space that will be vacated downtown by SummaCare once the insurer moves.

Earlier this month, Akron Public Schools Superintendent David James said the district is considering acquiring the building as the possible new school administration building.

James said district officials are “analyzing data and costs as part of the due diligence process.”

James said the district will not ask for additional funds from taxpayers to pay for any consolidation of administrative services.

The building is 100,000 square feet and enough space for the district’s offices now in two buildings, he said. The building also has 500 parking spaces.

The school district’s offices are in the Conrad C. Ott Building at 65 Steiner Ave., the former Miller School south of downtown, which houses educational administration; and the Sylvester Small Administration Building at 70 N. Broadway, the former Bowen School downtown.

On Friday, school spokesman Mark Williamson said the district has been kept updated on SummaCare’s move and the delay gives the district more time to do its research.

Staff writer Jim Mackinnon contributed to this report. Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

The Emergency Home Energy Assistance Program (E-HEAP) at Akron Summit Community Action Inc., will open Nov. 1 for the winter season.

The program serves income-eligible households in Summit County who are at or below 175 percent of the federal poverty guideline.

Through E-HEAP, which runs through March 31, eligible households will receive a one-time payment of $175 toward a utility bill if service is in threat of disconnection, is terminated, is new service or if the service is being transferred. Clients who use bulk fuel may be eligible for up to $750 to fill the tank if there is less than a 25 percent supply of bulk fuel.

Eligibility is by size of household. For instance, a family of four would need a three-month household income of $10,762.50 and a 12-month income of $43,050.

Applications for HEAP can be dropped off or mailed to Akron Summit Community Action Inc., 670 W. Exchange St., Akron 44302.

Customers with disconnection notices must call the toll-free E-HEAP appointment line at 866-504-7400 to schedule an appointment.

The scheduling line opens Thursday for making appointments Nov. 1 and thereafter.

If all E-HEAP appointments are filled, callers may opt to call back between 4 p.m. and 6 p.m. that day to schedule one of a limited number of walk-in time slots the next business day. Live operator assistance is available daily from 10 a.m. to noon and 2 p.m. to 4 p.m.

Extended walk-in service will be offered from Nov. 1 through Nov. 9 between 8:30 a.m. and 3:30 p.m. at the 670 W. Exchange St. office only.

Walk-in scheduling is determined on a first-come, first-served basis to customers whose utility services are off, need to be transferred, in need of a new service or those out of bulk fuel. Regular Monday only walk-in service will resume on Nov. 13.

Outpatient services resumed at Summa Health’s St. Thomas Hospital on Monday and inpatient services will restart 7 a.m. Tuesday following a fire earlier this month.

The hospital on North Main Street has been closed since Oct. 13 when a basement fire caused the building to be evacuated.

Summa officials released this statement Monday about the fire, which is still under investigation:

“Thanks to the quick response of St. Thomas staff and the Akron Fire Department, the fire was contained to the basement and extinguished Friday morning. However, smoke damage throughout the building necessitated closing the facility for cleaning and repairs.

“It has been determined that all fire suppression systems in the building were functioning properly, but due to the location of the fire, smoke was able to spread through an elevator shaft and plumbing chase. The Akron Fire Department is still investigating the exact cause of the fire.”

There were no injuries, and all patients and staff were evacuated from the building. About 100 Summa Health and Crystal Clinic Orthopaedic Center patients were transported to area facilities, including Western Reserve Hospital in Cuyahoga Falls and Summa’s Akron City and Barberton hospitals.

Summa officials said “treatment plans were implemented to ensure patients received appropriate care relative to their individual and specific needs.” The majority of evacuated patients were expected to remain at the receiving hospitals rather than being transferred back to St. Thomas when it reopens.

Monday evening, Crystal Clinic officials said the clinic’s St. Thomas outpatient services resumed earlier Monday and surgical services would begin on Tuesday.

The cleanup efforts at St. Thomas were completed by ServiceMaster, hospital officials said.

A team was brought in to remove all unserviceable equipment, remove linen for cleaning, replace ceiling tiles and conduct a general cleaning of all areas, officials said.

Hospital officials said while cleaning for patient and staff areas is complete, “the basement and a few other non-patient, non-public areas need a more thorough cleaning and will not be complete upon re-entry. Because the cleanup in specific areas where the fire occurred still is underway, the possibility exists there may be an occasional faint odor.

‘‘This is not unexpected and does not pose any health risks to those people inside the facility.”

Hospital officials also said St. Thomas “has received and passed multiple inspections, including the Akron Fire Department, Ohio Department of Health and both the Summa Health and Crystal Clinic Infection Prevention Teams. Additionally, all systems and equipment have been inspected and tested to ensure proper operation.”

“Summa Health would like to thank the Akron Fire Department, EMS crews, and staff at the Summa Health Akron Campus, Summa Health Barberton Campus, Western Reserve Hospital and the Crystal Clinic Orthopaedic Center for their work in managing the evacuation and taking care of our patients during this difficult time,” hospital officials said.

Both organizations have set up hotlines for patients and their families. Summa’s number is 330-375-7702 and Crystal Clinic’s number is 330-668-4486.

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty.

A convicted Akron businessman who was caught trying to run an income tax business while imprisoned was sent back to prison on Monday after failing to pay restitution to his victims.

Ronald Conte, 59, was found guilty in 2015 of charges that he collected taxes from local businesses for whom he did payroll, but did not forward the money to local, state and federal agencies. He was ordered to pay $558,102 in restitution.

He was granted a release in February, placed on strict probation for five years and ordered to tell all future clients of his crimes. He also was ordered to pay $2,500 a month in restitution to 38 area small-business owners, but got that amount reduced to $1,500 in April after telling Summit County Common Please Judge Christine Croce that he could not afford the monthly restitutions.

However, Conte paid only $2,234 of the restitution, according to the Summit County Prosecutor’s Office.

Conte was back in front of Croce for a hearing Monday morning. Croce had warned him during previous appearances that he must pay restitution or she would send him back to prison.

“The court found that Mr. Conte manipulates his assets when he wants to pay less and has not paid restitution based on his ability. His community control was revoked and the remainder of his prison sentence imposed. He has approximately 38 months remaining on his sentence,” the prosecutor’s office said in a prepared statement on Monday.

Prosecutors also told Croce in court Monday that credit card receipts show purchases for non-essential items such as new clothes and new copper cooking pots instead of paying restitution.

Conte was immediately taken into custody Monday morning to return to prison.

Conte’s attorney, Brian Williams, declined comment on the case, other than saying his client intended to appeal the decision. Williams was appointed as Conte’s attorney this summer after Conte was found to be indigent and his previous attorney withdrew from the case.

One of Conte’s victims, Cuyahoga Falls attorney Raymond Powell, who lost $16,700 to Conte and attended the hearing, said Conte belongs in prison.

Powell estimates he has received less than $60 in restitution from Conte.

“Obviously, I would like to receive my restitution. But in light of the fact that it was obvious he wasn’t going to pay it, he might as well serve the rest of his jail term,” Powell said.

Before his conviction for the payroll tax problem, Conte also ran an income tax preparation business. In 2016, questions arose about whether Conte was involved — while incarcerated — in his former Akron Income Tax business on Waterloo Road.

Conte sold the business and is involved in a separate civil case brought by some of his payroll tax victims.

Conte’s attorneys had insisted that Conte was not involved in the income tax business, but victim complaints about his possible involvement led to disciplinary actions by the Richland Correctional Institution.

Additionally, in a previous hearing before Croce, she said she listened to phone calls between Conte and his wife and believed that they were talking in code. The judge called Conte a manipulator who does not believe rules apply to him.

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty.

After 88 years, Buehler’s Fresh Foods soon will no longer be owned by the founding family.

But the new owners are extremely familiar with the grocery stores.

The 13 supermarkets are being sold to the company’s eligible employees through an employee stock ownership program, or ESOP. A new company named Buehler’s Fresh Foods will be formed and it will be led by three veteran Buehler’s executives.

E&H Family Group, the Wooster-based parent company of Buehler’s, said none of the stores’ 2,100 employees will lose their jobs. The company said all stores will remain open with the same hours of operation.

“This was a decision we did not take lightly. Our generation of Buehlers are reaching retirement age and we think this a better option than selling the business to outsiders,” Dan Buehler, E&H Family Group president and chief operating officer, said in a news release. “We want these supermarkets to be here serving customers and providing good jobs well into the future. There’s no one better qualified than our own employees to carry on that mission. We believe that the transition to an ESOP is a winning solution for the Buehler family, our employees and the communities we serve.”

Details of the Buehler’s ESOP deal were scant; officials declined to give more information.

In a phone interview, Greg Buehler, one of the five members of the third generation who have been active in running the business and known as the “Buehler Boys,” said the deal was signed Tuesday, announced Wednesday to employees and the public and will be completed in about a month.

While the Buehler Boys will no longer be involved in the grocery business, the family will continue to operate E&H Family Group, which owns and operates 22 hardware stores in Ohio under the E&H Ace Hardware name. The sale has no impact on that business.

“There’s a lot to work through. We’ve spent 88 years building the business and they’re intertwined. Separating them does not happen overnight,” said Buehler, who is vice president of training and development.

Buehler said customers should not see any change.

“As much as things are changing, things are staying the same,” he said.

The new ESOP grocery company will be run by Dan Shanahan, Buehler’s president and chief operating officer since 2011; Rick Lowe, vice president of human resources of the E&H Family Group since 1977, who is married to a third-generation Buehler; and Mike Davidson, vice president of store operations since 2015.

New company leader Shanahan, who was the first non-Buehler brought in to run the grocery business, did not return a call seeking more comment. In a statement, he said “we are happy for the Buehler family and excited for the opportunity to write the next chapter in the great Buehler story.”

Greg Buehler said four of the Buehler Boys are still active in the business (a fifth retired last year) and he declined to say whether there are any retirement plans for others. Two fourth-generation family members are involved in the E&H business, he said.

The family has grown the Ace business since the 1960s and “we still want to work and that’s a good business for us to continue to nurture and grow,” Buehler said.

The Buehler family will not participate in the grocery store’s ESOP program, he said.

The grocery chain was founded in 1929 by E.L. (Ed) and Helen Buehler. After opening their first store in New Philadelphia, they moved the business to Wooster in 1932.

Positive reaction

On social media, reaction to the sale was mostly positive.

“I think this is great and shows some loyalty between employer and employee which sadly in most companies has gone by the wayside,” said Ron C. Lee.

Diana Autry said, “Folk tend to take better care of things when it belongs to them vs. someone else.”

But on Buehler’s Facebook page, some employees questioned why they weren’t given more advance notice before the news was made public.

The move to sell to employees shows the business is “committed to being a community grocer,” said Kristin Mullins, president and chief executive officer of the Ohio Grocers Association in Columbus.

“They didn’t sell to a chain. They stayed an independent,” she said. “I think it’s a good thing for the Buehler’s family and the Buehler’s employees. … Ohio is still very blessed to have a large number of independents.”

Jim Trout, president of fellow Akron-area family-owned grocer Acme Fresh Markets, declined to comment on the sale.

The nation’s largest ESOP is a supermarket chain, Florida-based Publix Super Markets, with 188,000 employees, according to the National Center for Employee Ownership. Three of the top 10 largest employee-owned U.S. businesses are supermarket chains, according to the organization. (Davey Tree in Kent is the largest Ohio ESOP and 13th largest in the U.S. with 9,000 employees.)

Niche arrangement

Chris Cooper, program coordinator at Kent State University’s Ohio Employee Ownership Center, said ESOPs are a niche business ownership arrangement. The center, which provides assistance to people and businesses exploring employee ownership, was not involved in the Buehler’s decision.

Typically, a family-owned business decides to convert to an ESOP if there are no clearly identified heirs, Cooper said. Family business owners may not want to sell to an outside buyer in part out of a desire that the business remain independent and also out of concern that employees retain their jobs, he said.

“Children may not want to go into the family business,” Cooper said.

An ESOP, which technically is a qualified retirement plan similar in ways to a 401(k), provides a number of tax breaks to both the business owner and subsequently to the employee owners, Cooper said.

“Those things are very appealing,” he said. “Employees don’t have to put up any of their own money,” he said.

Employees also don’t own the company directly, either, under an ESOP, Cooper said. Instead, a tax-exempt trust owns all the shares in the business.

“It’s an indirect form of ownership,” he said.

If a closely held business is a so-called Subchapter S corporation — the most common form of corporation — meaning it passes income taxes through to its shareholders, then the tax-exempt trust means the ESOP business becomes income-tax free, Cooper said.

“That’s a nice competitive advantage,” Cooper said. “That can be very useful.”

(There are an estimated 4.7 million S corporations in the U.S., according to a trade organization.)

“This is the right thing to do for our family, our customers and suppliers, and I know my brother Gene and our mom and dad would agree,” Don Buehler, a second-generation Buehler who ran the business with his late brother Gene, said in a news release. He worked in the store as a child and after decades with the business stepped back from day-to-day responsibilities in June 1997.

“We have deep and long-standing relationships with thousands of customers and farmers in the communities we serve, and we owe them a debt of gratitude for their loyalty and support over the past 88 years,” he said.

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/bett. Jim Mackinnon can be reached at 330-996-3544 or [email protected]. Follow him @JimMackinnonABJ on Twitter or http://www.facebook.com/JimMackinnonABJ.

“They didn’t sell to a chain. They stayed an independent. I think it’s a good thing for the Buehler’s family and the Buehler’s employees.

Kristin Mullins

President and CEO of the Ohio Grocers Association

Summa St. Thomas Hospital likely will remain closed all week as the hospital cleans up after a fire, though there is a possibility outpatient services could open earlier.

In a statement released Monday, Summa Health officials said a firm reopening date for St. Thomas Hospital has not been set following a fire that caused significant damage Friday.

Summa spokesman Mike Bernstein said he could not give further details about the fire or the extent of damage at the hospital’s North Main Street facility.

Akron Fire Department Lt. Sierjie Lash said fire officials are still investigating the cause of the fire, which started in a storage unit in the basement. No estimates of damage have yet become available, she said.

Summa said the target for inpatient services to resume is early next week, though there is a possibility of that occurring sooner.

Summa Health has contracted with ServiceMaster to lead the cleanup. ServiceMaster crews of more than 100 individuals worked in tandem with Summa Health employees all weekend.

About 100 patients at St. Thomas were transferred on Friday to other facilities, including Summa’s Akron City and Barberton hospitals as well as Western Reserve Hospital in Cuyahoga Falls.

St. Thomas houses behavioral health programs, including Summa’s Center for the Treatment and Study of Traumatic Stress, and Ignatia Hall outpatient and opiate treatment programs.

The Crystal Clinic Orthopedic Center leases surgery space and beds at St. Thomas. On Friday, Crystal Clinic President and CEO Ron Suntken said the fire “inconvenienced and displaced” about 40 Crystal Clinic patients.

On Monday, no further updates were available from Crystal Clinic officials about its operations.

Both organizations have set up hotlines for patients and their families. Summa’s number is 330-375-7702 and Crystal Clinic’s number is 330-668-4486.

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty.

Need some help choosing a Medicare managed-care or drug plan?

Experts say anyone who isn’t computer savvy — and even some who are — should seek help navigating all the choices with Medicare, its managed care options and drug plans in coming weeks during open enrollment.

A plan that saves one consumer money may cost another consumer more depending on the prescription medications they take, their health and what hospital systems their doctors practice in.

Filling out an online form at Medicare.gov can guide consumers to the right plan to fit their needs.

But if you don’t feel comfortable using Medicare.gov, other help is available. Several organizations offer unbiased help, which are not sales calls as they do not represent insurance companies. The organizations will help consumers evaluate their choices.

Direction Home events

Direction Home — through the Akron Canton Area Agency on Aging and Disabilities — is offering a series of free local seminars that include a meal.

The sessions cover the enrollment process, coverage options, how to select coverage, Medicare protections and how to use Medicare’s website.

If you attend, be sure to bring your Medicare number, a list of prescription medications you take and the names of your physicians.

To register, call 330-776-4620 or email [email protected].

Here is a list of upcoming events in the Akron area. Registration begins at 9:30 a.m.; lunch is served at noon, unless otherwise noted:

■ Oct 24: Hartville Kitchen, 1015 Edison St. NW, Hartville, 10 a.m.-noon

■ Oct. 30: Guy’s Party Center, 500 E. Waterloo Road, Akron, 10 a.m. to noon

■ Nov. 7: Hartville Kitchen, 1015 Edison St. NW, Hartville, 10 a.m.-noon

■ Nov. 13: Hartville Kitchen, 1015 Edison St. NW, Hartville, 10 a.m.-noon

■ Nov. 17: Hilton Garden Inn, 8971 Wilcox Drive, Twinsburg, 9 a.m. to 11 a.m. (registration at 8:30 a.m., breakfast at 9 a.m.)

■ Nov. 21: Northeast Ohio Medical University, 4209 state Route 44, Rootstown, 10 a.m. to noon.

■ Nov. 28: Occasions Party Center, 6800 Manchester Road, Clinton, 10 a.m. to noon.

Nov. 30: Hilton Fairlawn, 3180 W. Market St., Fairlawn, 9 a.m. to 11 a.m. (registration at 8:30 a.m., breakfast at 9 a.m.)

Check-Up Days

The Ohio Department of Insurance’s Ohio Senior Health Insurance Information Program is offering free help during Medicare Check-Up Days in every county.

The program also offers a hotline at 800-686-1578. In addition, there are two webcasts available for those who cannot make it to a meeting. The webcasts will be held Oct. 5 and Nov. 2 from 10 a.m. to 11 a.m.

Here are some upcoming events in the Akron area. For a full list in other parts of the state or to register for the webcast, go to: http://tinyurl.com/y7a3ohtl.

■ Summit County: 9 a.m. Oct. 16. Counseling by appointment only. Twinsburg Senior Center, 10260 Ravenna Road, Twinsburg. RSVP to 330-963-8722.

■ Medina County: 10 a.m. Oct. 27. Senior Expo in field house. Medicare counseling in media room. Soprema Senior Center, 617 School Drive, Wadsworth.

■ Stark County: Two events. 2 p.m. and 6 p.m. Oct. 4: presentations only. Mercy Medical Center, 1320 Mercy Drive NW, Canton. RSVP to 330-489-1215. 9 a.m. Oct. 24: counseling by appointment only, also at Mercy Medical Center. Call 330-489-1215.

■ Wayne County: 9 a.m. Oct. 13. Counseling by appointment only. Brenn-Field Nursing Center, 1980 Lynn Drive.

■ Orrville RSVP to 330-682-6992.

Other help

The Medicare program also provides free personalized help over the phone at 800-633-4227.

If you believe you cannot afford the plans, there may be help available for free drug coverage or reduced monthly premiums and lower out-of-pocket costs.

For information, contact the Social Security Administration at 800-772-1213 or socialsecurity.gov.

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Open enrollment begins Sunday for older and disabled adults who want to shop for Medicare prescription drug or managed-care plans for 2018.

Enrollment begins every Oct. 15 and will continue through Dec. 7. Changes are effective Jan. 1.

The Medicare Part D prescription drug plans and Medicare Advantage managed-care plans are available for everyone covered by Medicare, the federal health insurance program for people 65 or older and some younger disabled Americans.

Enrollees should review their coverage and make sure they still have the best plan to meet their current needs because plans and prices change yearly, said Chris Reeg, director of the Ohio Department of Insurance’s Ohio Senior Health Insurance Information Program (OSHIP).

“A lot of folks do stay with the same plans year after year and they may not be the best,” she said. “Just because something was the best plan for 2017, it may not be the best plan for 2018.”

Similarly, spouses need to review their plans individually and often have to pick different providers, Reeg said.

“Sometimes there’s a substantial cost difference” because it depends on the health of the individual and the prescription drugs taken, she said.

More than 2.2 million Ohio residents covered by Medicare can select from among 23 Medicare prescription drug plans, also known as Medicare Part D plans.

Nationally, enrollment in Medicare Advantage is projected to reach an all-time high of 20.4 million enrollees in 2018, an increase of 1.7 million or 9 percent from 18.7 million this year, according to the Centers for Medicare and Medicaid Services.

In Summit County, there are 41 Medicare Advantage managed-care plans available that provide help paying for doctor visits, hospital stays and other medical services. All but four include prescription drug coverage.

The Medicare Part D plans are offered statewide; the Medicare Advantage plans vary county by county.

The federal government contracts with private insurance companies to provide drug and/or medical coverage to Medicare recipients who sign up for the plans. Everyone but the poorest enrollees pays a portion of the monthly premium; the government picks up the rest.

Francine Chuchanis, a Medicare ombudsman for the Direction Home Akron Canton Area Agency on Aging, reviews the Medicare Advantage plans offered in Summit County yearly.

This year, there have been minimal changes in premiums and coverage, she said. Some plans have increased deductibles, while others have decreased them.

“We have seen years where averages have gone up and down, but this year seems to be relatively stable,” Chuchanis said.

In Summit County, 13 Medicare Advantage plans have no monthly premiums for enrollees; three of those plans do not offer prescription drug coverage.

The cheapest monthly premium for a Part D prescription drug plan in Ohio is $12.60 a month from EnvisionRX Plus.

However, Chuchanis warns against simply choosing the cheapest plans without looking at other factors.

Consumers also need to look at out-of-pocket costs for services they use most, as well as costs for their prescription drugs, she said.

Both OSHIP and Direction Home offer workshops and phone consultations to help seniors research their choices.

“A growing demographic of Medicare patients are using the internet to gain information, but the majority are still a little gun shy or they want reassurance,” Reeg said. “Our job is to provide them factual information about the plans so they can make an educated decision in choosing their best plan during the year.”

Once seniors narrow down their choices, they also can talk to a representative from the company, who is usually on commission, Chuchanis said.

She suggests seniors check with their doctors to make sure their health-care providers will be included in the plan they want. Confirm the information with the insurance company by calling or visiting the insurer’s website.

Also, consumers should use Medicare’s quality star ratings, Chuchanis said. The ratings help people with Medicare, their families and their caregivers compare the quality of health and drug plans being offered. Managed-care and drug plans are given a rating on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance.

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty

Summa Health has cleared the first hurdle in restoring its ability to train new emergency medicine doctors.

This week, the national accreditation organization that earlier this year stripped Summa of its ability to train emergency medicine residents and placed the hospital system on probation lifted the probation.

The probation had prohibited the Akron-based health system from starting new residency programs or increasing the size of those that already exist.

In order for Summa to re-establish its emergency medicine residency program, the health system’s probation first needed to be lifted. Hospital officials have said their intention is to bring back the program, but acknowledged it may take time.

“Achieving this positive outcome was a group effort,” Summa officials said in a memo sent to employees Wednesday night.

“… We have a long, proud history of education at Summa and clearly we have many, many more bright days to come.”

In an interview in September, Dr. David Seaberg, Summa’s new chairman of the emergency department, said he had an ambitious goal to have a class of eight new residents begin in July 2019 once the probation was lifted.

Seaberg said one of the things the hospital needed to prepare for this week’s review was a disaster policy. Usually such policies are for earthquakes or tornadoes.

Summa’s revised plan includes contingencies to protect residents if the health system changes any contract with a physician staffing group that provides supervision for the doctors in training. The plan could require a 180-day notice for such changes.

In the case of Summa’s ER staffing changeover in January, the switch happened with just several days’ notice.

In the memo sent to Summa employees, Summa Interim President and CEO Dr. Cliff Deveny and Summa Vice President of Medical Education Dr. Cindy Kelley said the hospital system received “continued accreditation” status, effective Monday.

“This is the most favorable accreditation status that an institution can have and is indicative of Summa Health’s unwavering commitment to medical education,” they said in the memo. The accreditation penalties were announced earlier this year and went into effect July 1 — six months after the abrupt changeover of Summa’s longtime ER physician group on New Year’s Day and subsequent upheaval at Summa. Hundreds of doctors demanded former Summa CEO Dr. Tom Malone’s resignation before he agreed to step down in January.

The problems began during the last week of December when last-minute negotiations fell through between Summa and an independent physician group that staffed Summa’s five ERs. The physicians also served as supervising faculty for Summa’s emergency medicine residency. Malone, with the approval of Summa’s board of directors, replaced the longtime physician group with U.S. Acute Care Solutions (USACS), a Canton-based company that staffs more than 160 emergency departments nationwide.

A review by the Accreditation Council for Graduate Medical Education found that Summa patients were being sent home from Akron City’s ER after being seen by residents, not the supervising emergency medicine physicians, even after some of the residents sought their supervisors’ help.

The accreditation group also found delays in care for trauma patients and possible stroke victims and said new teaching staff from USACS lacked the expertise needed to train new doctors.

In late June, nine residents graduated from the program and 21 others had to leave for other programs. The majority went elsewhere in the country; six stayed in Ohio and four residents went to cross-town rival Cleveland Clinic Akron General.

Seaburg has a history of starting multiple residency programs, in addition to 25 years emergency medicine experience.

He has said he is continuing to rebuild Summa’s emergency medicine faculty and staff.

Betty Lin-Fisher can be reached at 330-996-3724 or [email protected]. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.ohio.com/betty