The joining of Robinson Health System in Ravenna with the University Hospital health system came to fruition on June 1. The announcement culminating the year-long process was made June 1 by Stephen Colecchi, president and chief executive officer of Robinson Health System, Inc., and Thomas F. Zenty III, CEO of University Hospitals.

"This is a very important day in the history of Robinson," Colecchi wrote in an announcement to the directors of the hospital, its foundation and affiliates.

In line with previous UH expansions, Robinson Memorial Hospital will be known as UH Robinson Medical Center. As part of the joint agreement, three members of University Hospital's board will be named to Robinson Health System's 15-member board. Those members have not been selected yet, according to Colecchi.

The process started a year ago when Robinson officials signed an agreement to join University Hospitals. It was the end of a process that started in 2013 when an affiliation agreement between Robinson and Summa Health System was allowed to expire at the end of 2013.

At the time, Robinson was converting from county-owned to not-for-profit status. Hospital officials proposed that change to county commissioners in August 2011, saying it would "ensure the future growth and success of the hospital."

Hospitals owned by state or local governments had gone through a steep decline by then, including the numbers in Ohio. That year, Robinson was one of only nine remaining county-owned hospitals.

The health care industry was in the throes of consolidation and expansion of service areas. Hospitals were facing increased financial pressures as a result of the growth in Medicare, Medicaid and the uninsured. County ownership also limited the hospital in what it could do to enhance its financial performance and keep it operating.

In November 2012, commissioners approved a lease agreement with Robinson Health System, Inc., that resulted in the conversion from county-owned to not-for-profit status.

That status change took effect Jan. 1, 2014, after the Internal Revenue Service granted tax exempt status on Sept. 30, 2013.

Officials then said they would seek proposals for "strategic alliance" from other health systems. The conversion also resulted in an expanded board for Robinson Health System, Inc., and a $50,000 annual payment to Portage County for the lease on the hospital and land its sits on.

In January 2014, University Hospitals and Robinson signed a letter of intent for Robinson to join the larger health system.

In April this year, the parties announced it had inked a final agreement for the merger. That announcement came the day after Robinson announced it was paying the U.S. government $10 to settle a compliance issue caused by lax oversight of contracts between Robinson and physicians.

Of the final agreement, Thomas F. Zenty III, CEO of University Hospitals, said "We look forward to growing and enhancing Robinson's services and programs to continue their long-standing tradition of providing patient-focused, superior-quality health care close to home."

Robinson Health System operates Robinson Memorial Hospital, a 117-staffed-bed hospital, which is the second-largest employer in Portage County. Robinson also operates an urgent care facility, comprehensive imaging facilities, a network of physician practices and outpatient centers and medical facilities throughout the county.

Robinson Memorial Hospital traces its history to White Hospital, which opened in Ravenna in 1894. That facility became the Portage County Hospital in 1917 and was renamed Robinson Memorial Hospital in 1932 when it moved to a new facility on South Chestnut Street. The present facility on North Chestnut Street opened in 1977.