University Hospitals and Parma Community General Hospital have signed a letter of intent to officially explore integrating the hospital into the UH health system.

Officials announced the letter of intent on Monday.

Parma Hospital employs 2,000 including more than 500 physicians on its medal staff. University Hospitals employs 18,000 and its health system includes 10 hospitals and 20 outpatient centers.

Terrence G. Deis, President and Chief Executive Officer of Parma Hospital says the evolving health care industry has made it more challenging for independent hospitals to prosper and grow.

"As an independent hospital, we -like many other independent hospitals-have faced increasing challenges and cost pressures that have made our mission more difficult to fulfill," said Deis. "The possibility of this integration is exciting and holds an opportunity for significant and positive investments ensuring our long-term viability."

The evaluation process is expected to last several months and a final agreement is anticipated by the end of the year.