The MetroHealth System is a nationally ranked non-profit, public health care system located in Cleveland, Ohio. Founded in 1837 as City Hospital, The MetroHealth System serves the residents of the city of Cleveland and Cuyahoga County. It is one of the three major health care systems in Cleveland, Ohio, along with Cleveland Clinic and University Hospitals of Cleveland. The system provides care at four hospitals, more than 20 health centers and 40 additional sites throughout Cuyahoga County. As of December 2018, it had more than 7,700 employees. The system is the 10th largest employer in Northeast Ohio. MetroHealth is a Level I Adult Trauma Center and Level II Pediatric Trauma Center. It offers the only adult and pediatric burn center in the state of Ohio. In 1982, MetroHealth established its Metro Life Flight air ambulance service. Metro Life Flight has completed more than 90,000 medical missions, all safely. This air ambulance service is internationally known and has trained crews from Poland to Japan. It uses a fleet of three EC-145 helicopters for its air ambulance service.