4A (Expenses $ 509376592 including grants of $ 1814045) (Revenue $ 604642567)
OPERATION OF A 504-BED ACUTE CARE HOSPITAL. THERE WERE 19,290 PATIENT ADMISSIONS, 83,228 PATIENT DAYS, 354,743 OUTPATIENT VISITS, AND 401,124 PHYSICIAN PRACTICE PATIENT VISITS IN THE CURRENT YEAR.

ADVENTHEALTH SHAWNEE MISSION
PART V, SECTION B, LINE 5: IN CONJUNCTION WITH CONDUCTING THEIR 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, SHAWNEE MISSION MEDICAL CENTER (HOSPITAL) CREATED A COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE (CHNAC) TO PROVIDE INPUT AND GUIDE THE HEALTH NEEDS ASSESSMENT PROCESS. IN ADDITION TO THE HOSPITAL REPRESENTATIVES, THE INDIVIDUALS SERVING ON THE CHNAC INCLUDED REPRESENTATIVES FROM MULTIPLE ORGANIZATIONS THAT FOCUS ON LOW INCOME, MINORITY AND OTHER UNDERSERVED POPULATIONS AND THAT HAVE SPECIALIZED KNOWLEDGE OF PUBLIC HEALTH. THE ORGANIZATIONS REPRESENTED AND THEIR AREAS OF FOCUS INCLUDE:UNITED COMMUNITY SERVICES - THE UNITED WAY AGENCY FOR JOHNSON COUNTY.REACH FOUNDATION - PROVIDES GRANTS TO ADVANCE EQUITY IN HEALTH CARE COVERAGE, ACCESS, AND QUALITY FOR POOR AND UNDERSERVED PEOPLE.JOHNSON COUNTY HEALTH & ENVIRONMENT (HEALTH DEPARTMENT) - LEADER IN HEALTH AND ENVIRONMENT FOR JOHNSON COUNTY BY PREVENTING DISEASE AND PROMOTING WELLNESS.HEALTH PARTNERSHIP CLINICS OF JOHNSON COUNTY - FEDERALLY QUALIFIED HEALTH CENTER (FQHC) FOR JOHNSON COUNTY.MID-AMERICA REGIONAL COUNCIL (MARC) - MARC PROMOTES REGIONAL COOPERATION THROUGH LEADERSHIP, PLANNING AND ACTION SERVING NINE COUNTIES IN THE KANSAS CITY REGION. REPRESENTED BY A PUBLIC HEALTH PLANNER.UNITED GOVERNMENT, WYANDOTTE HEALTH DEPARTMENT - PROVIDES HEALTH AND WELLNESS SERVICES FOR THE RESIDENTS OF WYANDOTTE COUNTY.COMMUNITY HEALTH COUNCIL OF WYANDOTTE COUNTY - LEADS AND SUPPORTS INITIATIVES TO ENHANCE HEALTH AND ACCESS TO CARE SERVICES FOR THE VULNERABLE RESIDENTS OF WYANDOTTE COUNTY.SHAWNEE MISSION SCHOOL DISTRICT - ONE OF THE MAJOR SCHOOL DISTRICTS IN THE HOSPITAL'S SERVICE AREA WITH MORE THAN 27,000 STUDENTS. REPRESENTED BY THE SCHOOL NURSE COORDINATOR AND THE DIRECTOR, FAMILY SERVICES.THE CNACH MET REGULARLY THROUGHOUT 2018 AND 2019 TO REVIEW THE PRIMARY AND SECONDARY DATA, TO HELP DEFINE THE PRIORITY ISSUES AND TO HELP DEVELOP THE COMMUNITY HEALTH PLAN.ADDITIONAL INPUT WAS SOLICITED THROUGH A VALIDATED TWO-STAGE CLUSTER SAMPLING METHOD TO COLLECT INFORMATION AT THE HOUSEHOLD-LEVEL BY CONDUCTING DOOR TO DOOR SURVEYS USING A RANDOM SELECTION OF HOUSEHOLDS WITHIN IDENTIFIED CENSUS BLOCKS BASED IN THE PRIMARY SERVICE AREA THAT INCLUDED BOTH JOHNSON AND WYANDOTTE COUNTIES. THERE WERE 183 SURVEYS COMPLETED.FURTHER INPUT WAS SOLICITED USING AN ONLINE SURVEY OF THE COMMUNITY AND IDENTIFIED HEALTH LEADERS. THERE WERE 623 ONLINE SURVEYS COMPLETED.

ADVENTHEALTH SHAWNEE MISSION
PART V, SECTION B, LINE 7D: THE HOSPITAL HAS ADOPTED A POLICY THAT ADDRESSES THE PUBLIC POSTING REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNDER THIS POLICY, THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS MUST BE POSTED ON THE HOSPITAL'S WEBSITE AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE WIDELY AVAILABLE ON ITS WEBSITE ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS. THE HOSPITAL WILL ALSO MAKE A PAPER COPY OF ITS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST AND WITHOUT CHARGE, AT LEAST UNTIL THE DATE THE HOSPITAL FACILITY HAS MADE AVAILABLE FOR PUBLIC INSPECTION ITS TWO SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.

ADVENTHEALTH SHAWNEE MISSION
"PART V, SECTION B, LINE 11: SHAWNEE MISSION MEDICAL CENTER, INC. D/B/A ADVENTHEALTH SHAWNEE MISSION WILL BE REFERRED TO IN THIS DOCUMENT AS ADVENTHEALTH SHAWNEE MISSION OR ""THE HOSPITAL"". THE HOSPITAL IS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). AHSSHC IS THE 501(C)(3) PARENT ORGANIZATION OF A HOSPITAL AND HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN JANUARY 2019, EVERY WHOLLY-OWNED ENTITY OF AHSSHC ADOPTED THE ADVENTHEALTH SYSTEM BRAND. OUR IDENTITY HAS BEEN UNIFIED TO REPRESENT THE FULL CONTINUUM OF CARE OUR SYSTEM OFFERS. ANY REFERENCES TO OUR PRIOR COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) OR PRIOR COMMUNITY HEALTH PLANS (CHPS) WILL UTILIZE OUR NEW NAME FOR CONSISTENCY. ADVENTHEALTH SHAWNEE MISSION IS PART OF THE MULTI-STATE DIVISION OF ADVENTHEALTH. THE DIVISION INCLUDES SIXTEEN HOSPITAL FACILITIES. THIS IS THE SECOND-YEAR UPDATE FOR ADVENTHEALTH SHAWNEE MISSION'S 2020-2022 COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY. THE HOSPITAL DEVELOPED THIS PLAN AND POSTED IT IN MAY 2020 AS PART OF ITS 2019 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. FOR THE DEVELOPMENT OF BOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND THE COMMUNITY HEALTH PLAN/IMPLEMENTATION STRATEGY, ADVENTHEALTH SHAWNEE MISSION WORKED TO DEFINE AND ADDRESS THE NEEDS OF LOW-INCOME, MINORITY AND UNDERSERVED POPULATIONS IN ITS SERVICE AREA. THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT USED PRIMARY DATA INTERVIEWS AND SURVEYS; SECONDARY DATA FROM LOCAL, REGIONAL AND NATIONAL HEALTH-RELATED SOURCES; AND HOSPITAL PREVALENCE DATA TO HELP THE HOSPITAL DETERMINE THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. ONCE THE DATA WAS GATHERED, THE PRIMARY ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE PRIORITIZED BY COMMUNITY AND HOSPITAL STAKEHOLDERS, WHO THEN SELECTED KEY ISSUES FOR THE HOSPITAL TO ADDRESS IN ITS 2020-2022 COMMUNITY HEALTH PLAN. THE SECOND-YEAR PROGRESS ON THE COMMUNITY HEALTH PLAN IS NOTED BELOW. THE NARRATIVE DESCRIBES THE PRIORITIZED ISSUES IDENTIFIED IN 2019 AND GIVES AN UPDATE ON THE STRATEGIES ADDRESSING THOSE ISSUES. THERE IS ALSO A DESCRIPTION OF THE IDENTIFIED ISSUES THAT THE HOSPITAL DID NOT ADDRESS. ADVENTHEALTH SHAWNEE MISSION CHOSE FOUR PRIORITIES FOR ITS 2020-2022 COMMUNITY HEALTH PLAN: 1. LACK OF RESOURCES TO MEET COMMUNITY MENTAL AND BEHAVIORAL HEALTH2. RISING HEALTH CARE COSTS AND LACK OF HEALTH INSURANCE3. CHRONIC DISEASE HEALTH DISPARITIES IN COMMUNITIES OF COLOR 4. POOR PREGNANCY OUTCOMES IN WYANDOTTE COUNTYPRIORITY 1: LACK OF RESOURCES TO MEET COMMUNITY MENTAL AND BEHAVIORAL HEALTH 2019 DESCRIPTION OF THE ISSUE:ADVENTHEALTH SHAWNEE MISSION IS ONE OF THE FEW HOSPITALS IN THE KANSAS CITY METROPOLITAN AREA THAT PROVIDES INPATIENT AND OUTPATIENT MENTAL AND BEHAVIORAL SERVICES. COLLABORATION WITH COMMUNITY PARTNERS WILL BE VITAL TO THE SUCCESS OF ADDRESSING THIS ISSUE. ADVENTHEALTH SHAWNEE MISSION'S HOUSEHOLD COMMUNITY CONCERN SURVEY RESPONSES INDICATED A HIGH IMPORTANCE AND LOW SATISFACTION ON MENTAL HEALTH. IN ADDITION, JOHNSON COUNTY HOUSEHOLD AND SOCIAL MEDIA COMMUNITY CONCERNS SURVEY RESULTS IDENTIFIED MENTAL HEALTH HIGH IN IMPORTANCE AND LOW IN SATISFACTION.KANSAS DEPARTMENT OF HEALTH AND ENVIRONMENT DATA ACCESSED THROUGH KANSAS HEALTH MATTERS (2015-2017) REPORTS THAT 8.6% OF RESIDENTS IN JOHNSON COUNTY AND 13.4% OF RESIDENTS IN WYANDOTTE COUNTY INDICATED THAT MENTAL HEALTH WAS NOT GOOD"" ON 14+ DAYS IN THE PAST MONTH. SUICIDE MORTALITY RATES IN JOHNSON COUNTY AND WYANDOTTE COUNTY ARE HIGHER THAN THE HEALTHY PEOPLE 2020 GOAL OF 10.2 SUICIDE MORTALITIES PER 100,000. IN JOHNSON COUNTY, SUICIDE RATES CONTINUE TO SIGNIFICANTLY INCREASE IN EVERY AGE RANGE WITH SUICIDES FOR AGES 15-24 AT 19.7 PER 100,000 AND 23 PER 100,000 IN AGES 45-64 IN 2017. 2021 UPDATE: THE ADVENTHEALTH SHAWNEE MISSION COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE LACK OF RESOURCES TO MEET COMMUNITY MENTAL AND BEHAVIORAL HEALTH PRIORITY. 1. REDUCE OVERDOSES AND DEATHS FROM PRESCRIPTION PAIN AND OPIOIDS 2. REDUCE NUMBER OF SUICIDE ATTEMPTS AND DEATHS IN JOHNSON COUNTY GOAL 1: REDUCE OVERDOSES AND DEATHS FROM PRESCRIPTION PAIN AND OPIOIDS OBJECTIVE 1: THE FIRST OBJECTIVE IS TO INCREASE REFERRALS TO THE HEALTH PARTNERSHIP CLINIC'S NEW MEDICAL ASSISTANCE TREATMENT FOR OPIOID DEPENDENCY/SUBSTANCE ABUSE PROGRAM. A BASELINE FOR REFERRALS WILL BE ESTABLISHED AFTER YEAR ONE WITH AN INCREASE OF 10% PER YEAR FOR YEARS TWO AND THREE. THE INITIATIVE IS DEPLOYED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. HEALTH PARTNERSHIP CLINIC IS A FEDERALLY QUALIFIED HEALTH CENTER THAT PROVIDES COMPREHENSIVE TREATMENT FOR COMMUNITY MEMBERS STRUGGLING WITH OPIOID DEPENDENCY. IN YEAR ONE, THE HOSPITAL ESTABLISHED A BASELINE OF EIGHT REFERRALS TO HEALTH PARTNERSHIP CLINIC. IN YEAR TWO, THE HOSPITAL MET ITS' METRIC OF INCREASING THE NUMBER OF REFERRALS. A TOTAL OF 13 CLIENTS WERE REFERRED FOR MEDICAL ASSISTANCE TREATMENT. NINE CLIENTS WERE REFERRED TO HEALTH PARTNERSHIP CLINIC, TWO CLIENTS WERE REFERRED TO BEHAVIORAL HEALTH GROUP AND TWO WERE REFERRED TO KC-CARE CLINIC. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO INCREASE THE NUMBER OF HEALTH PROFESSIONALS AND COMMUNITY MEMBERS WITH DEMONSTRATED SKILLS AND KNOWLEDGE TO RECOGNIZE AND RESPOND TO OVERDOSES BY INCLUDING THE AMERICAN HEART ASSOCIATION'S FIRST RESPONSE TO DRUG OVERDOSE MODULES INTO CPR PROGRAMS IN 280 PROGRAMS WITH 1,900 PARTICIPANTS WITH A BASELINE OF ZERO PROGRAMS AND ZERO PARTICIPANTS IN THREE YEARS. THE INITIATIVE IS MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. IN YEAR TWO, THE HOSPITAL EXCEEDED ITS' 3-YEAR METRIC WITH 436 PROGRAMS PROVIDED AND 2093 PARTICIPANTS COMPLETING THE PROGRAM. OBJECTIVE 3:THE THIRD OBJECTIVE IS TO INCREASE COMMUNITY AWARENESS AND PARTICIPATION IN NON-PHARMACEUTICAL APPROACHES FOR MANAGING PAIN BY 15% (5% PER YEAR). THE BASELINE IS 370 PARTICIPANTS IN THE FEEL WHOLE WELLNESS PROGRAMS AND MIND-BODY FITNESS CLASSES, ADDITIONALLY 1,380 MASSAGES IS THE BASELINE FOR INDIVIDUALS SEEKING NON-PHARMACEUTICAL APPROACHES TO PAIN. OUR GOAL IS TO HAVE 90% OF PARTICIPANTS REPORT REDUCED STRESS, ANXIETY OR PAIN THROUGH POST-SURVEY. THE INITIATIVE IS MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. IN YEAR TWO, THE HOSPITAL MADE PROGRESS ON THEIR GOAL OF INCREASING PARTICIPANTS IN FEEL WHOLE PROGRAMS FROM THE BASELINE, DUE TO COVID-19, YEAR TWO WAS STILL IMPACTED BY FEWER CLASS OFFERINGS AND THE REQUIREMENT FOR SMALLER CLASS SIZES. A TOTAL OF 174 INDIVIDUALS PARTICIPATED IN PROGRAMS WITH 89% REPORTING REDUCED STRESS, ANXIETY OR PAIN. THE SECOND METRIC FOR THE OBJECTIVE WAS EXCEEDED WITH A TOTAL OF 2,345 MASSAGES AND 100% REPORTING REDUCED STRESS, ANXIETY OR PAIN. OBJECTIVE 4:THE FOURTH OBJECTIVE IS TO INCREASE BY 15% OVER THREE YEARS THE NUMBER OF PATIENTS SUFFERING FROM BACK PAIN WHO ARE CONNECTED TO NON-PHARMACEUTICAL SOLUTIONS FOR MANAGEMENT OF BACK PAIN FROM A BASELINE ESTABLISHED IN YEAR ONE. THE INITIATIVE IS MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. IN YEAR ONE DUE TO COVID-19, THE HOSPITAL'S BACK PAIN NAVIGATOR WAS TEMPORARILY REASSIGNED TO OTHER DUTIES IN 2020, DELAYING THE INITIATIVE AND THE ESTABLISHMENT OF A BASELINE. IN YEAR TWO THE BACK PAIN NAVIGATOR REFERRED 134 PATIENTS EXPERIENCING BACK PAIN TO NON-PHARMACEUTICAL OPTIONS. SEE CONTINUATION 2"

ADVENTHEALTH SHAWNEE MISSION
PART V, SECTION B, LINE 13H: EFFECTIVE MARCH 1, 2020, THE FILING ORGANIZATION'S HOSPITAL FACILITY (OR FACILITIES) AUGMENTED THEIR FINANCIAL ASSISTANCE POLICY WITH A COVID-19 FINANCIAL GRACE ADDENDUM. PURSUANT TO THE COVID-19 FINANCIAL GRACE ADDENDUM, UNINSURED PATIENTS TREATED FOR COVID-19 RELATED EVALUATIONS ARE TO RECEIVE FREE OR DISCOUNTED CARE DEPENDING ON THE PATIENT'S COOPERATION IN SUBMITTING NECESSARY FINANCIAL ASSISTANCE INFORMATION. INSURED PATIENTS TESTED FOR COVID-19 ARE NOT EXPECTED TO HAVE OUT-OF-POCKET EXPENSES BASED ON INSURANCE COMMUNITY RESPONSE TO WAIVE PATIENT FINANCIAL RESPONSIBILITY. IF A PAYER UNEXPECTEDLY FAILS TO WAIVE PATIENT RESPONSIBILITY FOR COVID-19 RELATED TESTING, THE FILING ORGANIZATION WILL NOT BALANCE BILL PATIENTS FOR ANY OUT-OF-POCKET EXPENSES RELATED TO COVID-19. IN ADDITION, PATIENTS WITH EXISTING PAYMENT PLANS ARE PROVIDED OPPORTUNITIES FOR REDUCING THEIR MONTHLY PAYMENTS.

SCHEDULE H, PART V SECTION B LINE 11 - CONTINUATION 2
"GOAL 2: REDUCE NUMBER OF SUICIDE ATTEMPTS AND DEATHS IN JOHNSON COUNTY OBJECTIVE 1: THE FIRST OBJECTIVE IS THAT THE HOSPITAL WILL PROVIDE LEADERSHIP, PROFESSIONAL EXPERTISE AND COMMUNITY ENGAGEMENT TO SUPPORT THE STRATEGIC PLAN OF THE JOHNSON COUNTY SUICIDE PREVENTION COALITION TO REDUCE SUICIDE DEATHS IN JOHNSON COUNTY BY 10% IN THREE YEARS FROM A BASELINE OF 81 SUICIDE DEATHS IN 2019. THE INITIATIVE IS DRIVEN BY A COMMUNITY COALITION THROUGH WHICH THE HOSPITAL PROVIDES IN-KIND LEADERSHIP AND PARTICIPATION THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL EXCEEDED ITS' METRIC OF PROVIDING LEADERSHIP AND PROFESSIONAL EXPERTISE WITH THE LEADERSHIP LEADING AND ATTENDING 34 JOHNSON COUNTY SUICIDE PREVENTION COALITION AND SUICIDE FATALITY REVIEW MEETINGSOBJECTIVE 2: THE SECOND OBJECTIVE IS THAT THE HOSPITAL WILL INCREASE THE KNOWLEDGE AND SKILLS OF HEALTH PROFESSIONALS AND COMMUNITY MEMBERS TO RECOGNIZE, RESPOND AND SUPPORT MENTAL HEALTH NEEDS (INCLUDING CONTEMPLATION OF SUICIDE) THROUGH HOSTING AND FINANCIAL SUPPORT OF THE EVIDENCE-BASED CERTIFICATION PROGRAMS INCLUDING APPLIED SUICIDE INTERVENTION SKILLS TRAINING (ASIST) AND MENTAL HEALTH FIRST AID (MHFA) PROGRAMS FOR 150 INDIVIDUALS (50 PER YEAR) OVER THE NEXT THREE YEARS. THE INITIATIVE IS FUNDED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. IN YEAR ONE, THE HOSPITAL DID MEET ITS METRIC OF PROVIDING FINANCIAL SUPPORT TO JOHNSON COUNTY MENTAL HEALTH FOR INDIVIDUALS TO PARTICIPATE IN EVIDENCE-BASED MENTAL HEALTH PROGRAMS HOWEVER, DUE TO COVID-19, JOHNSON COUNTY MENTAL HEALTH WAS UNABLE TO OFFER ASIST OR MHFA PROGRAMS IN 2020. IN 2021, JOHNSON COUNTY MENTAL HEALTH RECEIVED FUNDING FROM ANOTHER FUNDER FOR MENTAL HEALTH FIRST AID AND ASIST PROGRAMS AND REQUESTED THE HOSPITAL RE-ALLOCATE FUNDING FOR THE EVIDENCE-BASED SOURCES OF STRENGTH. WITH THE HOSPITAL'S FINANCIAL SUPPORT, 206 ADULTS AND 1,090 STUDENTS HAVE BEEN TRAINED.OBJECTIVE 3: THE THIRD OBJECTIVE IS THAT THE HOSPITAL WILL REDUCE SUICIDE DEATHS BY PROVIDING NON-EMERGENT ASSESSMENTS TO EVALUATE SAFETY RISK AND PROVIDE SPECIFIC TREATMENT OPTIONS TO 1,500 INDIVIDUALS OVER THE NEXT THREE YEARS. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON THIS METRIC OF PROVIDING 391 NON-EMERGENT ASSESSMENT EVALUATIONS IN YEAR ONE AND 439 NON-EMERGENT ASSESSMENT EVALUATIONS IN YEAR TWO. IN ADDITION, THE HOSPITAL ALSO PROVIDED SUPPORT AND RESOURCES FOR 1,486 INDIVIDUALS WHO UTILIZED THE BEHAVIORAL HEALTH DEPARTMENT'S CRISIS LINE IN 2020 AND 1,672 IN 2021.PRIORITY 2: RISING HEALTH CARE COSTS AND LACK OF HEALTH INSURANCE 2019 DESCRIPTION OF THE ISSUE:COMMUNITY CONCERN SURVEY RESULTS FROM ADVENTHEALTH SHAWNEE MISSION, KEY STAKEHOLDERS AND JOHNSON COUNTY'S HOUSEHOLD AND SOCIAL MEDIA ALL AGREED THAT ""HEALTH INSURANCE FOR ALL"" HAD THE HIGHEST IMPORTANCE WITH THE LOWEST SATISFACTION. THE ADULT UNINSURED RATE FOR AGES 18-65 IS 11.58%. WYANDOTTE COUNTY'S ADULT UNINSURED RATE IS 22.32%. WHILE JOHNSON COUNTY'S UNINSURED RATE OF 7.85% IS SIGNIFICANTLY LOWER, THE TOTAL NUMBER OF ADULTS WITHOUT HEALTH INSURANCE IS APPROXIMATELY 7,000 HIGHER THAN JOHNSON COUNTY. OUR COMMUNITY SURVEY INDICATES 22.6% WERE UNABLE TO SEE A DOCTOR DUE TO COST. IN OUR COMMUNITY SURVEY, 25% OF RESIDENTS IN JOHNSON COUNTY REPORTED BEING WORRIED OR STRESSED ABOUT PAYING THEIR MEDICAL BILLS. WHILE ADDRESSING THE FACTORS EFFECTING RISING HEALTHCARE IS DIFFICULT, THE HOSPITAL WILL CONTINUE TO ADVOCATE FOR MEDICAID EXPANSION IN KANSAS. IN ADDITION, THE HOSPITAL IS IN THE POSITION TO ASSIST ACCESS FOR HEALTH INSURANCE FOR THOSE SEEKING CARE AND CAN ASSIST PATIENTS AND THE COMMUNITY ON HEALTH INSURANCE LITERACY AND SUPPORT AND PARTNER WITH SAFETY-NET CLINICS.2021 UPDATE: THE ADVENTHEALTH SHAWNEE MISSION COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE RISING HEALTH CARE COSTS AND LACK OF HEALTH INSURANCE PRIORITY. 1. INCREASE ACCESS TO HEALTH INSURANCE FOR LOW INCOME INDIVIDUALS 2. INCREASE NUMBER INDIVIDUALS WITH MEDICAL HOME GOAL 1: INCREASE ACCESS TO HEALTH INSURANCE FOR LOW INCOME INDIVIDUALS OBJECTIVE 1: THE FIRST OBJECTIVE IS THAT THE HOSPITAL WILL SIGN UP 150 INDIVIDUALS WITHOUT HEALTH COVERAGE TO AN APPROPRIATE HEALTH PLAN FOR THOSE LIVING WITHIN ONE MILE OF THE INTERSECTIONS OF 31ST AND MINNESOTA IN ZIP CODE 66102 AND 75TH AND QUIVIRA IN ZIP CODE 66203 IN THREE YEARS BY HOSTING AND SPONSORING COMMUNITY ENGAGEMENT EVENTS. THE INITIATIVE IS MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON ITS METRIC OF SIGNING INDIVIDUALS UP FOR HEALTH COVERAGE. IN 2021, THE HOSPITAL REFERRED AND CONFIRMED SIGNS UP 31 INDIVIDUALS FOR HEALTH COVERAGE AND PROVIDED EDUCATION AND SIGN-UP RESOURCES TO 425 FAMILIES. THREE HEALTH COVERAGE EDUCATION AND SIGN-UP EVENTS WERE HELD IN ZIP CODE 66203. IN ADDITION, HEALTH COVERAGE SIGN-UP RESOURCES WERE PROVIDED AT SIX FREE HEALTH CLINICS OFFERED IN ZIP CODE 66102. THESE HEALTH CLINICS WERE FUNDED BY THE HOSPITAL AND STAFFED WITH HOSPITAL VOLUNTEERS. GOAL 2: INCREASE THE NUMBER OF INDIVIDUALS WITH A MEDICAL HOME OBJECTIVE 1: THE FIRST OBJECTIVE IS THE HOSPITAL WILL INCREASE PATIENT CAPACITY FOR SAFETY NET CLINICS BY 250 PATIENTS EACH YEAR THROUGH FINANCIAL SUPPORT AND PATIENT REFERRALS. THE INITIATIVE IS FUNDED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL MET ITS METRIC OF INCREASING CAPACITY FOR SAFETY NET CLINICS BY PROVIDING $30,000 TO SAFETY NET CLINICS. THE HOSPITAL PROVIDED AN ADDITIONAL $22,000 FOR A 6-MONTH FREE MONTHLY HEALTH CLINIC WHERE 107 INDIVIDUALS RECEIVED CARE. OBJECTIVE 2: THE SECOND OBJECTIVE IS THE HOSPITAL WILL INCREASE THE NUMBER OF INDIVIDUALS WITH A MEDICAL HOME LIVING WITHIN ONE MILE OF THE INTERSECTION OF 31ST AND MINNESOTA IN ZIP CODE 66102 AND 75TH AND QUIVIRA IN ZIP CODE 66203 BY IDENTIFYING, REFERRING AND FOLLOWING UP WITH AN APPROPRIATE CARE PROVIDER FOR 100 INDIVIDUALS IN THREE YEARS. THE OBJECTIVE IS DRIVEN THROUGH COMMUNITY COLLABORATION WITH MERCY & TRUTH MEDICAL MISSIONS. ADVENTHEALTH SHAWNEE MISSION PROVIDES IN-KIND AND FINANCIAL SUPPORT. IN YEAR TWO, THE HOSPITAL PROGRESSED ON ITS METRIC OF IDENTIFYING AND CONNECTING 100 INDIVIDUALS TO A MEDICAL HOME. ONE HUNDRED AND SEVEN INDIVIDUALS WERE SEEN AT THE FREE SATURDAY CLINIC FUNDED BY ADVENTHEALTH AND STAFFED WITH ADVENTHEALTH VOLUNTEER PROVIDERS. OBJECTIVE 3: THE THIRD OBJECTIVE IS THE HOSPITAL WILL INCREASE THE NUMBER OF INDIVIDUALS WHO ARE UP TO DATE ON PREVENTIVE SCREENINGS AND IMMUNIZATIONS BY PROVIDING 150 HEALTH SCREENINGS AND IMMUNIZATIONS FOR FAMILIES LIVING WITHIN ONE MILE OF THE INTERSECTION OF 31ST AND MINNESOTA IN ZIP CODE 66102 AND 75TH AND QUIVIRA IN ZIP CODE 66203. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. IN 2021, THE HOSPITAL PROVIDED FUNDING AND NURSE VOLUNTEERS TO PROVIDE 385 FLU SHOTS IN TARGETED NEIGHBORHOODS. IN ADDITION, THE HOSPITAL PURCHASED THE NECESSARY REFRIGERATION EQUIPMENT SO THAT IMMUNIZATIONS NECESSARY FOR SCHOOL ENROLLMENT WOULD BE MORE EASILY AVAILABLE TO FAMILIES LIVING IN ZIP CODE 66203, THIRTEEN CHILDREN RECEIVED REQUIRED IMMUNIZATIONS. SEE CONTINUATION 3"

SCHEDULE H, PART V SECTION B LINE 11 - CONTINUATION 3
PRIORITY 3: CHRONIC DISEASE HEALTH DISPARITIES IN COMMUNITIES OF COLOR 2019 DESCRIPTION OF THE ISSUE:HOSPITAL ADMISSION RATES FOR DIABETES, STROKE, HEART DISEASE AND CONGESTIVE HEART FAILURE ARE SIGNIFICANTLY HIGHER FOR BLACKS THAN WHITES. IN WYANDOTTE COUNTY THE HOSPITAL ADMISSION RATE FOR DIABETES IS 51.5 PER 100,000 FOR BLACKS COMPARED TO 29.3 FOR WHITE ADMISSIONS. HEART DISEASE ADMISSION RATES FOR BLACKS ARE 325 PER 100,000 AS COMPARED TO 218 FOR WHITES. JOHNSON COUNTY RATES ARE LOWER THAN WYANDOTTE COUNTY BUT ALSO REFLECT THIS DISPARITY.POSITIVE LIFESTYLE BEHAVIORS HAVE A DIRECT IMPACT ON IMPROVED HEALTH AND REDUCING CHRONIC DISEASE. THE ADVENTHEALTH SHAWNEE MISSION COMMUNITY SURVEY INDICATED THAT 14% NEVER EAT FRUITS OR VEGETABLES AND 79% DO NOT EAT THE RECOMMENDED NUMBER OF FRUITS AND VEGETABLES.OUR COMMUNITY HEALTH SURVEY INDICATED 18% OF HOUSEHOLDS WERE WORRIED THAT FOOD WOULD RUN OUT BEFORE THEY HAD MONEY TO BUY MORE. ADDITIONALLY, 13% OF HOUSEHOLDS RAN OUT OF FOOD BEFORE THEY HAD THE MONEY TO BUY MORE. FEEDING AMERICA INDICATES A 16.8% FOOD INSECURITY RATE IN WYANDOTTE COUNTY AND 10.6% IN JOHNSON COUNTY.FOOD INSECURITY FOR RESIDENTS IN JOHNSON COUNTY IS LOWER THAN OUR NEIGHBORING WYANDOTTE COUNTY, YET THE NUMBER OF RESIDENTS THAT ARE FOOD INSECURE IS TWICE AS HIGH. THE GRAPHS COMPARE THE COUNTIES FOOD INSECURITY AS WELL AS DEMONSTRATING THE HIGH PERCENT OF FOOD INSECURE RESIDENTS IN JOHNSON COUNTY THAT ARE NOT ELIGIBLE FOR ASSISTANCE.ADULTS SMOKING CIGARETTES IN THE ADVENTHEALTH SHAWNEE MISSION CATCHMENT AREA IS 18%. IN WYANDOTTE COUNTY 24.7% OF ADULTS SMOKE CIGARETTES. THE HOSPITAL CAN PARTICIPATE, SUPPORT AND LEAD INITIATIVES THAT EFFECTIVELY ADDRESS CHRONIC DISEASES IN OUR COMMUNITY THROUGH FINANCIAL SUPPORT, EXPERTISE, ADVOCACY AND COMMUNITY OUTREACH AND EDUCATION.2021 UPDATE: THE ADVENTHEALTH SHAWNEE MISSION COMMUNITY HEALTH PLAN HAS TWO DESIRED GOAL STATEMENTS UNDER THE CHRONIC DISEASE HEALTH DISPARITIES IN COMMUNITIES OF COLOR PRIORITY. 1. INCREASE ACCESS TO HEALTHY FOOD FOR LOW-INCOME FAMILIES 2. INCREASE KNOWLEDGE, IMPROVE LIFESTYLE BEHAVIORS AND PROVIDE SUPPORT TO PREVENT AND MANAGE CHRONIC DISEASE IN THE HOSPITAL'S COMMUNITY GOAL 1: INCREASE ACCESS TO HEALTHY FOOD FOR LOW-INCOME FAMILIES OBJECTIVE 1: THE FIRST OBJECTIVE IS THE HOSPITAL WILL SIGN UP 75 NEW INDIVIDUALS FOR FOOD ASSISTANCE PROGRAMS IN THREE YEARS FOR FAMILIES LIVING WITHIN ONE MILE OF THE INTERSECTION OF 31ST AND MINNESOTA IN ZIP CODE 66102 AND 75TH AND QUIVIRA IN ZIP CODE 66203 BY HOSTING AND SPONSORING COMMUNITY ENGAGEMENT EVENTS. THE INITIATIVE IS MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL.THE HOSPITAL CONFIRMED SIGN-UP OF TWO FAMILIES FOR FOOD ASSISTANCE IN 2021. RESOURCES TO SIGN-UP FOR FOOD ASSISTANCE AND LOCATION OF FOOD PANTRIES WERE DISTRIBUTED TO OVER 400 REFUGEE FAMILIES LIVING IN THE 66102-ZIP CODE AND 185 FAMILIES LIVING IN THE 66203-ZIP CODE. OBJECTIVE 2: THE SECOND OBJECTIVE IS THE HOSPITAL WILL PROVIDE FINANCIAL SUPPORT AND FOOD DONATIONS TO NOT-FOR-PROFIT ORGANIZATIONS THAT FOCUS ON INCREASING ACCESS TO HEALTHY FOOD IN LOW FOOD ACCESS AREAS. THE INITIATIVE IS FUNDED AND DEPLOYED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL MET ITS METRIC BY PROVIDING $5,000 IN FUNDING FOR NOT-FOR-PROFIT ORGANIZATIONS FOCUSED ON INCREASING ACCESS IN FOOD DESERTS. THE SECOND METRIC FOR THE OBJECTIVE WAS MET, WITH A DONATION OF $2,000 FOR HEALTHY SNACKS AND FOOD FOR THE REFUGEE CHILDREN PARTICIPATING IN THE SUMMER CREATION LIFE KIDS CAMPS IN ZIP CODE 66102 AND PROVIDING 125 MEAL KITS FOR FAMILIES IN ZIP CODE 66203.GOAL 2: INCREASE KNOWLEDGE, IMPROVE LIFESTYLE BEHAVIORS AND PROVIDE SUPPORT TO PREVENT AND MANAGE CHRONIC DISEASE IN THE HOSPITAL'S COMMUNITY OBJECTIVE 1: THE FIRST OBJECTIVE IS THE HOSPITAL WILL INCREASE HEALTH KNOWLEDGE AND/OR IMPROVE HEALTH BEHAVIORS IN PARTICIPANTS OF FEEL WHOLE CLASSES AND MOVE-4-LIFE MONITORED FITNESS PROGRAMS, LIVING IN VITALITY WOMEN'S HEALTH CONFERENCE AND CHRONIC DISEASE SUPPORT GROUPS BY INCREASING PARTICIPATION BY 5% PER YEAR AND CONSISTENTLY DEMONSTRATING A 90% RESPONSE FROM PARTICIPANTS INDICATING NEW KNOWLEDGE, IMPROVED HEALTH OR BEHAVIOR CHANGE. THE 2019 BASELINE IS 2,700 PARTICIPANTS. THE INITIATIVE IS MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL MADE PROGRESS IN MEETING ITS GOAL WITH 811 PARTICIPANTS IN FEEL WHOLE, MOVE-4-LIFE AND LIVING IN VITALITY WOMEN'S HEALTH CONFERENCE. 100% OF FEEL WHOLE AND MOVE-4-LIFE PARTICIPANTS INCREASED HEALTH KNOWLEDGE AND/OR IMPROVED HEALTH BEHAVIORS. DUE TO COVID-19, THE LIVING VITALITY CONFERENCE WAS OFFERED VIRTUALLY RESULTING IN A 75% REDUCTION IN PROJECTED PARTICIPATION. OBJECTIVE 2: THE SECOND OBJECTIVE IS TO PROVIDE THE MEALS WITH SKILLS PROGRAM WHICH WILL INCREASE ACCESS TO HEALTHY FOOD FOR 150 LOW-INCOME FAMILIES AND WHO WILL DEMONSTRATE A 90% INCREASE IN KNOWLEDGE IN THREE YEARS FOR THOSE LIVING IN A TARGETED AREA. THE HOSPITAL IS FOCUSED ON THE COMMUNITY WITHIN ONE MILE OF THE INTERSECTION OF 31ST AND MINNESOTA IN ZIP CODE 66102 AND 75TH AND QUIVIRA IN ZIP CODE 66203. THE MEALS WITH SKILLS PROGRAM IS AN INTERNAL ADVENTHEALTH PROGRAM FOCUSED ON HEALTHY EATING ON A BUDGET, WHICH PROVIDES COOKING EDUCATION AND FOOD TO PARTICIPANTS. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. ALTHOUGH THE HOSPITAL WAS NOT ABLE TO PROVIDE THE PROGRAM DUE TO SOCIAL DISTANCING MEASURES AND COVID-19 CONSIDERATIONS, ONE HUNDRED TWENTY-FIVE LOW-INCOME FAMILIES RESIDING IN ZIP CODE 66203 RECEIVED MEALS WITH SKILLS KITS COMPLETE WITH INGREDIENTS, RECIPE AND MEAL PREPARATION TIPS. EIGHT REFUGEE TEENS RECEIVED MEALS WITH SKILLS TRAINING AND PREPARED HEALTHY SNACKS FOR OVER 400 REFUGEE CHILDREN PARTICIPATING IN CREATION LIFE KIDS CAMPS. ALL INDIVIDUALS WHO RECEIVED THE TRAINING DEMONSTRATED INCREASED KNOWLEDGE IN HEALTHY NUTRITION AND FOOD PREPARATION. SEE CONTINUATION 4

SCHEDULE H, PART V SECTION B LINE 11 - CONTINUATION 4
PRIORITY 4: POOR PREGNANCY OUTCOMES IN WYANDOTTE COUNTY 2019 DESCRIPTION OF THE ISSUE:IN WYANDOTTE COUNTY, 27% OF EXPECTING MOTHERS RECEIVE NO OR LATE PRENATAL CARE. THE INFANT MORTALITY RATE IN WYANDOTTE COUNTY IS 7 PER 1,000 LIVE BIRTHS WITH THE HIGHEST NUMBER OF INFANT DEATHS OCCURRING AMONG BLACK COMMUNITY MEMBERS. IN WYANDOTTE COUNTY, 8.5% OF MOTHERS SMOKED DURING PREGNANCY AS COMPARED TO THE HEALTHY PEOPLE GOAL FOR 2020 OF 1.4%. THE INFANT MORTALITY RATE AMONG THE BLACK POPULATION IS SIGNIFICANTLY HIGHER IN COMPARISON TO WHITE AND HISPANIC POPULATIONS.ADVENTHEALTH SHAWNEE MISSION DELIVERS OVER 5,000 BABIES PER YEAR AND PROVIDES EXCELLENT RESOURCES IN PRENATAL AND PARENTAL EDUCATION. AT THE WRITING OF THIS REPORT, THERE ARE STRATEGIC INITIATIVES IN WYANDOTTE COUNTY ADDRESSING THE HIGH INFANT MORTALITY RATES. CONSIDERING THAT GREATER THAN 20% OF BABIES DELIVERED AT OUR HOSPITAL ARE FROM WYANDOTTE COUNTY, OUR CONTINUED SUPPORT WILL BE ESSENTIAL FOR IMPROVING PREGNANCY OUTCOMES IN THIS COUNTY.2021 UPDATE: THE ADVENTHEALTH SHAWNEE MISSION COMMUNITY HEALTH PLAN HAS ONE DESIRED GOAL STATEMENTS UNDER THE POOR PREGNANCY OUTCOMES IN WYANDOTTE COUNTY PRIORITY. 1. REDUCE NUMBER OF INFANT DEATHS IN WYANDOTTE COUNTY GOAL 1: REDUCE NUMBER OF INFANT DEATHS IN WYANDOTTE COUNTY OBJECTIVE 1: THE FIRST OBJECTIVE IS THE HOSPITAL WILL INCREASE KNOWLEDGE OF THE COMMUNITY ON HOW TO PROVIDE A SAFE ENVIRONMENT THAT SUPPORTS INFANTS REACHING THEIR FIRST BIRTHDAY IN GOOD HEALTH THROUGH IMPLEMENTATION OF EVERY BABY TO 1, A FAITH-BASED INITIATIVE, AND WILL DEMONSTRATE A 60% INCREASE OF KNOWLEDGE FROM PRE-TEST TO POST-TEST IN THREE AFRICAN AMERICAN FAITH COMMUNITIES IN WYANDOTTE COUNTY. THE OBJECTIVE IS CONDUCTED THROUGH A COMMUNITY COALITION WITH IN-KIND AND FINANCIAL SUPPORT FROM ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL HAS COMPLETED THIS OBJECTIVE WITH TWO FAITH COMMUNITIES ACTIVELY ENGAGED IN EVERY BABY TO 1. AFTER COMPLETING THE POST-TEST, 100% OF PARTICIPANTS INCREASED KNOWLEDGE SUPPORTING A SAFE ENVIRONMENT FOR INFANTS. OBJECTIVE 2: THE SECOND OBJECTIVE IS THE HOSPITAL WILL PROVIDE SUPPORT TO THE COMMUNITY FOR 7,500 EXPECTING AND NEW PARENTS BY PROVIDING A FREE 24-7 PHONE NUMBER TO CALL WITH QUESTIONS OR SUPPORT AND FACILITATION OF SUPPORT GROUPS IN THE NEXT THREE YEARS. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. IN 2021, THE HOSPITAL PROGRESSED ON ITS METRIC WITH 1,190 PARENTS RECEIVING SUPPORT WITH IN-PERSON AND VIRTUAL SUPPORT GROUPS AND THE 24-7 PHONE LINE. OBJECTIVE 3:THE THIRD OBJECTIVE IS THE HOSPITAL WILL PROVIDE SUPPORT FOR MOTHERS EXPERIENCING POST-PARTUM DEPRESSION BY IDENTIFYING EXPECTING AND NEW MOMS AT RISK AND REFERRING TO RESOURCES AND FACILITATING SUPPORT GROUPS AND INDIVIDUAL CONVERSATIONS BY INCREASING THE NUMBER SERVED BY 15% OVER THE NEXT THREE YEARS FROM A BASELINE OF 6,700 IN 2019. THE INITIATIVE IS FUNDED AND MANAGED THROUGH ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL PROGRESSED ON ITS METRIC OF 2,233 RECEIVING SUPPORT WITH 552 MOMS PARTICIPATING IN SUPPORT GROUPS OR INDIVIDUAL PHONE CONVERSATIONS. DUE TO COVID-19, IN-PERSON CLASSES WERE TEMPORARILY CANCELLED AND TRANSITIONED TO VIRTUAL MEETINGS WITH FEWER PARTICIPANTS. THE HOSPITAL IS ADJUSTING THIS METRIC TO 600 MOMS RECEIVING SUPPORT AND INCREASING PARTICIPATION BY 10% BY YEAR THREE. OBJECTIVE 4:THE FOURTH OBJECTIVE IS THE HOSPITAL WILL PROVIDE SUPPORT THROUGH LEADERSHIP AND PROFESSIONAL EXPERTISE FOR NOT-FOR-PROFIT AND GOVERNMENTAL ORGANIZATIONS WITH STRATEGIC GOALS TO REDUCE PRE-TERM BIRTHS IN WYANDOTTE COUNTY. THE OBJECTIVE IS CONDUCTED THROUGH A COMMUNITY COALITION WITH IN-KIND AND FINANCIAL SUPPORT FROM ADVENTHEALTH SHAWNEE MISSION AND ALL OUTCOMES ARE SPECIFIC TO THE REPORTING HOSPITAL. THE HOSPITAL DID MEET ITS METRIC BY PROVIDING $9,000 IN FUNDING TO CRADLE-KC FOR SUPPORT OF EVERY BABY TO 1 PROGRAM AND PARTICIPATING IN 7 MEETINGS. COMMUNITY NEEDS NOT CHOSEN BY ADVENTHEALTH SHAWNEE MISSION:THE PRIMARY AND SECONDARY DATA IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED MULTIPLE COMMUNITY ISSUES. THE HOSPITAL AND COMMUNITY STAKEHOLDERS USED THE FOLLOWING CRITERIA TO NARROW THE LARGER LIST TO THE PRIORITY AREAS NOTED ABOVE:1. HOW ACUTE IS THE NEED? (BASED ON DATA AND COMMUNITY CONCERN)2. WHAT IS THE TREND? IS THE NEED GETTING WORSE?3. DOES THE HOSPITAL PROVIDE SERVICES THAT RELATE TO THE PRIORITY? 4. IS SOMEONE ELSE - OR MULTIPLE GROUPS - IN THE COMMUNITY ALREADY WORKING ON THIS ISSUE? 5. IF THE HOSPITAL WERE TO ADDRESS THIS ISSUE, ARE THERE OPPORTUNITIES TO WORK WITH COMMUNITY PARTNERS? BASED ON THIS PRIORITIZATION PROCESS, THE HOSPITAL DID NOT CHOOSE THE FOLLOWING COMMUNITY ISSUES:1. LACK OF AFFORDABLE HOUSING: OUR COMMUNITY SURVEY INDICATED 7.3% HAD CONCERN THEY MAY NOT HAVE STABLE HOUSING IN THE NEXT TWO MONTHS. THE STAKEHOLDER AND JOHNSON COUNTY COMMUNITY SURVEY IDENTIFIED THE AVAILABILITY OF AFFORDABLE HOUSING AS A HIGH PRIORITY WITH LOW SATISFACTION ON THE COMMUNITY'S RESPONSE. WHILE THE HOSPITAL DID NOT INCLUDE AFFORDABLE HOUSING AS ONE OF OUR TOP FOUR ISSUES TO BE ADDRESSED, THE HOSPITAL WILL CONTINUE TO ENGAGE AND SUPPORT THE EFFORTS OF UNITED COMMUNITY SERVICES AND OTHER AGENCIES THAT ARE CURRENTLY ADDRESSING THIS ISSUE. 2. LIMITED TRANSPORTATION OPTIONS: JOHNSON COUNTY IS A SPRAWLING COUNTY WITH MINIMAL ACCESS TO PUBLIC TRANSPORTATION. MANY NEIGHBORHOODS ARE NOT WALK-BIKE FRIENDLY. LESS THAN 1% OF ADVENTHEALTH SHAWNEE MISSION'S SERVICE AREA USES PUBLIC TRANSPORTATION AND 6.9% REPORTED LACK OF TRANSPORTATION AS A BARRIER TO HEALTH CARE. THE HOSPITAL PROVIDES RIDE VOUCHERS FOR PATIENTS AND WILL CONTINUE TO SUPPORT AND ADVOCATE FOR COMMUNITY INITIATIVES TO IMPROVE TRANSPORTATION ISSUES IN OUR COMMUNITY. 3. SOCIAL ISOLATION AND INCREASING RATES OF DEPRESSION: GREATER THAN 1-IN-5 INDICATED THEY OFTEN FEEL ISOLATED EITHER OFTEN OR SOME OF THE TIME IN THE HOSPITAL'S COMMUNITY SURVEY. THERE ARE A WIDE VARIETY OF AVAILABLE SOCIAL SUPPORT OPPORTUNITIES INCLUDING CHURCHES, LIBRARIES AND COMMUNITY CENTERS. THE HOSPITAL PROVIDES A WIDE RANGE OF SUPPORT GROUPS AND SOCIAL SUPPORT SERVICES. SOCIAL CONNECTEDNESS IS CONSIDERED IN THE DEVELOPMENT OF OUR COMMUNITY HEALTH PLAN.

SCHEDULE H, PART V SECTION B LINES 7A AND 10A:
LINE 7A. THE CHNA REPORT CAN BE FOUND AT URL:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSLINE 10A. THE HOSPITAL'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://WWW.ADVENTHEALTH.COM/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS

SCHEDULE H, PART V, LINE 16A, 16B, AND 16C
LINE 16ATHE FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT THE FOLLOWING WEBSITE: HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCELINE 16BTHE FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT THE FOLLOWING WEBSITE: HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCELINE 16CTHE PLAIN LANGUAGE SUMMARY CAN BE FOUND AT THE FOLLOWING WEBSITE: HTTPS://WWW.ADVENTHEALTH.COM/LEGAL/FINANCIAL-ASSISTANCE

PART I, LINE 6A:
"THE FILING ORGANIZATION WAS A WHOLLY OWNED SUBSIDIARY OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC) DURING ITS CURRENT TAX YEAR. DURING THE CURRENT YEAR, AHSSHC SERVED AS A PARENT ORGANIZATION TO 30 TAX-EXEMPT 501(C)(3) HOSPITAL ORGANIZATIONS AND A NUMBER OF OTHER HEALTH CARE FACILITIES THAT OPERATED IN 10 STATES WITHIN THE U.S. THE SYSTEM OF ORGANIZATIONS UNDER THE CONTROL AND OWNERSHIP OF AHSSHC IS KNOWN AS ""ADVENTHEALTH"".ALL HOSPITAL ORGANIZATIONS WITHIN ADVENTHEALTH COLLECT, CALCULATE, AND REPORT THE COMMUNITY BENEFITS THEY PROVIDE TO THE COMMUNITIES THEY SERVE. ADVENTHEALTH ORGANIZATIONS EXIST SOLELY TO IMPROVE AND ENHANCE THE LOCAL COMMUNITIES THEY SERVE. ADVENTHEALTH HAS A SYSTEM-WIDE COMMUNITY BENEFITS ACCOUNTING POLICY THAT PROVIDES GUIDELINES FOR ITS HEALTH CARE PROVIDER ORGANIZATIONS TO CAPTURE AND REPORT THE COSTS OF SERVICES PROVIDED TO THE UNDERPRIVILEGED AND TO THE BROADER COMMUNITY. EACH ADVENTHEALTH HOSPITAL FACILITY REPORTS THEIR COMMUNITY BENEFITS TO THEIR BOARD OF DIRECTORS AND STRIVES TO COMMUNICATE THEIR COMMUNITY BENEFITS TO THEIR LOCAL COMMUNITIES. ADDITIONALLY, THE FILING ORGANIZATION'S MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT AND ASSOCIATED IMPLEMENTATION STRATEGY CAN BE ACCESSED ON THE FILING ORGANIZATION'S WEBSITE."

PART I, LINE 7:
THE AMOUNTS OF COSTS REPORTED IN THE TABLE IN LINE 7 OF PART I OF SCHEDULE H WERE DETERMINED BY UTILIZING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, CONTAINED IN THE SCHEDULE H INSTRUCTIONS.

PART II, COMMUNITY BUILDING ACTIVITIES:
SHAWNEE MISSION MEDICAL CENTER (THE HOSPITAL) IS INVOLVED WITH AND SUPPORTIVE OF VARIOUS OTHER COMMUNITY AGENCIES IN ITS SERVICE AREA THAT WORK COLLABORATIVELY TO HELP THOSE IN NEED AND TO IMPROVE THE HEALTH AND SAFETY OF THE RESIDENTS OF THE COMMUNITY. THE HOSPITAL PARTICIPATES WITH A NUMBER OF OTHER COMMUNITY ORGANIZATIONS TO ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITY, SUCH AS THE HEALTH PARTNERSHIP OF JOHNSON COUNTY WHO SPECIALIZES IN TREATING LOW INCOME PERSONS. IN ADDITION TO OFFERING NUMEROUS CLASSES AND A SPIRITUAL WELLNESS PROGRAM, THE HOSPITAL IS SUPPORTIVE OF OTHER HEALTH AND WELLNESS EVENTS CURRENTLY CONDUCTED IN ITS COMMUNITY, SUCH AS THE AMERICAN HEART ASSOCIATION HEART WALK. THE HOSPITAL ALSO PROVIDES FINANCIAL SUPPORT AND ASSISTANCE TO OTHER COMMUNITY GROUPS THROUGH THE PROVISION OF GRANTS TO ORGANIZATIONS, SUCH AS THE SHAWNEE MISSION EDUCATION FOUNDATION AND BLUE VALLEY EDUCATION FOUNDATION.

PART III, LINE 2:
THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON LINE 2 OF SECTION A OF PART III IS RECORDED IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO REVENUE, NOT BAD DEBT EXPENSE.

PART III, LINE 4:
FINANCIAL STATEMENT FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS:THE FINANCIAL INFORMATION OF THE FILING ORGANIZATION IS INCLUDED IN A CONSOLIDATED AUDITED FINANCIAL STATEMENT FOR THE CURRENT YEAR.THE APPLICABLE FOOTNOTE FROM THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ADDRESSES ACCOUNTS RECEIVABLE, THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS, AND THE PROVISION FOR BAD DEBTS CAN BE FOUND ON PAGES 8-9. PLEASE NOTE THAT DOLLAR AMOUNTS ON THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE IN THOUSANDS.

PART III, LINE 8:
COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.RATIONALE FOR INCLUDING A MEDICARE SHORTFALL AS COMMUNITY BENEFIT:AS A 501(C)(3) ORGANIZATION, THE FILING ORGANIZATION PROVIDES EMERGENCY AND NON-ELECTIVE CARE TO ALL REGARDLESS OF ABILITY TO PAY. ALL HOSPITAL SERVICES ARE PROVIDED IN A NON-DISCRIMINATORY MANNER TO PATIENTS WHO ARE COVERED BENEFICIARIES UNDER THE MEDICARE PROGRAM. AS A PUBLIC INSURANCE PROGRAM, MEDICARE PROVIDES A PRE-ESTABLISHED REIMBURSEMENT RATE/AMOUNT TO HEALTH CARE PROVIDERS FOR THE SERVICES THEY PROVIDE TO PATIENTS. IN SOME CASES, THE REIMBURSEMENT AMOUNT PROVIDED TO A HOSPITAL MAY EXCEED ITS COSTS OF PROVIDING A PARTICULAR SERVICE OR SERVICES TO A PATIENT. IN OTHER CASES, THE MEDICARE REIMBURSEMENT AMOUNT MAY RESULT IN THE HOSPITAL EXPERIENCING A SHORTFALL OF REIMBURSEMENT RECEIVED OVER COSTS INCURRED. IN THOSE CASES WHERE AN OVERALL SHORTFALL IS GENERATED FOR PROVIDING SERVICES TO ALL MEDICARE PATIENTS, THE SHORTFALL AMOUNT SHOULD BE CONSIDERED AS A BENEFIT TO THE COMMUNITY. TAX-EXEMPT HOSPITALS ARE REQUIRED TO ACCEPT ALL MEDICARE PATIENTS REGARDLESS OF THE PROFITABILITY, OR LACK THEREOF, WITH RESPECT TO THE SERVICES THEY PROVIDE TO MEDICARE PATIENTS. THE POPULATION OF INDIVIDUALS COVERED UNDER THE MEDICARE PROGRAM IS SUFFICIENTLY LARGE SO THAT THE PROVISION OF SERVICES TO THE POPULATION IS A BENEFIT TO THE COMMUNITY AND RELIEVES THE BURDENS OF GOVERNMENT. IN THOSE SITUATIONS WHERE THE PROVISION OF SERVICES TO THE TOTAL MEDICARE PATIENT POPULATION OF A TAX-EXEMPT HOSPITAL DURING ANY YEAR RESULTS IN A SHORTFALL OF REIMBURSEMENT RECEIVED OVER THE COST OF PROVIDING CARE, THE TAX-EXEMPT HOSPITAL HAS PROVIDED A BENEFIT TO A CLASS OF PERSONS BROAD ENOUGH TO BE CONSIDERED A BENEFIT TO THE COMMUNITY. DESPITE A FINANCIAL SHORTFALL, A TAX-EXEMPT HOSPITAL MUST AND WILL CONTINUE TO ACCEPT AND CARE FOR MEDICARE PATIENTS. TYPICALLY, TAX-EXEMPT HOSPITALS PROVIDE HEALTH CARE SERVICES BASED UPON AN ASSESSMENT OF THE HEALTH CARE NEEDS OF THEIR COMMUNITY AS OPPOSED TO THEIR TAXABLE COUNTERPARTS WHERE PROFITABILITY OFTEN DRIVES DECISIONS ABOUT PATIENT CARE SERVICES THAT ARE OFFERED. PATIENT CARE PROVIDED BY TAX-EXEMPT HOSPITALS THAT RESULTS IN MEDICARE SHORTFALLS SHOULD BE CONSIDERED AS PROVIDING A BENEFIT TO THE COMMUNITY AND RELIEVING THE BURDENS OF GOVERNMENT.

SCHEDULE H, PART VI, LINE 7:
THE FILING ORGANIZATION DOES NOT FILE AN ANNUAL COMMUNITY BENEFIT REPORT WITH ANY STATE AGENCIES.

PART III, LINE 3:
METHODOLOGY FOR DETERMINING THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE THAT MAY REPRESENT PATIENTS WHO COULD HAVE QUALIFIED UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY:SELF-PAY PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM). IF AN INDIVIDUAL DOES NOT SUBMIT A COMPLETE FAA FORM WITHIN 240 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL, AN INDIVIDUAL MAY BE CONSIDERED FOR PRESUMPTIVE ELIGIBILITY BASED UPON A SCORING TOOL THAT IS DESIGNED TO CLASSIFY PATIENTS INTO GROUPS OF VARYING ECONOMIC MEANS. THE SCORING TOOL USES ALGORITHMS THAT INCORPORATE DATA FROM CREDIT BUREAUS, DEMOGRAPHIC DATABASES, AND HOSPITAL SPECIFIC DATA TO INFER AND CLASSIFY PATIENTS INTO RESPECTIVE ECONOMIC MEANS CATEGORIES. INDIVIDUALS WHO EARN A CERTAIN SCORE ON THE SCORING TOOL ARE CONSIDERED TO QUALIFY AS ELIGIBLE FOR THE MOST GENEROUS FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS DETERMINED BY THE FILING ORGANIZATION, A NOMINAL AMOUNT OF SUCH A PATIENT'S BILL IS WRITTEN OFF AS BAD DEBT EXPENSE, WHILE THE REMAINING PORTION OF THE PATIENT'S BILL IS CONSIDERED NON-STATE CHARITY. THE AMOUNT WRITTEN OFF AS BAD DEBT EXPENSE FOR THOSE PATIENTS WHO POTENTIALLY QUALIFY AS NON-STATE CHARITY USING THE SCORING TOOL IS THE AMOUNT SHOWN ON LINE 3 OF SECTION A OF PART III. RATIONALE FOR INCLUDING CERTAIN BAD DEBTS IN COMMUNITY BENEFIT:THE FILING ORGANIZATION IS DEDICATED TO THE VIEW THAT MEDICALLY NECESSARY HEALTH CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS SHOULD BE ACCESSIBLE TO ALL, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, CULTURAL BACKGROUND, PHYSICIAN MOBILITY, OR ABILITY TO PAY. THE FILING ORGANIZATION TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY OR THE AVAILABILITY OF THIRD-PARTY COVERAGE. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE FILING ORGANIZATION IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. AS A 501(C)(3) HOSPITAL ORGANIZATION, THE FILING ORGANIZATION MAINTAINS A 24/7 EMERGENCY ROOM PROVIDING CARE TO ALL WHOM PRESENT. WHEN A PATIENT'S ARRIVAL AND/OR ADMISSION TO THE FACILITY BEGINS WITHIN THE EMERGENCY DEPARTMENT, TRIAGE AND MEDICAL SCREENING ARE ALWAYS COMPLETED PRIOR TO REGISTRATION STAFF PROCEEDING WITH THE DETERMINATION OF A PATIENT'S SOURCE OF PAYMENT. IF THE PATIENT REQUIRES ADMISSION AND CONTINUED NON-ELECTIVE CARE, THE FILING ORGANIZATION PROVIDES THE NECESSARY CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY. THE FILING ORGANIZATION'S OPERATION OF A 24/7 EMERGENCY DEPARTMENT THAT ACCEPTS ALL INDIVIDUALS IN NEED OF CARE PROMOTES THE HEALTH OF THE COMMUNITY THROUGH THE PROVISION OF CARE TO ALL WHOM PRESENT. CURRENT INTERNAL REVENUE SERVICE GUIDANCE THAT TAX-EXEMPT HOSPITALS MAINTAIN SUCH EMERGENCY ROOMS WAS ESTABLISHED TO ENSURE THAT EMERGENCY CARE WOULD BE PROVIDED TO ALL WITHOUT DISCRIMINATION. THE TREATMENT OF ALL AT THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT IS A COMMUNITY BENEFIT. UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, EVERY EFFORT IS MADE TO OBTAIN A PATIENT'S NECESSARY FINANCIAL INFORMATION TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. HOWEVER, NOT ALL PATIENTS WILL COOPERATE WITH SUCH EFFORTS AND A FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION CANNOT BE MADE BASED UPON INFORMATION SUPPLIED BY THE INDIVIDUAL. IN THIS CASE, A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE THROUGH THE FILING ORGANIZATION'S EMERGENCY DEPARTMENT SHOULD BE CONSIDERED COMMUNITY BENEFIT AS CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR PURPOSE OF MEETING THE NEED FOR EMERGENCY MEDICAL CARE SERVICES AVAILABLE TO ALL IN THE COMMUNITY.

PART III, LINE 9B:
COLLECTION POLICIES:THE HOSPITAL FILING ORGANIZATION'S COLLECTION PRACTICES ARE IN CONFORMITY WITH THE REQUIREMENTS SET FORTH IN THE 2014 FINAL REGULATIONS REGARDING THE REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R)(4) - (R)(6). NO EXTRAORDINARY COLLECTION ACTIONS (ECA'S) ARE INITIATED BY THE HOSPITAL FILING ORGANIZATION IN THE 120-DAY PERIOD FOLLOWING THE DATE AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL (OR, IF LATER, THE SPECIFIED DEADLINE GIVEN IN A WRITTEN NOTICE OF ACTIONS THAT MAY BE TAKEN, AS DESCRIBED BELOW). INDIVIDUALS ARE PROVIDED WITH AT LEAST ONE WRITTEN NOTICE (NOTICE OF ACTIONS THAT MAY BE TAKEN) AND A COPY OF THE FILING ORGANIZATION'S PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY THAT INFORMS THE INDIVIDUAL THAT THE HOSPITAL FILING ORGANIZATION MAY TAKE ACTIONS TO REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES/BUREAUS IF THE INDIVIDUAL DOES NOT SUBMIT A FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM) OR PAY THE AMOUNT DUE BY A SPECIFIED DEADLINE. THE SPECIFIED DEADLINE IS NOT EARLIER THAN 120 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT IS SENT TO THE INDIVIDUAL AND IS AT LEAST 30 DAYS AFTER THE NOTICE IS PROVIDED. A REASONABLE ATTEMPT IS ALSO MADE TO ORALLY NOTIFY AN INDIVIDUAL ABOUT THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. IF AN INDIVIDUAL SUBMITS AN INCOMPLETE FAA FORM DURING THE 240-DAY PERIOD FOLLOWING THE DATE ON WHICH THE FIRST POST-DISCHARGE BILLING STATEMENT WAS SENT TO THE INDIVIDUAL, THE HOSPITAL FILING ORGANIZATION SUSPENDS ANY REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS (OR CEASES ANY OTHER ECA'S) AND PROVIDES A WRITTEN NOTICE TO THE INDIVIDUAL DESCRIBING WHAT ADDITIONAL INFORMATION OR DOCUMENTATION IS NEEDED TO COMPLETE THE FAA FORM. THIS WRITTEN NOTICE CONTAINS CONTACT INFORMATION INCLUDING THE TELEPHONE NUMBER AND PHYSICAL LOCATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY, AS WELL AS CONTACT INFORMATION OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS OR, ALTERNATIVELY, A NONPROFIT ORGANIZATION OR GOVERNMENTAL AGENCY THAT CAN PROVIDE ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS IF THE HOSPITAL FACILITY IS UNABLE TO DO SO. IF AN INDIVIDUAL SUBMITS A COMPLETE FAA FORM WITHIN A REASONABLE TIME-PERIOD AS SET FORTH IN THE NOTICE DESCRIBED ABOVE, THE HOSPITAL FILING ORGANIZATION WILL SUSPEND ANY ADVERSE REPORTING TO CONSUMER CREDIT REPORTING AGENCIES/BUREAUS UNTIL A FINANCIAL ASSISTANCE POLICY ELIGIBILITY DETERMINATION CAN BE MADE.

SUPPLEMENTAL SCHEDULE TO SCHEDULE H, PART III, SECTION B, LINE 8:
RECONCILIATION OF SCHEDULE H REPORTED MEDICARE SURPLUS/(SHORTFALL) TO UNREIMBURSED MEDICARE COSTS ASSOCIATED WITH THE PROVISION OF SERVICESTO ALL MEDICARE BENEFICIARIES:THE MEDICARE REVENUE AND ALLOWABLE COSTS OF CARE REPORTED IN SECTION B OF PART III OF SCHEDULE H ARE BASED UPON THE AMOUNTS REPORTED IN THE FILING ORGANIZATION'S MEDICARE COST REPORT IN ACCORDANCE WITH THE IRS INSTRUCTIONS FOR SCHEDULE H. ON AN ANNUAL BASIS, THE FILING ORGANIZATION ALSO DETERMINES ITS TOTAL UNREIMBURSED COSTS ASSOCIATED WITH PROVIDING SERVICES TO ALL MEDICARE PATIENTS. UNREIMBURSED COSTS ARE CONSIDERED A COMMUNITY BENEFIT TO THE ELDERLY AND ARE COMBINED INTO AN ANNUAL COMMUNITY BENEFIT STATEMENT PREPARED BY ADVENTHEALTH. THE PRIMARY RECONCILING ITEMS BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF PART III OF SCHEDULE H AND THE FILING ORGANIZATION'S UNREIMBURSED COSTS OF SERVICES PROVIDED TO ALL MEDICARE PATIENTS ARE AS FOLLOWS:- MEDICARE SURPLUS/(SHORTFALL) SHOWN ON LINE 7 OF SECTION B OF SCHEDULE H: $ (2,911,753)- DIFFERENCE IN COSTING METHODOLOGY: (24,485,307)- UNREIMBURSED COSTS INCURRED FOR SERVICES PROVIDED TO MEDICARE PATIENTS THAT ARE NOT INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT: (25,516,544) -------------TOTAL UNREIMBURSED COSTS OF SERVING ALL MEDICARE PATIENTS PER THE FILING ORGANIZATION'S COMMUNITY BENEFIT REPORTING: $(52,913,604) AS INDICATED ABOVE, THE PRIMARY DIFFERENCES BETWEEN THE MEDICARE SURPLUS/(SHORTFALL) REPORTED ON SCHEDULE H, PART III, SECTION B, LINE 7 AND THE FILING ORGANIZATION'S PORTION OF THE COMPANY'S ANNUAL COMMUNITY BENEFIT STATEMENT IS DUE TO A DIFFERENCE IN THE COSTING METHODOLOGY AND DIFFERENCES IN THE POPULATION OF MEDICARE PATIENTS WITHIN THE CALCULATION. THE COST METHODOLOGY UTILIZED IN CALCULATING ANY MEDICARE SURPLUS/(SHORTFALL) FOR PURPOSES OF THE ANNUAL COMMUNITY BENEFIT REPORTING IS BASED UPON THE COST-TO-CHARGE RATIO OUTLINED IN WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE SAME COST-TO-CHARGE RATIO IS USED TO DETERMINE THE COSTS ASSOCIATED WITH SERVICES PROVIDED TO CHARITY CARE PATIENTS AND MEDICAID PATIENTS AS REPORTED IN SCHEDULE H, PART I, LINE 7. IN ADDITION, THE MEDICARE COST REPORT EXCLUDES SERVICES PROVIDED TO MEDICARE PATIENTS FOR PHYSICIAN SERVICES, SERVICES PROVIDED TO PATIENTS ENROLLED IN MEDICARE HMOS, AND CERTAIN SERVICES PROVIDED BY OUTPATIENT DEPARTMENTS OF THE FILING ORGANIZATION THAT ARE REIMBURSED ON A FEE SCHEDULE. THE COMPANY'S OWN COMMUNITY BENEFIT STATEMENT CAPTURES THE UNREIMBURSED COST OF PROVIDING SERVICES TO ALL MEDICARE BENEFICIARIES THROUGHOUT THE ORGANIZATION.

PART VI, LINE 2:
THE HOSPITAL CONDUCTS COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) EVERY THREE YEARS. ITS 2019 CHNA WAS ADOPTED BY ITS GOVERNING BOARD BY DECEMBER 31, 2019, THE END OF THE HOSPITAL'S TAXABLE YEAR IN WHICH IT CONDUCTED THE CHNA. THE HOSPITAL'S 2019 CHNA COMPLIED WITH THE GUIDANCE SET FORTH BY THE IRS IN FINAL REGULATION SECTION 1.501(R)-3. IN ADDITION TO THE CHNA DISCUSSED ABOVE, A VARIETY OF PRACTICES AND PROCESSES ARE IN PLACE TO ENSURE THAT THE FILING ORGANIZATION IS RESPONSIVE TO THE HEALTH NEEDS OF ITS COMMUNITY.SUCH PRACTICES AND PROCESSES INVOLVE THE FOLLOWING:1.A HOSPITAL OPERATING/COMMUNITY BOARD COMPOSED OF INDIVIDUALS BROADLY REPRESENTATIVE OF THE COMMUNITY, COMMUNITY LEADERS, AND THOSE WITH SPECIALIZED MEDICAL TRAINING AND EXPERTISE;2.POST-DISCHARGE PATIENT FOLLOW-UP RELATED TO THE ON-GOING CARE AND TREATMENT OF PATIENTS WHO SUFFER FROM CHRONIC DISEASES; 3.SPONSORSHIP AND PARTICIPATION IN COMMUNITY HEALTH AND WELLNESS ACTIVITIES THAT REACH A BROAD SPECTRUM OF THE FILING ORGANIZATION'S COMMUNITY; AND 4.COLLABORATION WITH OTHER LOCAL COMMUNITY GROUPS TO ADDRESS THE HEALTH CARE NEEDS OF THE FILING ORGANIZATION'S COMMUNITY.

PART VI, LINE 3:
THE FINANCIAL ASSISTANCE POLICY (FAP), FINANCIAL ASSISTANCE APPLICATION FORM (FAA FORM), AND THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY (PLS) OF THE FILING ORGANIZATION'S HOSPITAL FACILITY ARE TRANSPARENT AND AVAILABLE TO ALL INDIVIDUALS SERVED AT ANY POINT IN THE CARE CONTINUUM. THE FAP, FAA FORM, PLS, AND CONTACT INFORMATION FOR THE HOSPITAL FACILITY'S FINANCIAL COUNSELORS ARE PROMINENTLY AND CONSPICUOUSLY POSTED ON THE FILING ORGANIZATION'S HOSPITAL FACILITY'S WEBSITE. THE WEBSITE INDICATES THAT A COPY OF THE FAP, FAA FORM, AND PLS IS AVAILABLE AND HOW TO OBTAIN SUCH COPIES IN THE PRIMARY LANGUAGES OF ANY POPULATIONS WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY (REFERRED TO BELOW AS LEP DEFINED POPULATIONS). SIGNAGE IS DISPLAYED IN PUBLIC LOCATIONS OF THE FILING ORGANIZATION'S HOSPITAL FACILITY, INCLUDING AT ALL POINTS OF ADMISSION AND REGISTRATION AND THE EMERGENCY DEPARTMENT. THE SIGNAGE CONTAINS THE HOSPITAL FACILITY'S WEBSITE ADDRESS WHERE THE FAP, FAA FORM, AND PLS CAN BE ACCESSED AND THE TELEPHONE NUMBER AND PHYSICAL LOCATION THAT INDIVIDUALS CAN CALL OR VISIT TO OBTAIN COPIES OF THE FAP, FAA FORM AND PLS OR TO OBTAIN MORE INFORMATION ABOUT THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS. PAPER COPIES OF THE HOSPITAL FACILITY'S FAP, FAA FORM AND PLS ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE, BOTH IN PUBLIC LOCATIONS IN THE HOSPITAL FACILITY AND BY MAIL. PAPER COPIES ARE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGES OF ANY LEP DEFINED POPULATIONS. THE FILING ORGANIZATION'S HOSPITAL FACILITY'S FINANCIAL COUNSELORS SEEK TO PROVIDE PERSONAL FINANCIAL COUNSELING TO ALL INDIVIDUALS ADMITTED TO THE HOSPITAL FACILITY WHO ARE CLASSIFIED AS SELF-PAY DURING THE COURSE OF THEIR HOSPITAL STAY OR AT TIME OF DISCHARGE TO EXPLAIN THE FAP AND FAA FORM AND TO PROVIDE INFORMATION CONCERNING OTHER SOURCES OF ASSISTANCE THAT MAY BE AVAILABLE, SUCH AS MEDICAID. A PAPER COPY OF THE HOSPITAL FACILITY'S PLS WILL BE OFFERED TO EVERY PATIENT AS A PART OF THE INTAKE OR DISCHARGE PROCESS. A CONSPICUOUS WRITTEN NOTICE IS INCLUDED ON ALL BILLING STATEMENTS SENT TO PATIENTS THAT NOTIFIES AND INFORMS RECIPIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FILING ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, INCLUDING THE FOLLOWING: 1) THE TELEPHONE NUMBER OF THE HOSPITAL FACILITY'S OFFICE OR DEPARTMENT THAT CAN PROVIDE INFORMATION ABOUT THE FAP AND THE FAA FORM; AND 2) THE WEBSITE ADDRESS WHERE COPIES OF THE FAP, FAA FORM AND PLS MAY BE OBTAINED. REASONABLE ATTEMPTS ARE MADE TO INFORM INDIVIDUALS ABOUT THE HOSPITAL FACILITY'S FAP IN ALL ORAL COMMUNICATIONS REGARDING THE AMOUNT DUE FOR THE INDIVIDUAL'S CARE. COPIES OF THE PLS ARE DISTRIBUTED TO MEMBERS OF THE COMMUNITY IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS OF THE COMMUNITY WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE.

PART VI, LINE 4:
THE FILING ORGANIZATION (THE HOSPITAL) IS LOCATED IN MERRIAM, KANSAS, AND IS LICENSED FOR 504 ACUTE CARE BEDS. THE HOSPITAL'S 54-ACRE CAMPUS INCLUDES AN OUTPATIENT SURGERY CENTER, SEVEN MEDICAL OFFICE BUILDINGS AND AN ASSOCIATE CHILD CARE CENTER. IN ADDITION TO OPERATING A HOSPITAL, THE FILING ORGANIZATION ALSO RUNS TWO SATELLITE CAMPUSES WHICH INCLUDE HOSPITAL-BASED EMERGENCY DEPARTMENTS AND OTHER AMBULATORY SERVICES; AND VARIOUS OCCUPATIONAL MEDICINE, REHABILITATION AND URGENT CARE CLINICS IN THE KANSAS CITY AREA. THE FILING ORGANIZATION EMPLOYS MORE THAN 3,500 LOCAL RESIDENTS AND SUPPORTS AN EXCEPTION STAFF OF NEARLY 700 PHYSICIANS, THE LARGEST FULL-SERVICE MEDICAL STAFF IN KANSAS CITY.ADVENTHEALTH SHAWNEE MISSION (AHSM) IS A CRUCIAL COMMUNITY AND REGIONAL ASSET. AHSM HAS THE BUSIEST EMERGENCY DEPARTMENT IN JOHNSON COUNTY, THE AREA'S FIRST ACCREDITED CHEST PAIN EMERGENCY CENTER, DELIVERS MORE BABIES THAN ANY OTHER HOSPITAL IN THE METROPOLITAN AREA, IS THE ONLY CERTIFIED MEMBER OF THE MD ANDERSON CANCER NETWORK IN KANSAS CITY, AND SINCE 1986 HAS BEEN OPERATING NURSELINE, WHICH ALLOWS INDIVIDUALS IN THE COMMUNITY TO SEEK FREE AND DEPENDABLE HEALTH INFORMATION FROM A REGISTERED NURSE 24 HOURS A DAY. A TOTAL OF FIVE OTHER COMPETING HOSPITALS ARE LOCATED WITHIN A RADIUS OF 12 MILES OR LESS FROM THE HOSPITAL'S PRIMARY HOSPITAL FACILITY.DURING 2021, THE HOSPITAL'S PATIENT PERCENTAGE POPULATION WAS MADE UP OF THE BELOW PAYORS WITH THE REMAINING PERCENTAGE OF THE PATIENTS BEING COVERED UNDER COMMERCIAL INSURANCE. IN 2021, ABOUT 57.7% OF THE HOSPITAL'S IN-PATIENTS WERE ADMITTED THROUGH THE HOSPITAL'S EMERGENCY DEPARTMENT. - MEDICARE PATIENTS 42.8% - MEDICAID PATIENTS 7.2% - SELF-PAY PATIENTS 4.3% THE DEMOGRAPHIC MAKEUP OF THE HOSPITAL'S (OR COUNTY, IF FROM CHNA COMMUNITY MAY BE DEFINED AS COUNTY) COMMUNITY IS AS FOLLOWS: - POPULATION 1,462,539 - POPULATION OVER 65 13.9% - POVERTY (BELOW 100% FPL) 11.5% - UNEMPLOYMENT RATE 5.2% - VIOLENT CRIME RATE (PER 100,000 POP.) 375.4 - POP. AGE 25+ WITH NO HIGH SCHOOL DIPLOMA 8% - UNINSURED ADULTS 11.58% - UNINSURED CHILDREN 3.91% - FOOD INSECURITY RATE 14.5% - POP. WITH LOW FOOD ACCESS 24.96%

PART VI, LINE 5:
"THE PROVISION OF COMMUNITY BENEFIT IS CENTRAL TO SHAWNEE MISSION MEDICAL CENTER'S MISSION OF SERVICE AND COMPASSION. RESTORING AND PROMOTING THE HEALTH AND QUALITY OF LIFE OF THOSE IN THE COMMUNITIES SERVED BY THE HOSPITAL IS A FUNCTION OF ""EXTENDING THE HEALING MINISTRY OF CHRIST AND EMBODIES THE HOSPITAL'S COMMITMENT TO ITS VALUES AND PRINCIPLES. THE HOSPITAL COMMITS SUBSTANTIAL RESOURCES TO PROVIDE A BROAD RANGE OF SERVICES TO BOTH THE UNDERPRIVILEGED AS WELL AS THE BROADER COMMUNITY. IN ADDITION TO THE COMMUNITY BENEFIT AND COMMUNITY BUILDING INFORMATION PROVIDED IN PARTS I, II AND III OF THIS SCHEDULE H, THE HOSPITAL CAPTURES AND REPORTS THE BENEFITS PROVIDED TO ITS COMMUNITY THROUGH FAITH-BASED CARE. EXAMPLES OF SUCH BENEFITS INCLUDE THE COST ASSOCIATED WITH CHAPLAINCY CARE PROGRAMS AND MISSION PEER REVIEWS AND MISSION CONFERENCES. DURING THE CURRENT YEAR, THE HOSPITAL PROVIDED $814,236 OF BENEFIT WITH RESPECT TO THE FAITH-BASED AND SPIRITUAL NEEDS OF THE COMMUNITY IN CONJUNCTION WITH ITS OPERATION OF A COMMUNITY HOSPITAL. THE HOSPITAL ALSO PROVIDES BENEFITS TO ITS COMMUNITY'S INFRASTRUCTURE BY INVESTING IN CAPITAL IMPROVEMENTS TO ENSURE THAT FACILITIES AND TECHNOLOGY PROVIDE THE BEST POSSIBLE CARE TO THE COMMUNITY. AS A FAITH-BASED MISSION-DRIVEN COMMUNITY HOSPITAL, THE HOSPITAL IS CONTINUALLY INVOLVED IN MONITORING ITS COMMUNITY, IDENTIFYING UNMET HEALTH CARE NEEDS AND DEVELOPING SOLUTIONS AND PROGRAMS TO ADDRESS THOSE NEEDS. IN ACCORDANCE WITH ITS CONSERVATIVE APPROACH TO FISCAL RESPONSIBILITY, SURPLUS FUNDS OF THE HOSPITAL ARE CONTINUALLY BEING INVESTED IN RESOURCES THAT IMPROVE THE AVAILABILITY AND QUALITY OF DELIVERY OF HEALTH CARE SERVICES AND PROGRAMS TO ITS COMMUNITY."

PART VI, LINE 6:
SHAWNEE MISSION MEDICAL CENTER IS A PART OF A FAITH-BASED HEALTHCARE SYSTEM OF ORGANIZATIONS WHOSE PARENT IS ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). THE SYSTEM IS KNOWN AS ADVENTHEALTH. AHSSHC IS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AHSSHC AND ITS SUBSIDIARY ORGANIZATIONS OPERATE 48 HOSPITALS THROUGHOUT THE U.S., PRIMARILY IN THE SOUTHEASTERN PORTION OF THE U.S. AHSSHC AND ITS SUBSIDIARIES ALSO OPERATE 10 NURSING HOME FACILITIES AND OTHER ANCILLARY HEALTH CARE PROVIDER FACILITIES, SUCH AS AMBULATORY SURGERY CENTERS AND DIAGNOSTIC IMAGING CENTERS. AS THE PARENT ORGANIZATION OF ADVENTHEALTH, AHSSHC PROVIDES EXECUTIVE LEADERSHIP AND OTHER PROFESSIONAL SUPPORT SERVICES TO ITS SUBSIDIARY ORGANIZATIONS. PROFESSIONAL SUPPORT SERVICES INCLUDE AMONG OTHERS IT, CORPORATE COMPLIANCE, LEGAL, REIMBURSEMENT, RISK MANAGEMENT, AND TAX AS WELL AS TREASURY FUNCTIONS. CERTAIN SUPPORT SERVICES, SUCH AS HUMAN RESOURCES, PAYROLL, A/P, AND SUPPLY CHAIN MANAGEMENT ARE PROVIDED PURSUANT TO A SHARED SERVICES MODEL BY AHSSHC TO ITS SUBSIDIARY ORGANIZATIONS. THE PROVISION OF THESE EXECUTIVE AND SUPPORT SERVICES ON A CENTRALIZED BASIS BY AHSSHC PROVIDES AN APPROPRIATE BALANCE BETWEEN PROVIDING EACH ADVENTHEALTH SUBSIDIARY HOSPITAL ORGANIZATION WITH MISSION-DRIVEN CONSISTENT LEADERSHIP AND SUPPORT WHILE ALLOWING THE HOSPITAL ORGANIZATION TO FOCUS ITS RESOURCES ON MEETING THE SPECIFIC HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. THE READER OF THIS FORM 990 SHOULD KEEP IN MIND THAT THIS REPORTING ENTITY MAY DIFFER IN CERTAIN AREAS FROM THAT OF A STAND-ALONE HOSPITAL ORGANIZATION DUE TO ITS INCLUSION IN A LARGER SYSTEM OF HEALTHCARE ORGANIZATIONS. AS A PART OF A SYSTEM OF HOSPITAL AND OTHER HEALTH CARE ORGANIZATIONS, THE FILING ORGANIZATION BENEFITS FROM REDUCED COSTS DUE TO SYSTEM EFFICIENCIES, SUCH AS LARGE GROUP PURCHASING DISCOUNTS, AND THE AVAILABILITY OF INTERNAL RESOURCES SUCH AS INTERNAL LEGAL COUNSEL. EACH AHS SUBSIDIARY PAYS A MANAGEMENT FEE TO AHSSHC FOR THE INTERNAL SERVICES PROVIDED BY AHSSHC. AS A RESULT, MANAGEMENT FEE EXPENSE REPORTED BY AN ADVENTHEALTH SUBSIDIARY ORGANIZATION MAY APPEAR GREATER IN RELATION TO MANAGEMENT FEE EXPENSE THAT MAY BE REPORTED BY A SINGLE STAND-ALONE HOSPITAL. THE SINGLE STAND-ALONE HOSPITAL WOULD LIKELY REPORT COSTS ASSOCIATED WITH MANAGEMENT AND OTHER PROFESSIONAL SERVICES ON VARIOUS EXPENSE LINE ITEMS IN ITS STATEMENT OF REVENUE AND EXPENSE AS OPPOSED TO REPORTING SUCH COSTS IN ONE OVERALL MANAGEMENT FEE EXPENSE. AS THE REPORTING OF THE FORM 990 IS DONE ON AN ENTITY BY ENTITY BASIS, THERE IS NO SINGLE FORM 990 THAT CAPTURES THE PROGRAMS AND OPERATIONS OF ADVENTHEALTH AS A WHOLE. THE READER IS DIRECTED TO VISIT THE WEB-SITE OF ADVENTHEALTH AT WWW.ADVENTHEALTH.COM TO LEARN MORE ABOUT THE MISSION AND OPERATIONS OF ADVENTHEALTH.