4A (Expenses $ 937791360 including grants of $ 11634176) (Revenue $ 1632254621)
"St. Elizabeth Healthcare is one of the oldest, largest and most respected medical providers in the Northern Kentucky, Southern Ohio and Southern Indiana Areas. For more than 150 years, St. Elizabeth has been the heart and soul of healthcare in Northern Kentucky. Founded with one small hospital in 1861, St. Elizabeth Healthcare now operates six facilities throughout Northern Kentucky and Southeast Indiana - St. Elizabeth Covington, St. Elizabeth Edgewood, St. Elizabeth Florence, St. Elizabeth Ft. Thomas, St. Elizabeth Grant and St. Elizabeth Dearborn. St. Elizabeth Healthcare is sponsored by the Diocese of Covington and provided approximately $66 million in uncompensated care and benefit to the community in 2021. Within our thriving, multi-faceted organization, some of the nation's top medical professionals are working together to deliver the best care available to these areas. Our mission is to provide comprehensive and compassionate care that improves the health of the people we serve. We accomplish this through state-of the-art technology and our dedicated associates, led by a well-respected board and executive leadership team who love this organization and our community. St. Elizabeth Healthcare's state-of-the-art technology includes a secure, internal electronic medical records system that not only gives providers access to their patients' medical records at any St. Elizabeth Healthcare or St. Elizabeth Physicians facility, but also gives the patient faster, more convenient access to their personal medical records, test results and healthcare providers through a web portal called ""MyChart."" St. Elizabeth Healthcare also became the first and only healthcare system in Kentucky, Ohio or Indiana to pass Mayo Clinic's rigorous review process and become a member of the Mayo Clinic Care Network, a collaboration that allows physicians from St. Elizabeth Healthcare to consult with Mayo Clinic physicians, providing even better care to our patients. St. Elizabeth Healthcare has invested in our community for generations. St. Elizabeth Healthcare believes that reaching out to help the underprivileged and improving the overall health of the community is the foundation of its mission to provide comprehensive and compassionate care to our neighborhood and our families. It is because of this belief that the St. Elizabeth Healthcare community benefit program helps others have access to St. Elizabeth Healthcare resources and services. It is St. Elizabeth Healthcare's intention to always balance financial viability with compassionate care, and to stay true to its non-profit roots. During 2021 St. Elizabeth Healthcare had total admissions of 109,654; total patient visits of 235,577 and total emergency room visits of 187,073."

Schedule H, Part V, Section B, Line 5 Facility A, 1
Facility A, 1 - St. Elizabeth Healthcare - Florence, Edgewood, Grant & Ft. Thomas. DURING 2021, ST. ELIZABETH HEALTHCARE CONDUCTED ITS NEXT REQUIRED CHNA FOR YEARS 2022 -2023. In preparation for the 2021 CHNA, primary data was collected from persons who represent the broad interests of the community, including those with expertise in public health. Representation included area health departments, local governmental/civic agencies, other healthcare providers, community-based social service agencies and area school districts. The methodology used to collect the data included presentations to groups, phone calls and an online survey. The process included an explanation of the CHNA requirements and how the data garnered would be used to develop the CBIP. Participants were then asked to list in order from most important to least important what they believed were the top five community health needs that should be addressed and/or considered in the assessment. Concentrating on social service agencies, school districts and civic services ensured that the CHNA identified and received data on the most pressing health needs within the community served. The following is a listing of the community participants: Social Service Agencies: Batesville Food Pantry Brighton Center Butler Foundation (Corporex) Catholic Charities Center for Great Neighborhoods Children's Home of NKY Clearinghouse Community Foundation of Switzerland County Community Mental Health Center Dearborn Community Foundation Faith Community Pharmacy Franklin County Community Foundation Henry Hosea House Hispanic Community Advisory Committee Ida Spence Mission Life Learning Center LifeTime Resources New Horizons Rehabilitation, Inc. NKU NACU NKY Community Action Commission Pregnancy Care Center Rosedale Green Transitions United Way Greater Cincinnati Southeast Indiana Businesses: Absolute Web Design African American Chamber of Commerce Covington Business Council Maxwell Construction Company NKY Chamber of Commerce Northern Kentucky Area Development District Schools: Batesville Community Schools Bishop Brossart Campbell County Schools Community Christian Academy Covington Schools Erlanger-Elsmere Schools Franklin County Schools Grant County Schools Jac-Cen-Del Community Schools Kenton County Schools Ludlow Schools Milan Community Schools Rising Sun - Ohio County Schools South Dearborn Community Schools South Ripley Community Schools St. Lawrence Catholic School St. Nicholas School Sunman Dearborn Schools Switzerland County Schools Walton Verona Schools Health Depts: Dearborn County Health Dept NKY Health Dept Ripley County Health Dept Switzerland County Health Dept Three Rivers District Health Dept Civic Services: Boone County Detention Center Campbell County Detention Center Campbell County Fiscal Court Dearborn Circuit Clerk Dearborn County Commissioner Kenton County Detention Center NKY Area Development District Pendleton County Fiscal Court Cities: Batesville Bellevue Covington Crestview Hills Dillsboro Edgewood Fort Wright Greendale Southgate Union Williamstown First Responders: Alexandria Batesville Fire Bellevue/Dayton Fire Brookville Fire Covington Fire Dillsboro Police Dry Ridge Fire Edgewood Erlanger Fire/EMS Florence Florence Fire Franklin County Sheriff Gallatin Fire Grant County Sheriff Greendale Police Independence Kentucky State Police Kentucky State Police Kentucky State Police Lawrenceburg Police Ludlow Fire Pendleton County Fire Switzerland County Sheriff Villa Hills Walton Fire Wilder

Schedule H, Part V, Section B, Line 5 Facility A, 2
Facility A, 2 - ST. ELIZABETH DEARBORN. ST. ELIZABETH DEARBORN HAS ADOPTED ALL ST. ELIZABETH POLICIES INCLUDING FINANCIAL ASSISTANCE POLICY, BAD DEBT, MEDICARE, AND COLLECTION PRACTICES.

Schedule H, Part V, Section B, Line 6a Facility A, 1
Facility A, 1 - ST. ELIZABETH HEALTHCARE. ST. ELIZABETH - EDGEWOOD ST. ELIZABETH - FLORENCE ST. ELIZABETH - FT. THOMAS ST. ELIZABETH - GRANT COUNTY ST. ELIZABETH - DEARBORN

Schedule H, Part V, Section B, Line 11 Facility A, 1
"Facility A, 1 - St. Elizabeth Healthcare - Florence, Edgewood, Grant & Ft. Thomas. Prioritization of Identified Health Needs: Like many communities in Kentucky, heart disease, cancer, stroke, obesity, diabetes, mental health and substance abuse are prevalent in all of the NKADD counties. After the assessment data was gathered, it was summarized into categories and tabulated. The findings were presented to the System's Community Benefits Steering Committee for review and thoroughly discussed. The committee was tasked with ranking the community's most important health needs and providing suggestions for hospital priorities. Many of the needs listed are currently being addressed by St. Elizabeth Healthcare or community providers. A vote was taken to determine which of the needs identified should be addressed in the new Plan. The three top needs identified to be addressed were Mental Health, Drug Addiction/Treatment and Heart Disease. The prioritized list along with the assessment findings were presented to the Strategic Planning Committee of the Board for review, discussion and a combination of the identified priorities. This step in the CHNA process is significant because the priorities identified drive the development of an implementation strategy and the related goals. 2019 ACCOMPLISHMENTS TOWARDS THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT PLAN: Mental Health * Developed a comprehensive telemedicine system for therapy * Assisted Brighton Center with getting access to Vivitrol to treat patients * Added Behavioral Health specialists to 3 primary care offices * Convened and/or sponsored 9 community education events focused on depression and suicide awareness Substance Abuse * Implemented comprehensive opioid prescribing guidelines, tracking system, education and surveillance for all SEP prescribers * Developed a plan for a set of meaningful outcomes measures for the treatment of substance use disorder * Assisted NKY Regional Steering Committee with development of NKY Strategic Plan to address Substance Use Disorder (SUD) * Collaborated with state and local agencies and community partners to develop a continuum of care model for pregnant women with SUD 2020 ACCOMPLISHMENTS TOWARDS THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT PLAN: SUBSTANCE USE DISORDERS (SUD) * Referred 1,345 individuals to Journey Recovery Center * Provided 2 Medication Assisted Treatment Waiver trainings * Finalized an opioid stewardship committee to address pain management * Chemical Dependency Educators visited over 1,300 inpatients at our 5 hospital campuses Mental Health * Implemented the transition planning strategy developed in 2019 with SUN Behavorial Health assuring that new adult SEP patients upon discharge have access to aftercare * Supported 8 community education events through Activating Hope Collaborative * Placed 2 Nurse Practitioners at Brighton Women's Recovery Center Heart Disease * Provided 167 screening dates through the CardioVascular Mobile Health Unit * Reached 790 individuals through community education despite COVID restrictions * Provided tobacco cessation support to 94 individuals through the Fresh Start program Oncology * Provided 29 education/best-practice events to other healthcare organizations virtually and in person for the Lung Screening program * Provided 3,843 lung screenings to patients 2021 ACCOMPLISHMENTS TOWARDS THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT PLAN: Mental Health: * Supported 9 community agencies participating in the Activating Hope Collaborative. * Developed a comprehensive telemedicine system for therapy. * Increased Behavioral Health staff by 18 providers to deliver greater access to BH services. * Developed and posted 29 mental health education modules on the Activating Hope website for youth 7-12 grade, parents, and general consumers. Substance Use Disorders (SUD): * Implemented a comprehensive opioid prescribing policy for all St. Elizabeth Physicians' prescribers. * Developed and posted 25 primary SUD prevention/education modules for K-12 students and to the Activating Hope website. * Strengthened our recovery model by partnering with Life Learning Center (LLC) and planning to offer Journey Recover Center (JRC) services at the LLC location. * Referred 487 individuals to Baby Steps. * Chemical Dependency Educators visited over 1,750 inpatients at our 5 hospital campuses * Peer Recovery Coach meets patients who were consulted with SUD * Participate in the Dearborn CARE (Community Action Recovery Effort) program * Member of Dearborn County CASA which is a prevention coalition that are youth ambassadors who hold a youth summit for all 8th grade students in all the Dearborn County school districts which around 700 students participated * Established a free Narcan take home kit program for those with SUD * Member of the Dearborn County SOFR (Suicide and Overdose Fatality Review Team) Heart Disease: * Launched the ""Freedom from Smoking"" tobacco cessation program. * Provided 200 screening dates through the CardioVascular Mobile Health Unit. * Provided 33 education sessions in the community in both virtual and in-person formats regarding prevention and early recognition of cardiovascular disease. * Offered 14 Take Time for Your Heart prevention and wellness series. * Developed 18 60-second videos regarding the danger of vaping for use on social media platforms. Cancer: * Opened our 250,000 sq ft state-of-the-art Cancer Center on our Edgewood Campus. * Participated in multiple clinical trials for cancer treatment. * Provided 6,200 lung screenings to patients. * Provided 25,450 breast screenings to patients. * Provided 13,730 colon screenings to patients. * Completed site plans for new Cancer Center in Greendale, IN * Expanded Med-Onc services in Dearborn * Updated all imaging equipment in Dearborn Breast Center"

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
ST. ELIZABETH HEALTHCARE RECOGNIZES PATIENT SERVICE REVENUE AT THE TIME SERVICES ARE RENDERED FOR, EVEN THOUGH ST. ELIZABETH HEALTHCARE DOES NOT ASSESS THE PATIENT'S ABILITY TO PAY. AS A RESULT, THE PROVISION FOR BAD DEBTS AND CHARITY CARE ARE PRESENTED AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL PROVISIONS AND DISCOUNTS). ST. ELIZABETH HEALTHCARE RECOGNIZES REVENUE WHEN SERVICES ARE RENDERED FOR UNINSURED AND UNDERINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE. BASED ON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF ST. ELIZABETH HEALTHCARE'S UNINSURED AND UNDERINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES RENDERED. AS A RESULT, ST. ELIZABETH HEALTHCARE RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED AND UNDERINSURED PATIENTS IN THE PERIOD THE SERVICES ARE RENDERED. FOR FINANCIAL STATEMENT PURPOSES, ST. ELIZABETH HEALTHCARE HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ST. ELIZABETH HEALTHCARE'S FINANCIAL ASSISTANCE POLICY ON A GROSS BASIS.

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
THE ESTIMATED AMOUNT OF ST. ELIZABETH HEALTHCARE'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER ST. ELIZABETH HEALTHCARE'S FINANCIAL ASSISTANCE POLICY IS $2,863,983. THE PERCENTAGE OF BAD DEBTS THAT LIKELY COULD BE CHARITY CARE, IF ENOUGH INFORMATION WAS OBTAINED UP FRONT, WAS DEVELOPED WITH THE HELP OF OUR LARGEST COLLECTION AGENCY WHO HAS DETERMINED, BASED ON ACCOUNTS REVIEWED, WHO MAY NOT HAVE HAD THE FINANCIAL ABILITY TO PAY. ST. ELIZABETH HEALTHCARE ALSO BELIEVES THAT MANY PATIENTS FALL INTO THE CATEGORY WHERE THEY DO NOT MEET THE FEDERAL POVERTY GUIDELINES BUT YET CANNOT AFFORD THE COST OF THE SERVICES RENDERED, OR HAVE INSURANCE THAT MAY NOT COVER THE COST OF SERVICES. THEREFORE, ST. ELIZABETH HEALTHCARE BELIEVES THESE NON REIMBURSED COSTS SHOULD BE COUNTED AS A BENEFIT TO THE COMMUNITY WE SERVE. THE AMERICAN HOSPITAL ASSOCIATION'S POSITION IS THAT BAD DEBTS SHOULD BE COUNTED AS A COMMUNITY BENEFIT

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
Patient accounts are reported at the net consideration in which St. Elizabeth Healthcare expects to be entitled to in exchange for providing patient care. The portfolio approach is used to determine the reduction to accounts receivables based upon the historical collection experience of St. Elizabeth Healthcare adjusted for current environmental risks and trends for each major payor source. Amounts recognized are subject to adjustment upon review by third-party payors. Significant price concessions are made for self-pay patient accounts in the period of service based on past collection experience and are reported at the net amount St. Elizabeth Healthcare expects to collect. St. Elizabeth Healthcare recognizes patient service revenue at the time in which performance obligations are satisfied. These amounts are due from patient, third-party payers, (including managed care and governmental programs), and others are subject to contractual adjustments, discounts and implicit price concessions. Patient service revenue is reported at the net consideration in which St. Elizabeth Healthcare expects to be entitled to in exchange for providing patient care. Settlements are recorded on an estimated basis in the period the related services are rendered and adjusted in future periods based upon additional information, filed cost reports, interim settlements, and final settlements. St. Elizabeth Healthcare recognizes patient service revenue at the time services are rendered even though they do not assess the patient's ability to pay. As a result, implicit price concessions are presented as a deduction from patient service revenue (net of contractual provisions and discounts). Amounts determined to qualify as charity care are not reported as patient service revenue. For uninsured and underinsured patients that do not qualify for charity care, St. Elizabeth Healthcare recognizes revenue when services are provided. Based on historical experience, a significant portion of St. Elizabeth Healthcare's uninsured and underinsured patients will be unable or unwilling to pay for the services provided. Thus, St. Elizabeth Healthcare records significant implicit price concessions related to uninsured and underinsured patients in the period the services are provided.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
ST. ELIZABETH HEALTHCARE USES THE STEP DOWN METHODOLOGY TO DETERMINE COSTS FOR MEDICARE. THE REPORTS WERE THEN COMPLETED BY FOLLOWING THE GUIDANCE PROVIDED IN THE INSTRUCTIONS FOR PART III. ST. ELIZABETH HEALTHCARE BELIEVES MEDICARE LOSSES SHOULD BE AN ALLOWABLE COMMUNITY BENEFIT. ST. ELIZABETH HEALTHCARE PROVIDES NEEDED SERVICES TO THE ELDERLY AND DISABLED MEDICARE POPULATION AT A FINANCIAL LOSS TO ST. ELIZABETH HEALTHCARE TO HELP THOSE INDIVIDUALS GET THE CARE THEY NEED IN THE COMMUNITY WE SERVE. THE AMERICAN HOSPITAL ASSOCIATION'S POSITION IS ALSO THAT MEDICARE LOSSES SHOULD BE COUNTED AS COMMUNITY BENEFIT.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
ST. ELIZABETH HEALTHCARE HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, CERTAIN COLLECTION PRACTICES DO NOT APPLY.

Schedule H, Part V, Section B, Line 16a FAP website
A - ST. ELIZABETH FLORENCE: Line 16a URL: https://www.stelizabeth.com/care/pay-my-bill;

Schedule H, Part V, Section B, Line 16b FAP Application website
A - ST. ELIZABETH FLORENCE: Line 16b URL: https://www.stelizabeth.com/care/pay-my-bill;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
A - ST. ELIZABETH FLORENCE: Line 16c URL: https://www.stelizabeth.com/care/pay-my-bill;

Schedule H, Part VI, Line 7 State filing of community benefit report
KY

Schedule H, Part VI, Line 2 Needs assessment
"IN 2021, ST. ELIZABETH HEALTHCARE CONTINUED TO WORK WITH THE NORTHERN KENTUCKY HEROIN IMPACT TASK FORCE TO ADDRESS THE HEROIN EPIDEMIC, ALSO PROVIDING FINANCIAL SUPPORT FOR THE HEROIN HOTLINE. THIS INCLUDED PROVIDING DATA AND SUPPORT TO THE STATE OF KENTUCKY LEGISLATURE TO ENACT NEW LEGISLATION DIRECTED TOWARDS EXPANDING TREATMENT. IN ADDITION, ST. ELIZABETH HEALTHCARE DEVELOPED AN INTERNAL WORKGROUP FOCUSED ON ENHANCING PREVENTION AND PROVIDING TREATMENT FOR THE COMMUNITIES IT SERVES. IN 2021, ST. ELIZABETH HEALTHCARE CONTINUED TO COLLABORATE WITH PHYSICIANS AND THE NORTHERN KENTUCKY HEALTH DEPARTMENT TO ENSURE EMERGENCY PREPAREDNESS MEASURES WERE IN PLACE SHOULD ANY MEMBER OF THE COMMUNITY (PATIENT, RESIDENT, AND/OR VISITOR) EXHIBIT SYMPTOMS OF EBOLA. PREPAREDNESS MEASURES INCLUDED (I) FOLLOWING PROTOCOLS FOR REVIEWING ST. ELIZABETH HEALTHCARE'S INFECTION CONTROL POLICIES AND PROCEDURES, (II) PROVIDING PERSONAL PROTECTIVE EQUIPMENT, AND (III) PROVIDING TRAINING AND EDUCATION TO STAFF MEMBERS, WHICH INCLUDED CONSTRUCTING A SIMULATION ROOM FOR TRAINING EXERCISES AND A SPECIALIZED EBOLA RESPONSE TEAM WAS ORGANIZED. IN 2021, ST. ELIZABETH HEALTHCARE CONTINUED TO SUPPORT A PERTUSSIS COCOONING PROJECT TO HELP PREVENT THE DEADLY EFFECTS OF INFANT PERTUSSIS BY SURROUNDING INFANTS WITH A PROTECTIVE ""COCOON"" AND IMMUNIZED MOTHERS, FAMILY MEMBERS, AND CAREGIVERS. PERTUSSIS, ALSO KNOWN AS WHOOPING COUGH, IS A HIGHLY CONTAGIOUS RESPIRATORY DISEASE CAUSED BY THE BORDETELLA PERTUSSIS BACTERIUM. WHOOPING COUGH IS KNOWN FOR CONTROLLABLE, VIOLENT COUGHING WHICH OFTEN MAKES IT HARD FOR INFANTS TO BREATHE. IN 2021, ST. ELIZABETH HEALTHCARE CONTINUED TO PROVIDE THE PATIENT AND FAMILY ADVISORY COUNCIL (PAFAC), WHICH MEETS EVERY TWO (2) MONTHS TO IDENTIFY NEEDS OF THE COMMUNITY BASED ON THE FEEDBACK OBTAINED FROM OUR PATIENTS AND FAMILY MEMBERS. CONTINUOUSLY, ST. ELIZABETH EVALUATES DATA FROM SOURCES SUCH AS OUR PATIENT SATISFACTION AND COMMUNITY HEALTH SURVEYS TO IDENTIFY THE NEEDS OF OUR COMMUNITY FOR THE PEOPLE WE SERVE."

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
"THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED ON ST. ELIZABETH HEALTHCARE'S WEB SITE. A WRITTEN COPY IS ALSO INCLUDED IN THE PATIENT HANDBOOK PROVIDED TO INPATIENT ADMISSIONS. A NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR QUALIFYING INDIVIDUALS ON THE PATIENT BILLS. FINANCIAL COUNSELORS ARE AVAILABLE TO ASSIST PATIENTS TO DETERMINE QUALIFICATION AND A COPY OF THE POLICY IS AVAILABLE TO PATIENTS UPON REQUEST. PATIENT FINANCIAL ASSISTANCE PROGRAM INFORMATION IS POSTED AT EACH SITE (THERE IS A FRAMED SIGN POSTED IN SPANISH AND ENGLISH) -IN ADDITION, THERE IS A 1-PAGE DESCRIPTION OF OUR FINANCIAL ASSISTANCE PROGRAM THAT IS ATTACHED TO THE ""PATIENT RIGHTS AND RESPONSIBILITIES"" DOCUMENT, AND ALL PATIENTS ARE GIVEN THESE DOCUMENTS UPON REGISTRATION. -IF A PATIENT DOES NOT HAVE INSURANCE, THEY ARE ALSO OFFERED AN APPLICATION PACKET FOR FINANCIAL ASSISTANCE. PATIENTS ARE NOTIFIED OF THEIR FINANCIAL RESPONSIBILITY -THE PATIENT RIGHTS AND RESPONSIBILITIES DOCUMENT GIVEN TO ALL PATIENTS STATES THEY HAVE A RESPONSIBILITY TO ""PROVIDE NECESSARY FINANCIAL INFORMATION TO ASSURE ACCURATE BILLING AND MEET FINANCIAL COMMITMENTS."" -THE FINANCIAL ASSISTANCE PLAN DOCUMENT THEY ARE GIVEN PROVIDES DETAILED INFORMATION ON ELIGIBLE FINANCIAL AID SERVICES, AND ALSO STATES THAT ""FINANCIAL ASSISTANCE IS NOT CONSIDERED AN ALTERNATIVE OPTION TO PAYMENT, AND PATIENTS MAY BE ASSISTED IN FINDING OTHER MEANS OF PAYMENT FOR FINANCIAL ASSISTANCE BEFORE APPROVAL FOR ST. ELIZABETH FINANCIAL ASSISTANCE PROGRAM."""

Schedule H, Part VI, Line 4 Community information
ST. ELIZABETH HEALTHCARE SERVES THE NORTHERN KENTUCKY COUNTIES, WHICH INCLUDE: BOONE, BRACKEN, CAMPBELL, CARROLL, GALLATIN, GRANT, HARRISON, KENTON, MASON, OWEN, PENDLETON, ROBERTSON, AND SOUTHEASTERN INDIANA COUNTIES: DEARBORN, FRANKLIN, RIPLEY, OHIO, AND SWITZERLAND. THESE SERVICE AREAS INCLUDE URBAN, SUBURBAN, AND RURAL AREAS. THE TOTAL POPULATION OF THE SERVICE AREAS IS OVER 580,000. ST. ELIZABETH HEALTHCARE'S PRIMARY SERVICE AREAS DURING 2021 WAS DETERMINED BY IDENTIFYING WHERE 90% OF ITS PATIENT POPULATION ORIGINATES. THIS APPROACH ENSURES THAT THE ASSESSMENT WAS NOT LIMITED TO CERTAIN GEOGRAPHIC AREAS BUT INCLUDED THE MAJORITY OF THE POPULATION SERVED. THE DATA REVEALED THAT 90.9% OF THE PATIENT POPULATION RESIDES IN THE COUNTIES THAT MAKE UP THE NORTHERN KENTUCKY AREA DEVELOPMENT DISTRICT (NKADD). THE NKADD ENCOMPASSES THE COUNTIES OF BOONE, CAMPBELL, CARROLL, GALLATIN, GRANT, KENTON, OWEN AND PENDLETON, AND REPRESENTS OVER 464,000 RESIDENTS. WITH THE EXCEPTION OF ST. ELIZABETH DEARBORN, ALL OTHER HOSPITALS IN THE ST. ELIZABETH HEALTHCARE SYSTEM ARE LOCATED IN THIS REGION. THE PRIMARY SERVICE AREAS ARE PREDOMINANTLY NORTHERN KENTUCKY AND SOUTHEAST INDIANA. POPULATION BY ORIGIN: 93.35% WHITE, 1.65% BLACK, 2.75% HISPANIC, 0.73% ASIAN, 0.13% NATIVE HAWAIIAN AND OTHER PACIFIC ISLANDER, 0.35% AMERICAN INDIAN AND ALASKA NATIVE, 1.55% OTHER. POPULATION BY AGE: UNDER 5 ; 5.92%; UNDER 18; 23.22%; 19-64; 59.01%; 65+; 17.77% (SOURCE: WWW.CENSUS.GOV/QUICKFACTS). PERSONS BELOW POVERTY LEVEL IN NKY, ALL AGES: 10.22% DUE TO THE ENACTMENT OF THE AFFORDABLE CARE ACT, IT IS ESTIMATED THAT APPROXIMATELY 6.04% OF THE NORTHERN KENTUCKY AND SOUTHEASTERN INDIANA POPULATION OVER AGE 65 REMAINS UNINSURED . THE POVERTY LEVEL OF THE REGION IS AS FOLLOWS: CARROLL COUNTY - 16.2%, OWEN COUNTY - 15.10%, GRANT COUNTY - 12.8%, CAMPBELL COUNTY - 10.6%, KENTON COUNTY - 11.0%, BOONE COUNTY - 6.5%, GALLATIN COUNTY - 13.3%, PENDLETON COUNTY - 13.6%, DEARBORN COUNTY - 7.8%, FRANKLIN COUNTY - 7.7%, RIPLEY COUNTY - 9.5%, SWITZERLAND COUNTY - 14.0%, OHIO COUNTY - 9.8%. THERE ARE SIX (6) OTHER HOSPITALS THAT SERVE THE NORTHERN KENTUCKY COMMUNITY. 1. GATEWAY REHABILITATION HOSPITAL IN BOONE COUNTY, 2. CARROLL COUNTY MEMORIAL HOSPITAL IN CARROLL COUNTY, 3. HARRISON MEMORIAL HOSPITAL IN HARRISON COUNTY, 4. ENCOMPASS REHABILITATION HOSPITAL IN KENTON COUNTY, 5. MEADOWVIEW REGIONAL MEDICAL CENTER IN MASON COUNTY, AND 6. SUN BEHAVORIAL HEALTH IN ERLANGER. THERE IS ONE (1) OTHER HOSPITAL THAT SERVES THE SOUTHERN INDIANA COMMUNITY - MARGARET MARY HEALTH HOSPITAL IN RIPLEY COUNTY. THERE ARE A NUMBER OF HOSPITALS THAT SERVE THE SOUTHERN OHIO COMMUNITY, INCLUDING; THE CHRIST HOSPITAL, TRIHEALTH, MERCY HEALTH, AND THE UNIVERSITY OF CINCINNATI MEDICAL CENTER. THERE ARE A FEW FEDERALLY DESIGNATED - MEDICALLY UNDERSERVED AREAS OR POPULATIONS IN THE COMMUNITIES.

Schedule H, Part VI, Line 5 Promotion of community health
ST. ELIZABETH HEALTHCARE FURTHERS ITS EXEMPT PURPOSES IN IMPROVING COMMUNITY HEALTH STATUS BY: 1) ENCOURAGING AND SUPPORTING STAFF TO PARTICIPATE ON VARIOUS COMMUNITY BOARDS/ACTIVITIES THAT SUPPORT AND/OR DEVELOP PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS AND WORKFORCE DEVELOPMENT. 2) ST. ELIZABETH HEALTHCARE'S BOARD OF TRUSTEES IS MADE UP OF COMMUNITY REPRESENTATIVES TO ENSURE THAT ST. ELIZABETH HEALTHCARE ADHERES TO ITS MISSION TO IMPROVE THE HEALTH OF THE PEOPLE WE SERVE. THE MAJORITY OF THE GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE WITHIN ST. ELIZABETH'S PRIMARY SERVICE AREA. ST. ELIZABETH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. 3) THROUGH ITS PRIMEWISE SENIOR SERVICES FOR AGE 50+ PERSONS, ST. ELIZABETH HEALTHCARE SUBSIDIZES COURSE OFFERINGS TO SENIOR CITIZENS INCLUDING DRIVER'S SAFETY, LOW IMPACT EXERCISE, COMPUTER SKILLS, MEDICATION REVIEW AND HEALTH SCREENINGS, ALONG WITH PROVIDING LITERATURE PERTINENT TO THIS AGE GROUP. 4) Each year, St. Elizabeth Healthcare produces and distributes more than 600,000 different pieces of health-related information or invitations to health-related educational events throughout the community - which is an average of nearly 4 pieces of information per Northern Kentucky household. 5) PERIODICALLY, ST. ELIZABETH HEALTHCARE WILL PARTNER WITH COMMUNITY ORGANIZATIONS AND BUSINESS AGENCIES TO PRESENT HEALTH RELATED PROGRAMS AND HEALTH SCREENINGS. 6) ST. ELIZABETH APPLIES SURPLUS FUNDS TO IMPROVE PATIENT CARE BY IMPROVING FACILITIES, ACCESS TO CARE, TECHNOLOGY, RECRUITING AND RETAINING TOP TALENT, AND CONTINUING EDUCATION OF OUR STAFF THROUGH EITHER RESIDENCY OR COLLEGE EDUCATIONAL PROGRAMS. EXAMPLES OF HOW SURPLUS FUNDS WERE APPLIED IN 2021 ARE AS FOLLOWS: A) ST. ELIZABETH HEALTHCARE CONTINUES TO PARTNER WITH THE MAYO CLINIC CARE NETWORK TO ENHANCE THE QUALITY OF CARE AND IMPROVE THE ACCESS FOR THE PEOPLE WE SERVE TO THE MAYO CLINIC'S SPECIALISTS AND PROTOCOLS. B) ST. ELIZABETH HEALTHCARE PROVIDED OUTREACH TO THE COMMUNITIES THROUGH THE MOBILE MAMMOGRAPHY AND MOBILE HEART PROGRAMS. C) ST. ELIZABETH HEALTHCARE PROVIDED COHORT EDUCATIONAL PROGRAMS WITH THE NORTHERN KENTUCKY UNIVERSITY (NKU), THOMAS MORE UNIVERSITY (TMU), AND MT. SAINT JOSEPH UNIVERSITY (MSJU) TO PROVIDE FOR CONTINUING AND/OR ADDITIONAL EDUCATION FOR OUR STAFF. D) THE CONTINUED FINANCIAL ASSISTANCE AND SUPPORT FOR THE FAMILY PRACTICE RESIDENCY PROGRAM WHICH IS COMPRISED OF TWENTY-FOUR (24) FAMILY PRACTICE RESIDENTS WHO LIVE AND STAY IN THE COMMUNITY TO IMPROVE AND ENHANCE THE ACCESS TO PRIMARY CARE FOR THE PEOPLE WE SERVE. E) ST. ELIZABETH HEALTHCARE CONTINUES FINANCIAL SUPPORT FOR OUR PARISH NURSING PROGRAM WHICH PROVIDES OUTREACH, EDUCATION, AND PREVENTION INFORMATION TO OVER EIGHTY-ONE (81) CHURCHES AND NINE (9) COMMUNITY SITES. F) ST. ELIZABETH HEALTHCARE CONTINUES FINANCIAL SUPPORT FOR PREVENTION AND INJURY TREATMENT FOR ATHLETES ATTENDING SCHOOLS IN OUR COMMUNITIES. G) ST. ELIZABETH HEALTHCARE SPONSORS COMMUNITY BENEFITS TO ADDRESS THE HEALTHCARE NEEDS FOR DISEASES SUCH AS OBESITY, DIABETES, AND HEART DISEASE FOR THE PEOPLE WE SERVE. H) ST. ELIZABETH PHYSICIANS PRIMARY CARE PROVIDED ENHANCED SERVICES FOR EDUCATION AND RESOURCES TO THOSE IN THE COMMUNITY WE SERVE WHO STRUGGLE WITH OBESITY AND ENSUING CO-MORBIDITIES.

Schedule H, Part VI, Line 6 Affiliated health care system
ST. ELIZABETH HEALTHCARE IS A SYSTEM THAT FEATURES FIVE (5) FACILITIES THROUGHOUT NORTHERN KENTUCKY WHICH ARE: (I) ST. ELIZABETH - EDGEWOOD; (II) ST. ELIZABETH - FLORENCE; (III) ST. ELIZABETH - FORT THOMAS; (IV) ST. ELIZABETH - GRANT (V) ST. ELIZABETH - COVINGTON; PLUS ST. ELIZABETH - DEARBORN IN SOUTHEAST INDIANA. EACH OF THESE FACILITIES ADDRESSES THE SPECIFIC NEEDS OF ITS LOCALE AS IDENTIFIED BY THE PATIENTS IN THE COMMUNITY. THE SERVICE AREAS VARY FROM RURAL AREAS TO SUBURBAN AREAS TO URBAN AREAS. ST. ELIZABETH HEALTHCARE OFFERS OVER 1,190 LICENSED BEDS, OVER 9,900 EMPLOYEES , 756 PHYSICIAN PROVIDERS WITH FULL ADMITTING PRIVILEGES AND A WHOLLY OWNED PHYSICIAN ORGANIZATION (SEP) WHICH INCLUDES OVER 146 PRIMARY CARE AND SPECIALTY OFFICE LOCATIONS. ST. ELIZABETH HEALTHCARE IS SPONSORED BY THE DIOCESE OF COVINGTON