4A (Expenses $ 2783780610 including grants of $ 8655265) (Revenue $ 3403605272)
See Schedule O

Part V, Section B
Facility Reporting Group A

Facility Reporting Group A consists of:
- Facility 1: Baptist Health Lexington, - Facility 2: Baptist Health Louisville, - Facility 3: Baptist Health Hardin, - Facility 4: Baptist Health Paducah, - Facility 5: Baptist Health Floyd, - Facility 6: Baptist Health Corbin, - Facility 7: Baptist Health La Grange, - Facility 8: Baptist Health Richmond

Group A-Facility 1 -- Baptist Health Lexington Part V, Section B, line 5:
The Baptist Health Lexington CHNA committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. There are numerous health departments in the Baptist Health Lexington service area responsible for the counties Baptist Health Lexington serves. Each health department's community improvement plan was evaluated by the CHNA committee and those initiatives were considered throughout the process of determining the goals for the Baptist Health Lexington Community Health Needs Assessment. The committee also solicited public opinion on community health needs using a survey distributed via social media, on the Baptist Health Lexington website and via email to Baptist Health Lexington patients. Survey responses, coupled with the information from the respective health departments, were considered as primary data. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health Lexington's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health Lexington should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 1 -- Baptist Health Lexington Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health Lexington can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. The CHNA committee ranked substance abuse as their first priority in terms of public health issues. Opioid abuse has become an epidemic across the country and locally we are seeing a similar surge of opioid usage admissions and emergency room visits. Opioid abuse has a significant impact on overall health and can lead to other co-morbidities. In addition, the service area is seeing steady occurrences of drug-addicted newborns that must be sent to neonatal intensive care units to treat withdrawal symptoms. We are working to reduce the number of opioids prescribed by physicians and educating our nursing staff on opioid utilization. We will actively engage in community education partnerships, such as working with Voices of Hope, community Opioid Awareness Day and other local agencies to assist in educating the community. Expanding access to substance abuse services throughout the community and reducing the stigma surrounding treatment are important steps to mitigating this public health crisis.As cancer continues to be a leading cause of death in this service area, the committee ranked it as their second priority in terms of public health issues. The committee acknowledged the continued need for board-certified oncologists and easier access to cancer-related services such as chemotherapy and radiation therapy, as well as improved access to preventative screenings. Construction is underway on the first phase of Baptist Health Hamburg, a new campus that will include a cancer center, a comprehensive diagnostic center and a multistory physician office complex. This state-of-the-art facility is scheduled to open during 2024. The goal is to provide convenient access to additional healthcare services for those who live near the growing Hamburg area and in surrounding counties. Early diagnosis and expanded treatment options will help to mitigate the impact of cancer on our community.The committee's third priority was cardiovascular disease, which encompasses coronary artery disease, heart attack, arrhythmias, heart failure, cardiomyopathy and vascular disease. A focus on education, prevention and treatment will be a priority as the goal is to expand public awareness of disease root causes and commonly associated conditions to increase compliance with standard-of-care protocols and to decrease the occurrence of these health issues.It is not within the scope of Baptist Health Lexington's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health Lexington works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 1 -- Baptist Health Lexington Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 1 -- Baptist Health Lexington Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Group A-Facility 2 -- Baptist Health Louisville Part V, Section B, line 5:
The Baptist Health Louisville CHNA committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. There are four health departments responsible for the counties Baptist Health Louisville serves: Louisville Metro Public Health & Wellness (Jefferson County); the Bullitt County Health Department; the Oldham County Public Health Department and the North Central District Health Department, which serves both Shelby and Spencer counties. The Louisville Metro Public Health & Wellness Health Equity Report 2017 proved to be a valuable resource of primary data for the committee. Several members of the Baptist Health Louisville leadership team serve on committees and boards throughout the community including Hospice/Hosparus, the Center for Women and Families, Leadership Louisville and various school boards, which provided additional sources of data. Baptist Health Louisville solicited public opinion information on community health needs using a survey distributed via social media, through the Baptist Health Louisville website and via email to Baptist Health Louisville patients. Through these contacts, data resources and public surveys, Baptist Health Louisville gained valuable information regarding the current health issues confronting its service area. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health Louisville's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health Louisville should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 2 -- Baptist Health Louisville Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health Louisville can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. Based upon the data collected and analyzed through this assessment, the CHNA committee identified the following as the primary health issues that the hospital will focus on over the next three years: mental health services; health equity - heart disease; preventative health screening and opioid reduction.Mental health illnesses and the related health effects on individuals and families was the consensus among the committee as the most pressing community concern. Mental illness has a significant impact on overall health and well-being, and can contribute to other health issues such as obesity and substance abuse disorders. Comparing primary data from the survey conducted in 2018 to the results of the survey in 2021 did highlight areas of concern, as there were noted increases in the number of people who have been directly impacted by mental health illnesses and opioid use. The committee members discussed the services Baptist Health Louisville already provides as well as goals to improve access for outpatient mental health wellness programs. To drive improved quality outcomes for our patients, Baptist Health recognizes the importance of integrating behavioral health care into all aspects of care. We also realize the importance of reducing the stigma of seeking behavioral health care services. As a result, we are expanding access and creating new avenues for people to receive care. These efforts include a network of providers who will work in collaboration with our treatment team and a Virtual Care hub for behavioral health that provides services to nearly 50 primary care locations. By the end of fiscal year 2022-23, these services will be embedded into every Baptist Health Medical Group primary care location. Additional behavioral health risk assessment tools, expanded treatment options and the combined efforts of medical professionals, schools, churches and government agencies will contribute to our success in reducing the stigma around mental health care and educating and engaging individuals to seek better care for themselves and their loved ones. Eliminating health disparities that exist for heart health care was identified as the second priority in the CHNA. Kentucky has some of the highest rates in the nation for preventable health conditions and for behaviors that have been identified as unhealthy. Improved access to preventable health screenings via online tools and through collaborations with community partners will help achieve greater heart health equity in our communities. Opioid abuse has become an epidemic across the country and locally we are seeing a similar surge of opioid usage admissions, emergency room visits and drug-addicted newborns who must be sent to neonatal intensive care units to treat withdrawal symptoms. Opioid abuse has a significant negative impact on overall health and can lead to other co-morbidities. Comparing 2018 to 2021 survey results showed a 20% increase in the number of survey respondents who have been directly impacted, or know someone who has been directly impacted, by opioid abuse. All of these factors support increased efforts to reduce the number of opioids reaching the streets and the continued community-wide initiatives to combat the disease of addiction. Our providers will continue to monitor health trends to ensure compliance with best practices for prescribing opioids and continue to educate patients and family members on the warning signs and dangers of addiction as well as available treatment options. It is not within the scope of Baptist Health Louisville's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health Louisville works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 2 -- Baptist Health Louisville Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 2 -- Baptist Health Louisville Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Group A-Facility 4 -- Baptist Health Paducah Part V, Section B, line 5:
The Baptist Health Paducah CHNA committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. This is the fourth Community Health Needs Assessment conducted by Baptist Health Paducah. This CHNA builds on the research and action plans of the first through third assessments. The service area has been expanded from one county (McCracken) in the first assessment to seven counties in Kentucky and one in Illinois to better identify the needs of the expanded community Baptist Health Paducah serves. The Purchase Area Health Connections Coalition, established several years ago, continues to meet on a regular basis. This group is comprised of representatives from the Purchase District Health Department, which serves Ballard, Carlisle, Fulton, Hickman and McCracken counties in the Purchase Area Development District and the following organizations: the City of Paducah; the UK County Extension Offices; the United Way of Paducah-McCracken County; Murray Calloway County Hospital Four Rivers Behavioral Health; Murray State University; West Kentucky Community & Technical College; KentuckyCare; the Purchase Area Health Education Center; Mercy Health and Baptist Health Paducah. Bringing these groups together promotes unity in our mission and helps to avoid any duplication of efforts in data collection and resource allocation. A survey was sent to community leaders and another was widely publicized and available to the general community both in paper form and through the hospital website. Primary data and feedback on the health issues confronting our service area was collected through the surveys and through engagement with the Purchase Area Health Connections Coalition. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health Paducah's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health Paducah should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 4 -- Baptist Health Paducah Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health Paducah can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. After studying the primary and secondary data, the committee prioritized the three most prevalent community health issues based on their severity and on the ability of Baptist Health Paducah and its partners to help improve them. Access to healthcare, the prevention of obesity and related illnesses and the prevention and treatment of mental health and substance abuse were the most prevalent community health concerns.The main health priority identified was ample access to health care. The ability of individuals in a community to access healthcare resources to preserve and improve health is essential. Access to healthcare has an immediate impact on overall health status, the prevention of disease, quality of life and life expectancy. Access to care issues include all potential barriers to receiving necessary healthcare services. These barriers include financial difficulties, lack of knowledge, transportation difficulties, physician shortages, service distribution and scheduling issues. By improving access to care, whether by increasing service locations, reducing cost options, expanding hours of operations or offering new services and innovative programs, the overall health of the community will improve. Baptist Health Paducah has the potential to affect all of these areas. Baptist Health Paducah and Four Rivers Behavioral Health collaborate to provide school clinics with primary care services and mental health care services for students, faculty, staff, parents and siblings of pupils. These clinics ensure the delivery of quality care on many levels, effectively reducing the spread of illnesses in our community and providing access to quality mental health care for persons challenged with difficult circumstances. Baptist Health Paducah will strive to ensure service area residents have sufficient access to health care services through primary care and specialist physician planning and conveniently located physician offices and ambulatory care facilities. New and expanded health services; school clinics; the hospital's call center; education resources and healthcare screenings will also help improve access to care.Obesity and related illness prevention continue to be primary health concerns in our community. To increase the awareness of obesity as a health threat to our service area residents and to encourage healthier living through diet, exercise and other means remains a top priority. Obesity can cause serious health problems, including Type 2 diabetes, heart disease, high cholesterol, high blood pressure, asthma, osteoarthritis and several forms of cancer. Failing to diminish obesity in the community will lead to higher mortality rates, increased healthcare costs and a decrease in the quality of life for families in our community. The hospital is providing resources to meet this need through its bariatric surgery and metabolic disease management programs, Project Fit America and GoNoodle fitness programs in area schools, and internal programs to improve employees' health. The hospital has collaborated with numerous local agencies to develop the Pat & Jim Brockenborough Rotary Health Park and to implement the CATCH (Coordinated Approach to Child Health) program in Paducah schools.Mental Health and Substance Abuse prevention and treatment continue to be a top health need in our community. Baptist Health Paducah does not have a behavioral health program either on an inpatient or outpatient basis; however, the hospital works with Four Rivers Behavioral Health, a private, not-for-profit agency providing comprehensive, integrated mental health, substance abuse and developmental disability care services to residents in our service area. To drive improved quality outcomes for our patients, Baptist Health recognizes the importance of integrating behavioral health care into all aspects of care. We also realize the importance of reducing the stigma of seeking behavioral health care services. As a result, we are expanding access and creating new avenues for people to receive care. These efforts include a network of providers who will work in collaboration with our treatment team and a Virtual Care hub for behavioral health that provides services to nearly 50 primary care locations. By the end of fiscal year 2022-23, these services will be embedded into every Baptist Health Medical Group primary care location.The use of illicit drugs or the abuse of prescription or over-the-counter medications for purposes other than those for which they are intended, or in a manner or in quantities other than directed, is a growing problem in the service area. In spite of not having the resources other agencies have to address substance abuse directly, Baptist Health Paducah works to meet the needs of the community in ways that support the efforts of other agencies and care facilities. The annual Addiction Symposium focuses on training clinicians on the physical and mental health issues surrounding addiction. The educational program has been a catalyst to provide caregivers with an increased knowledge of the disease of addiction and the care and resources available for those suffering from this disease.It is not within the scope of Baptist Health Paducah's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health Paducah works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 4 -- Baptist Health Paducah Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 4 -- Baptist Health Paducah Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Group A-Facility 5 -- Baptist Health Floyd Part V, Section B, line 5:
The Baptist Health Floyd CHNA committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. The CHNA committee worked with the New Albany Floyd County School System and the six health departments responsible for the counties Baptist Health Floyd serves: the Clark County Health Department; the Crawford County Health Department; the Floyd County Health Department; the Harrison County Health Department; the Scott County Health Department and the Washington County Health Department. The committee also solicited public opinion on community health needs using a survey distributed via social media and through the Baptist Health Floyd website. Through these contacts, consultations with other community agencies, public surveys and focus groups, Baptist Health Floyd solicited primary feedback on the health issues confronting its service area. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Indiana vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health Floyd's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health Floyd should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 5 -- Baptist Health Floyd Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health Floyd can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. Community discussions and survey responses identified multiple community needs that were ranked based on the following criteria: magnitude, severity, opportunity to intervene at a prevention level, degree of success in affecting the problem and resources available. The top four community health priorities that were identified are as follows: Cardiovascular disease; mental health; social determinants of health, (food security, transportation and housing) and substance abuse disorders. The committee's highest priority health need was cardiovascular disease, which encompasses coronary artery disease, heart attack, arrhythmias, heart failure, cardiomyopathy and vascular disease. Mortality rates for coronary heart disease are high in several of our communities compared to state and national statistics. Strategies to address the prevention of cardiovascular disease include the promotion of positive behaviors and an active lifestyle, community-wide screenings to educate residents on their risk of cardiovascular disease and sufficient access to healthcare providers. A focus on education, prevention and treatment will be a priority as the goal is to expand public awareness of disease root causes and commonly associated conditions to increase compliance with standard-of-care protocols and to decrease the occurrence of these health issues.Mental health illnesses and the related health effects on individuals and families was the second most prevalent community health need. Mental illness has a significant impact on overall health and well-being, and can contribute to other health issues such as obesity and substance abuse disorders. There are significant increases in the number of people in our communities who have been directly impacted by mental health illnesses and substance abuse. The committee discussed enhanced engagement with Indiana's System of Care, (SOC), county governments and school systems to improve access to, and the quality of, behavioral and mental health services for the youth and families in our community. Additional behavioral health risk assessment tools, expanded treatment options and the combined efforts of medical professionals, schools, churches and government agencies will contribute to our success in reducing the stigma around mental health and substance abuse care and educating and engaging individuals to better care for themselves and their loved ones. To drive improved quality outcomes for our patients, Baptist Health recognizes the importance of integrating behavioral health care into all aspects of care. We also realize the importance of reducing the stigma of seeking behavioral health care services. As a result, we are expanding access and creating new avenues for people to receive care. These efforts include a network of providers who will work in collaboration with our treatment team and a Virtual Care hub for behavioral health that provides services to nearly 50 primary care locations. By the end of fiscal year 2022-23, these services will be embedded into every Baptist Health Medical Group primary care location.Eliminating health disparities that exist for social determinants of health, (food security, transportation and housing) was identified as the third priority in the CHNA. Indiana has some of the highest rates in the nation for preventable health conditions and for behaviors that have been identified as unhealthy. The ability of individuals in a community to access health care resources to preserve and improve health is essential. Improved access to preventable health screenings via online tools and through collaborations with community partners will help achieve greater health equity in our communities. The reduction of the risk of chronic diseases and the promotion of a healthy and active lifestyle will help reduce the effects of countless health issues in our communities. One of our goals is to help improve Floyd County residents' access to healthy food and nutrition and to increase health education. Screening tools used to identify food insecurity for Baptist Health Floyd patients and community nutrition and cooking classes will help to promote healthier lifestyles. Reducing the number of patients that do not receive care due to a lack of reliable transportation will help reduce the spread of illness throughout the community. It is not within the scope of Baptist Health Floyd's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health Floyd works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Indiana Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 5 -- Baptist Health Floyd Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 5 -- Baptist Health Floyd Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Group A-Facility 6 -- Baptist Health Corbin Part V, Section B, line 5:
The Baptist Health Corbin CHNA committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. There are numerous health departments in the Baptist Health Corbin service area responsible for the counties we serve. The committee evaluated each health department's community improvement plan, and those initiatives were considered throughout the process of determining the goals for the Baptist Health Corbin Community Health Needs Assessment. The CHNA Committee also solicited public opinion on community health needs using a survey distributed via social media, the Baptist Health Corbin website and via email to Baptist Health Corbin patients. Survey responses, coupled with the information from the respective health departments, were considered as primary data. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health Corbin's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health Corbin should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 6 -- Baptist Health Corbin Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health Corbin can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. After studying the primary and secondary data, the committee identified the top five health concerns that the hospital will focus on over the next three years. They are: opioid abuse; obesity; cancer; cardiovascular disease; mental health and substance abuse. Opioid abuse has become an epidemic across the country. Locally, we are seeing a similar surge of opioid usage admissions and emergency room visits. This health issue is creating additional stress on healthcare and civic agencies throughout the community. Opioid abuse has a significant impact on overall health and can lead to other co-morbidities. In addition, the service area is seeing steady occurrences of drug-addicted newborns that must be sent to neonatal intensive care units to treat withdrawal symptoms. We are working to reduce the number of opioids prescribed by physicians, educating our nursing staff on opioid utilization and increasing care options. We will actively engage in community awareness partnerships with local agencies to assist in educating the community. Expanding access to substance abuse services throughout the community and reducing the stigma surrounding treatment are important steps to mitigating this public health crisis.Obesity and related illness prevention remain a top community health concern because they have a significant impact on other health issues, including Type 2 diabetes, heart disease, high cholesterol, high blood pressure, asthma, osteoarthritis, joint deterioration and several forms of cancer. Kentucky has some of the highest rates in the nation for preventable health conditions and for behaviors that have been identified as unhealthy. To increase the awareness of obesity as a health threat to area residents and to encourage healthier living through diet, exercise and other means remains a top priority. Failing to diminish obesity in the community will lead to higher mortality rates, increased healthcare costs and a decrease in the quality of life for families in our community. Improved access to screening tools, public education and an increased awareness of healthy lifestyle alternatives will help.Because cancer continues to be a leading cause of death in this service area, the committee ranked it as its third priority in terms of public health issues. Mortality levels from cancer are better in our community than the state and national averages but are still a significant threat. The committee acknowledged the continued need for board-certified oncologists, easier access to cancer-related services and screenings available for the early detection of cancer. Providing world-class cancer care in our community is the focus of Baptist Health Corbin's new radiation oncology center. The center's technology, which includes external beam radiation therapy, is comparable to nearby metro areas where radiation oncology patients were transferred before the center's 2021 opening. Now patients can receive care close to home. Increasing the availability of screenings, providing higher levels of care in our community and disseminating educational materials are some of the components of our action plan.Cardiovascular disease ranked as the committee's fourth priority and encompasses coronary artery disease, heart attack, arrhythmias, heart failure, cardiomyopathy and vascular disease. Strategies to address the prevention of cardiovascular disease include the promotion of positive behaviors and an active lifestyle, community-wide screenings to educate residents on their risk of cardiovascular disease and sufficient access to healthcare providers. The goal is to increase public awareness of the disease, its root causes and commonly associated conditions to increase compliance with standard-of-care protocols. Patient transportation is a major issue in the Baptist Health Corbin service area. Many patients do not own automobiles and there are very limited resources for public transportation. The committee agreed it was important to explore grant opportunities for providing transportation services to patients in need.It is not within the scope of Baptist Health Corbin's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health Corbin works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 6 -- Baptist Health Corbin Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 6 -- Baptist Health Corbin Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Group A-Facility 7 -- Baptist Health La Grange Part V, Section B, line 5:
The Baptist Health La Grange CHNA committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. To complete the CHNA, the Baptist Health La Grange committee reached out to government and nonprofit leaders in the community to solicit feedback regarding the most pressing community needs. There are three health departments responsible for the counties Baptist Health La Grange serves: the Oldham County Public Health Department (OCHD), the North Central District Health Department (NCDHD), which serves both Henry and Trimble counties and the Three Rivers District Health Department (TRDHD), which serves Carroll County. Baptist Health La Grange also solicited public opinion on community health needs using a survey distributed via social media, the Baptist Health La Grange website, and in paper form. Survey responses, coupled with the information from the respective community leaders and health departments, were considered as primary data. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health La Grange's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health La Grange should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 7 -- Baptist Health La Grange Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health La Grange can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. The committee identified several community health issues, the top four that we will focus on are obesity, cancer, maternal and child health and mental and behavioral health.The prevention of obesity and the illnesses related to obesity are the primary health concerns in our community. Obesity has a significant impact on other health issues such as cardiovascular disease, diabetes, pulmonary disease, cancer and joint deterioration. There are a variety of reasons why obesity is difficult to combat - a lack of access to healthy foods, the higher costs of healthy foods, sedentary populations, a lack of exercise options and poor dietary habits. It is incumbent for the hospital and the community to make a concerted effort to increase the awareness of obesity as a serious health threat to our service area residents and to encourage healthier living through diet, exercise and other means. Failing to diminish obesity in the community will lead to higher mortality rates, increased healthcare costs and a decrease in the quality of life for families in our community. Improved access to screening tools, public education and awareness of healthy lifestyle alternatives will help. We will partner with the Hope Health Clinic to provide educational materials that address topics related to obesity and use the National Diabetes Prevention Program to support healthy lifestyles.As cancer continues to be a leading cause of death in this service area, the committee ranked it as its second priority in terms of public health issues. Oldham County mortality levels are better than the state and national averages but are still a significant threat. The committee acknowledged the continued need for board-certified oncologists, easier access to cancer-related services and screenings available for the early detection of cancer. Baptist Health La Grange has made great advancements in oncology care since the last Community Health Needs Assessment and plans to expand on current services and care offerings. Providing online risk assessments and disseminating educational materials are some of the components of our action plan.Maternal and Child Health was identified as a high priority need based on the review of the secondary data. Low birth weight, teen births and children in single parent households, along with high infant mortality rates are issues effecting the primary service area. Providing mothers and infant caregivers with information to influence common factors that can effect infant mortality is important. Discharge instructions to educate parents and caregivers on safe infant sleep practices, pre-natal monitoring for health risks of the mother and the baby and post-partum checks will help to manage these health risks.Mental and behavioral health illnesses and their related health effects on individuals and families was identified as a pressing community need. The secondary data shows that mortality related to mental and behavioral health disorders for every county in the service area is above the national and state incidence rate. Mental illness has a significant impact on overall health and well-being, and can contribute to other health issues such as obesity and substance abuse disorders. Improved access for outpatient mental health wellness programs, additional behavioral health risk assessment tools, expanded treatment options and the combined efforts of medical professionals, schools, churches and government agencies will contribute to our success in reducing the stigma around mental health care and educating and engaging individuals to live healthier lifestyles. To drive improved quality outcomes for our patients, Baptist Health recognizes the importance of integrating behavioral health care into all aspects of care. We also realize the importance of reducing the stigma of seeking behavioral health care services. As a result, we are expanding access and creating new avenues for people to receive care. These efforts include a network of providers who will work in collaboration with our treatment team and a Virtual Care hub for behavioral health that provides services to nearly 50 primary care locations. By the end of fiscal year 2022-23, these services will be embedded into every Baptist Health Medical Group primary care location.It is not within the scope of Baptist Health La Grange's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health La Grange works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 7 -- Baptist Health La Grange Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 7 -- Baptist Health La Grange Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Group A-Facility 8 -- Baptist Health Richmond Part V, Section B, line 5:
The Baptist Health Richmond CHNA Committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. The Madison County Health Department is responsible for the county Baptist Health Richmond serves. The Health Department's Community Improvement Plan and initiatives were considered throughout the process of determining the goals for the Baptist Health Richmond Community Health Needs Assessment. The CHNA committee also solicited public opinion on community health needs using a survey distributed via social media, the Baptist Health Richmond website and via email to Baptist Health Richmond patients. Survey responses, coupled with the information from the health department, were considered as primary data. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health Richmond's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health Richmond should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 8 -- Baptist Health Richmond Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health Richmond can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. The committee identified a number of pressing community health issues and will focus on the following over the next three years: behavioral health and substance abuse, social determinants of health and obesity and healthy lifestyles. Baptist Health Richmond has made behavioral health a priority as the community need continues to increase. The committee ranked expanding access to these services as the most important community health initiative. The committee ranked opioid abuse as their second priority in terms of public health issues. Opioid abuse has become an epidemic across the country, and locally we are seeing a similar surge of opioid emergency room visits and usage admissions. Opioid abuse has an impact on overall health and can lead to other co-morbidities. In addition, the service area is seeing a greater presence of drug-addicted newborns that must be cared for in neonatal intensive care units to properly treat withdrawal symptoms. A $5.5 million behavioral health expansion project that will convert 11 beds at Baptist Health Richmond is underway. The project includes adding three dedicated rooms for behavioral health patients in the emergency department. Thrive Center at Baptist Health will provide an interdisciplinary team approach to behavioral health care for patients and their families. Services will include psychiatric evaluation and treatment; individual, group and family therapy and psychoeducation; individualized treatment and aftercare planning; therapeutic recreational activities; access to peer support and case management and referrals to community resources.Our action plan to address both of these health issues is to ensure that residents have sufficient and timely access to mental health and substance abuse counseling and related services. Currently, behavioral health staff complete acute assessments 24/7 at the hospital. To drive improved quality outcomes for our patients, Baptist Health recognizes the importance of integrating behavioral health care into all aspects of care. We also realize the importance of reducing the stigma of seeking behavioral health care services. As a result, we are expanding access and creating new avenues for people to receive care. These efforts include a network of providers who will work in collaboration with our treatment team and a Virtual Care hub for behavioral health that provides services to primary care locations. By the end of fiscal year 2022-23, these services will be embedded in to every Baptist Health Medical Group primary care location. The hospital also continues to maintain a substance abuse hotline, an Intensive Outpatient Program and select telemedicine services are provided on an outpatient basis. Obesity was one of the top personal health challenges identified by the survey, and remains a significant threat to the health of our community. The state of Kentucky is known for having one of the worst ratings in the United States for obesity and Kentucky has some of the highest rates in the nation for preventable health conditions and behaviors that have been identified as unhealthy. There are a variety of reasons why obesity is difficult to combat - a lack of access to healthy foods, the higher costs of healthy foods, sedentary populations, a lack of exercise options and poor dietary habits. Obesity contributes to so many other health issues (heart disease, stroke, high blood pressure, diabetes, osteoporosis, joint deterioration, cancer, etc), that it is incumbent for the hospital and the community to make a concerted effort to curb this health issue. We are working to ensure that residents have access to a primary care physician, outpatient nutritional counseling and disease management programs for diabetes and related health issues. Improved access to screening tools, public education and public awareness of healthy lifestyle alternatives will also help our community members.Social determinants of health is increasingly becoming a major issue in Richmond and Madison County. Many people in the community are without safe housing, transportation and access to nutritious foods. These issues inevitably lead to a decrease in the quality of a person's health. Baptist Health Richmond has many patients whose poor health began with social determinants that could have been prevented with more community resources. Through the combined efforts of medical professionals, schools, churches and government agencies, we will help to educate and engage individuals to better care for themselves and their families and to utilize available support options. An increased awareness of the importance of the early detection and prevention of disease through screening programs will also improve the health of our community members. It is not within the scope of Baptist Health Richmond's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health Richmond works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 8 -- Baptist Health Richmond Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 8 -- Baptist Health Richmond Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Group A-Facility 3 -- Baptist Health Hardin Part V, Section B, line 5:
This is the first Community Health Needs Assessment conducted by Baptist Health Hardin. (Hardin Memorial Health, a county-owned hospital, was acquired by Baptist Healthcare System in September 2020). The Baptist Health Hardin CHNA committee worked closely with a wide variety of community partners and resources to gather, disseminate and prioritize the information needed for the Community Health Needs Assessment. Such a community-driven plan of action engages the public and develops partnerships that help promote wellness and healthier communities. The CHNA Committee formed a community health coalition with other healthcare, civic, governmental and educational organizations in the area to share resources and work collaboratively to identify and address the medical and socioeconomic factors affecting the health of the people in our community. Baptist Health Hardin solicited public opinion on community health needs through a survey distributed via social media and the Baptist Health Hardin website and took measures to ensure that the survey would be distributed to reach a representative sample of the population, including demographic groups often underrepresented in public data gathering. The Lincoln Trail District Health Department, a strong community partner with the hospital that serves a six-county area including Hardin, LaRue, Marion, Meade, Nelson and Washington counties was a valuable resource for this CHNA. The department provides environmental, preventive, curative and health maintenance services to our community through direct healthcare, health education, counseling and the enforcement of laws that protect health and the environment. Through these contacts and public surveys, Baptist Health Hardin collected primary data and feedback on the health issues confronting its service area. Survey responses, coupled with information from the area health departments and community partners, were considered as primary data. Secondary data obtained from national, state and local demographic and socioeconomic sources was used, including Kentucky vital statistics, disease prevalence studies, outcome measures and health indicators and statistics. The most recent data came from the Robert Wood Johnson County Health rankings, which were published in 2020. Data regarding health outcomes, health behaviors, clinical care availability, socioeconomic factors and physical environment risks for each county in Baptist Health Hardin's service area was analyzed.The Community Health Needs Assessment Committee included senior hospital leadership and specific department directors. The committee reviewed the information gathered through the primary and secondary data sources combined with the information obtained through community partners, and the comprehensive list of community health needs were documented. The committee then prioritized how and where Baptist Health Hardin should concentrate its resources over the next three years to most effectively address these pressing health needs that create hardships for our residents and stress on agencies throughout our communities. The final CHNA and SIP were approved by the administrative Board of Directors of the hospital and by the Baptist Healthcare System Board of Directors.

Group A-Facility 3 -- Baptist Health Hardin Part V, Section B, line 11:
The CHNA committee's purpose was to identify health challenges and risk factors that can be modified or prevented to improve the health of our community. The committee identified and prioritized community needs for the service area that Baptist Health Hardin can address and affect by implementing programs, providing educational support and sponsoring preventive screenings. Based upon the data collected and analyzed through this assessment, the CHNA committee identified the following as the primary health issues that the hospital will focus on over the next three years: smoking/vaping/lung cancer; obesity; mental health/substance abuse and access to healthcare services.Tobacco use and many of the known health results of tobacco use, (heart disease, stroke, high blood pressure and cancer), were included in the top ten health concerns in the community. Nine of the ten counties in the service area have very high adult smoking rates and significantly higher occurrences of lung cancer. Hardin County has an astonishing 38% of adults who smoke. Baptist Health Hardin has a long history of providing tobacco cessation classes, health screenings and educational resources for community members and continues to lead in this area. Health coalitions, like the Coalition for a Smoke-Free Tomorrow, (Baptist Health is a member), are trying to improve Kentuckians' health by reducing the high rate of smoking and tobacco use in Kentucky. Currently, the group is advocating for local control, allowing cities and counties to adopt ordinances that govern the sale and usage of tobacco products in their communities. Tobacco use is the proximate cause of numerous health issues, including several types of cancer, emphysema, Chronic Obstructive Pulmonary Disease (COPD), heart disease and stroke. Reducing smoking will have a positive effect on all these conditions. Obesity was the top personal health challenge identified by the survey, and the fourth highest health concern in the community. Only one county in the service area had a lower percentage of obesity than the state of Kentucky as a whole, which is known for having one of the worst ratings in the United States for obesity. There are a variety of reasons why obesity is difficult to combat - a lack of access to healthy foods, the higher costs of healthy foods, sedentary populations, a lack of exercise options and poor dietary habits. Obesity contributes to so many other health issues (heart disease, stroke, high blood pressure, diabetes, osteoporosis, joint deterioration, cancer, etc), that it is incumbent for the hospital and the community to make a concerted effort to curb this health issue. Improved access to screening tools, public education and awareness of healthy lifestyle alternatives will help.There were a variety of markers that led to the choice of mental health and substance abuse as top health issues for the community. Mental/behavioral health and substance abuse were the two biggest health concerns on the public survey. More than 26.7% of survey respondents indicated they had 'high or 'very high' levels of stress. Almost 18% rate their own mental health as 'fair or 'unhealthy and over 40% said that the mental health of the community is 'unhealthy or 'very unhealthy'. Substance abuse is a common crisis throughout the state and within our community. Baptist Health Hardin has an inpatient behavioral health unit and there is another psychiatric hospital in Hardin County (Lincoln Trail Behavioral Health System), but expanding the presence of mental health providers in primary care offices throughout the service area would bring improved access to much-needed care. To drive improved quality outcomes for our patients, Baptist Health recognizes the importance of integrating behavioral health care into all aspects of care. We also realize the importance of reducing the stigma of seeking behavioral health care services. As a result, we are expanding access and creating new avenues for people to receive care. These efforts include a network of providers who will work in collaboration with our treatment team and a Virtual Care hub for behavioral health that provides services to primary care locations. By the end of fiscal year 2022-23, these services will be embedded in to every Baptist Health Medical Group primary care location. The hospital will also continue to partner with other local resources to combat these complex issues.Access to healthcare was also one of the top health concerns in the community. Baptist Health Hardin has a very low admission rate of patients who come to their Emergency Department, which indicates that patients do not see a primary care physician in a timely manner. This is an area that Baptist Health Hardin and the Baptist Health Medical Group can potentially affect the most. The hospital is building a new Medical Pavilion directly to the northwest of the hospital that will house multiple specialties and health services, consolidating several from other locations. The facility will have medical and radiation oncology, surgical services, pulmonary care, wound care, urology, cardiology and cardiac catheterization services. Active recruitment of additional primary care physicians and advanced care providers, coupled with easier access to more services and providers, will help significantly to eliminate this community concern.It is not within the scope of Baptist Health Hardin's services, expertise or resources to be able to address all of the risk factors that have been identified as influencers of our community's health status. However, it is through networking, partnerships and collaboration with other community stakeholder organizations and agencies that these issues are being addressed. Increasing communication between community service providers, enhancing the public's awareness of the agencies and services available and promoting assistance provided by local community partners is a common goal of our healthcare and civic leaders. Baptist Health Hardin works collaboratively with other community resources to provide support and to serve as a referral source to address the additional identified health needs that fall below the significant prevalence level for our service area. Impact issues such as unemployment and uninsured populations are being managed by economic development groups, the Kentucky Chamber of Commerce, city and county governments and county health departments.

Group A-Facility 3 -- Baptist Health Hardin Part V, Section B, line 13b:
Based on the information provided in the Financial Assistance Policy application and/or through the presumptive eligibility process, a patient or guarantor whose income plus liquid assets are less than 300% of the current federal poverty level for his or her family size may be eligible for a full discount under the FAP after all other healthcare payment resources have been utilized and exhausted. A patient or guarantor whose family income plus liquid assets is between 300% and 1200% of the current federal poverty level for his or her family size may be eligible for partial assistance. Patients have a total yearly obligation of 10% of their annual income plus liquid assets. Patients or guarantors whose family income plus liquid assets is above 1200% have a total yearly obligation of 20% of their annual income plus liquid assets. If a patient is uninsured or their health insurance does not cover emergency or medically necessary care provided by a Baptist Health hospital, then the patient will be allowed a discount that limits payment responsibility to the amounts generally billed to individuals who have insurance covering such care.

Group A-Facility 3 -- Baptist Health Hardin Part V, Section B, line 20e:
Prior to referring individuals to a collection agency, BHS processes all self-pay accounts through an external scoring application to determine additional eligibility for financial assistance.

Part V, Section B, Line 3e
Each hospital facility did include a prioritized list of the community's significant health needs in its CHNA report.

Part V, Section B, Lines 16 a,b,c
https://www.baptisthealth.com/Pages/patients-and-visitors/billing- information/financial-assistance.aspx

Part V, Section B, Lines 7 a,b and 10a
https://www.baptisthealth.com/pages/news/community-health-needs-assessment.aspx

Part I, Line 7:
"COSTING METHODOLOGY:BHS utilizes a sophisticated cost accounting system that identifies the cost of delivering care at the individual procedure and item (supply) level for direct costs and a detailed step-down methodology to allocate overhead costs as accurately as possible. Costs are determined for each patient based upon the specific procedures performed and items used for each patient. Patients are also categorized by: 1. Patient type (inpatient and outpatient), 2. Payer plan (Charity, state-sponsored charity and the uninsured are among the uniquely identified payer plans), and 3. Clinical service (52 unique clinical services). The cost of care for uninsured patients who qualify for ""full"" charity care (under a State-sponsored or BHS sponsored charity program) is determined by calculating the cost of each uninsured charity patient (at the procedure and item level) and accumulating the cost of each patient. For insured patients who also qualify for partial charity under the BHS sponsored charity program, costs are allocated to each portion (insurance, partial charity, patient payments and bad debt) using the patient's payer plan cost-to-charge ratio (CCR). For example, this CCR is multiplied by the charges covered by insurance to determine the cost of insurance, multiplied by charges covered by partial charity to determine the cost of partial charity, multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt.The cost of care for uninsured patients who do NOT qualify for charity care (full or partial bad debt accounts) are allocated to each portion (patient paid portion and unpaid portion) using the patient's uninsured payer plan CCR. For example, this CCR is multiplied by patient payments to determine the cost of paid services and multiplied by unpaid charges to determine the cost of bad debt. Much care is taken to ensure that costs used for community benefit reporting are directly related to exempt-purpose patient care and that costs are reported accurately. For example, the cost of charity and Medicaid are removed from the calculation of the loss on subsidized services."

Part I, Line 7g:
In order to meet the health and wellness needs of our communities throughout Kentucky and southern Indiana, Baptist Healthcare System, (BHS), provides grants to Baptist Health Medical Group, Inc., (BHMG), a nonprofit Section 501(c)(3) entity that is organized and operated to provide healthcare facilities and services. These grants allow BHMG to continue to provide support and care for Medicaid and charity care patients through primary care centers, rural health clinics, urgent care centers and specialty health clinics that meet a demonstrated community need. BHS makes these grants on the condition that BHMG use the grant funds only for the following activities:1. To provide care for patients participating in Medicaid and other means-tested government health programs, including but not limited to the Kentucky Children's Health Insurance (KCHIP) program.2. To provide care, for free or at discounted rates, to low-income patients who cannot afford the cost of care.3. To fund the operations of rural health clinics that provide care for the patients described above.4. To engage in community activities and programs in response to demonstrated community needs to improve community health, including but not limited to health screenings; COVID testing; vaccinations and community health education. The expenses related to the above activities are included in Schedule H, Part I, Line 7g; Subsidized Health Services.

Form 990, Part I, Line 6A
Each hospital within Baptist Healthcare System, Inc. (BHS), (61-0444707), prepares a Community Benefit Report. In addition, a summary Community Benefit Report is prepared on a consolidated basis for all entities.

Part III, Line 2:
As a result of certain changes required by Accounting Standards Update(ASU) 2014-09, the majority of Baptist's provision for uncollectible accounts is recorded as a direct reduction to net patient service revenue instead of being presented as a separate line on the consolidated statements of operations. The core principle of the guidance in ASU No. 2014-09 is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. For Baptist's health care operations, the adoption of ASU No. 2014-09 resulted in changes to the presentation for and disclosure of revenue related to uninsured and underinsured patients. Under ASU No. 2014-09, the estimated uncollectible amounts due from these patients are generally considered an implicit price concession and are a direct reduction to patient service revenue.

Part III, Line 3:
Rationale for including other bad debt amount in community benefit:No other bad debt amounts have been included as community benefit. The hospital educates patients with limited ability to pay regarding financial assistance and for this reason, the organization believes it accurately captures all charity care deductions provided according to the financial assistance policy, and the amount of bad debt expense attributable to patients eligible under the organization's charity care policy is negligible.

Part III, Line 4:
BAD DEBT EXPENSE FOOTNOTE:A separate footnote for bad debt expense is not included in the audited financial statements. However, beginning in 2012 BHS reported the provision for uncollectible accounts related to patient service revenue as a deduction from patient service revenue. The costing methodology of bad debt is outlined in Schedule H, Part VI, Line 1.

Part III, Line 8:
"MEDICARE COSTING METHODOLOGYMedicare revenues and allowable costs were taken from the ""as filed"" Medicare cost report. Much care is taken to ensure that all adjustments to remove non-allowable costs are taken. Due to the fact that Medicare rates are non-negotiable and are established by the government, all of the shortfall for Medicare should be included as a community benefit."

Part VI, Line 4:
COMMUNITY INFORMATION:BHS is comprised of eight regional hospitals, each serving a unique and diverse geographic area in Kentucky and Indiana.Baptist Health Lexington (BHLEX) is an award-winning acute, skilled care facility and major medical research and education center. Established in 1954, BHLEX is recognized for its excellence in maternity, heart and cancer care and the groundbreaking research conducted at the Clinical Research Center. Specialized comprehensive services include: neurosciences/stroke care; CyberKnife treatment; genetic counseling; orthopedics; home care; rehab and occupational health. BHLEX serves as a regional referral center for tertiary care services not offered by other area hospitals. Over 500 physicians and advanced practitioners are on staff supporting more than 50 medical specialties at numerous points of care in the region.BHLEX is located five miles from I-75 and I-64, providing access for Lexington metro patients and those from central and eastern Kentucky. The primary geographic service area accounts for approximately 78% of BHLEX's inpatients and is comprised of Fayette and seven other counties. Approximately 14.4% of the population of the local area is over 65 and the unemployment rate averages approximately 3.1%, compared to 3.9% for Kentucky and 3.7% nationally for 2022.Baptist Health Louisville (BHLOU) opened in 1975 and serves as a general acute care facility, specializing in cardiovascular and comprehensive rehabilitation services. Area residents benefit from the hospital's emergency services, including special teams for heart attack and stroke care. The hospital's cancer services include freestanding radiation centers and the Osborn Cancer Center that includes a resource center and a multidisciplinary lung care clinic. Women's health services include digital mammography, ultrasound and bone-density scanning. Other areas of expertise include orthopedics, neurosurgery, behavioral health and home care. The Innovative Learning and Development Department supports educational programs for community healthcare providers, physicians, clinicians and employees. BHLOU is located in St. Matthews in Jefferson County, five miles east of downtown Louisville, near Interstate 64, a main access to downtown, and Interstate 264, a main beltway around Louisville. The primary geographic service area for BHLOU consists of Jefferson and four surrounding counties, where approximately 75% of BHLOU's inpatients reside. Approximately 17% of the population of the local area is over 65 and the average unemployment rate is approximately 3.3%, compared to 3.9% for Kentucky and 3.7% nationally for 2022.Baptist Health Hardin (BHHAR) is a tertiary acute care hospital located in Elizabethtown, KY in Hardin County. BHHAR opened in February 1954 as Hardin Memorial Health, a county-owned hospital. BHS managed the facility for over twenty years before purchasing the hospital in 2020. Area residents benefit from compassionate care provided with advanced innovative technology available in over 40 specialty services including cancer care, cardiology, pulmonary care, women's health services and obstetrics, and a Level II Neonatal Intensive Care Unit (NICU).BHHAR is located in central Kentucky at the crossroads of Interstate 65 and the Bluegrass and Western Kentucky Parkways. Primary and secondary service areas include Hardin and nine other Kentucky counties. Approximately 63% of BHHAR's acute care patients are residents of Hardin County, where BHHAR is the market share leader with 59.3% of all acute care hospital discharges. Approximately 14.7% of area residents are over the age of 65 and the average unemployment rate is approximately 3.9%, compared to 3.9% for Kentucky and 3.7% nationally for 2022.Baptist Health Paducah (BHPAD) opened in 1953 in Paducah, KY, and is a tertiary acute care hospital. A respected regional medical and referral center, BHPAD offers over 20 points of care and provides a full range of services, including cardiac care; diagnostic imaging; women's and children's services; surgery; rehabilitation; transitional care and wound care. BHPAD offers the region's only cancer center, the only Joint Commission certified Advanced Primary Stroke Center, the only Level III NICU and the only certified robotic surgeons, using the region's first da Vinci robotic surgical system. BHPAD is one of only two hospitals located in Paducah, the largest city in BHPAD's service area. The primary service area for BHPAD consists of McCracken and five other counties in Kentucky and Massac County in Illinois, with a total service area of 18 counties. Approximately 35% of BHPAD's acute care patients are residents of McCracken County. Approximately 20.7% of the population of the local area is over 65 and the average unemployment rate is approximately 4%, compared to 3.9% for Kentucky and 3.7% nationally for 2022.Baptist Health Floyd (BHF) was acquired by BHS in 2016. Since its inception in 1953, BHF, located in New Albany, IN, has grown to be an outstanding regional healthcare provider. BHF is a general acute care facility, specializing in cardiovascular services, cancer care and comprehensive rehabilitation services. BHF has a 24-hour ED, inpatient and outpatient surgery, lab, pharmacy and imaging capabilities. The BHF primary service area includes Floyd, Clark, and five other counties in Indiana. Over 60% of the patients served come directly from Floyd and Clark counties. BHF is conveniently located minutes from downtown Louisville. Approximately 16.9% of the population of the local area is over 65 and the average unemployment rate is approximately 2.5%, compared to 4% for Indiana and 3.7% nationally for 2022.Baptist Health Corbin (BHCOR) opened in 1986 in Corbin, KY and celebrated 35 years of service in 2021. BHCOR is a general acute care facility, offering 24 points of care in a full continuum from inpatient care to rehab services to behavioral health services, and is a vital part of its community offering outreach, educational and screening programs. Patient services include robotic surgery; palliative care; outpatient diagnostic centers; home care; occupational medicine and physical therapy clinics; expanding cancer, cardiac and neurologic programs; a women's center and advanced MRI and microsurgery technologies. BHCOR is located less than one mile off Interstate 75, near U.S. Highway 25, providing access from several surrounding communities. BHCOR primarily serves the Tri County area that includes Whitley, Knox and Laurel counties and secondary markets that include Bell, Clay and McCreary counties. Over 90% of BHCOR's inpatients originate from these counties. Approximately 16.1% of the population of the local area is over 65 and the average unemployment rate is approximately 4.3%, compared to 3.9% for Kentucky and 3.7% nationally for 2022.Baptist Health La Grange (BHLAG) opened as Tri-County Community Hospital in 1987, and after joining BHS in 1992 expanded facilities and services to meet the needs of a growing community. The hospital offers an ED that is stroke certified by the Joint Commission; inpatient and outpatient surgery; imaging and MRI services; 3D mammography and stereotactic breast biopsy; occupational therapy and a five-star rated Skilled and Rehab Care Center. BHLAG recently completed a $2.5 million renovation of the Rawlings Women's Center, new cardiac and infusion centers and modernized pre- and post-op areas.BHLAG is located off Interstate 71, 20 minutes northeast of Louisville. Approximately 83% of BHLAG's inpatients come from Oldham, Henry, Trimble and Carroll counties. Approximately 14.2% of the local population is over 65 and the average unemployment rate is approximately 2.6%, compared to 3.9% for Kentucky and 3.7% nationally for 2022.Baptist Health Richmond (BHR) was founded in 1892 and joined BHS in 2012. BHR is a rural, acute care hospital that has served its community for more than a century. The hospital offers 19 points of care in a full continuum with a vast network of providers. Services include cardiac surgery and rehab; orthopedics; occupational, physical and respiratory therapy; women's health and childbirth services; cancer care; diabetic treatment; infusion services; MRI and radiologic imaging, and nuclear medicine. Staff and board certified emergency physicians in the ED train for disaster preparedness annually with the federal Chemical Stockpile Emergency Preparedness Program (CSEPP).BHR is located in Madison County, in the Appalachian region. Richmond is 26 miles south of Lexington and 103 miles southeast of Louisville. More than 33% of BHR's patients are from low-income or underserved populations. Over 78% of BHR's patients reside in Madison County and 97% live in Appalachia. Approximately 14.2% of the local population is over 65 and the average unemployment rate is approximately 3.5%, compared to 3.9% for Kentucky and 3.7% nationally.

Part VI, Line 7, Reports Filed With States
KY,IN

Part II, Community Building Activities:
COMMUNITY CARE: To help Baptist Health accomplish its mission to positively impact and transform the health of our communities, the entire organization is committed to clinical excellence, patient safety and continued growth to best meet the needs of our patients and the unique needs of each of the communitites we serve. Our providers remain focused on helping people get well and stay well, and the system is investing in a wide range of initiatives centered on enhancing quality and providing personalized care that is both efficient and proactive. We strive to maintain the highest quality safety standards; we seek new outreach and wellness initiatives to create a culture of health in each community we serve; we grow our programs and facilities to make comprehensive care more accessible for everyone; we embrace new research and clinical trials, and seek new opportunities to connect with our patients through comprehensive, personalized care. WELLNESS: Baptist Health's Wellness team is constantly seeking creative new opportunities to change the health of our communities for the better, one individual at a time. The team strives to create a culture of health and accountability, effectively engaging participants to help them reach their health and wellness goals. Baptist's innovative, award-winning wellness programs include smoking-cessation classes, weight-management programs, diabetes prevention, nutritional health, stress management and fitness/physical activity. Partnerships with other like-minded organizations within the community further enhance, support and promote these successful initiatives and programs.COLLABORATIONS: Improving the health of those in the communities we serve at the grassroots level takes partnerships. In conjunction with leadership teams from other health systems and the Kentucky Hospital Association, Baptist Health played a lead role in advising state leaders as they developed the State's COVID-19 policies and guidelines to assure the safety of patients, healthcare staff, first responders, childcare workers, nursing home residents and the community at large. Baptist Health provided millions of dollars worth of critical PPE and other supplies to assist other facilities and coordinated relationships with vendors that allowed the State to secure critically depleted supplies. These alliances with state and local governments and community leaders continue as the effects of the pandemic continue to disrupt our communities.In Paducah and Corbin, a Congregational Health Network links those just released from the hospital to trained fellow church members willing to help with their care needs. Physically fit youngsters is the goal of the Project Fit America partnership, bringing funding, equipment, teacher training and a curriculum to elementary and middle schools in over 23 communities. Baptist Health is among 10 health systems that founded the Kentucky Health Collaborative to share best practices for improving the health of the Commonwealth's citizens.ADVOCACY: Baptist Health is continuously working with community and state leaders, local schools, health departments and other partners to improve the health of our communities. Our efforts focus on the passage of smoke-free legislation to help children breathe clean air; tort reform, which can lower the cost of healthcare; telehealth to make healthcare more accessible and programs and opportunities to combat substance abuse and addiction. RESEARCH: Baptist Healthcare System's leadership in clinical research is directly linked to our organizational mission of serving the healthcare needs of patients and communities across Kentucky and Southern Indiana. Our goal is to provide the latest innovations and the newest therapies and treatment options in a community-based setting. Clinicians in Baptist Health facilities are currently engaged in more than 200 clinical studies, addressing a variety of medical conditions that include:--Cancer --Heart disease --Infections and infectious diseases --Neurological disorders --Nephrology --Pulmonary/respiratory diseasesCancer research at Baptist Health has grown tremendously in the last 20 years with continued growth expected through the collaboration of the Baptist Health Cancer Research Network, (BHCRN). The BHCRN is a joint effort among physicians, nurses, patients, caregivers and administrators to improve cancer care at Baptist Health through research. Our program is unique among community research sites because it has always been hospital-based and has improved our ability to provide patients with National Cancer Institute(NCI)-sponsored, cooperative-group studies, culminating in our recent designation as a Main Member for NRG Oncology and Gaurdian Research Network (GRN) research organizations. Phase II, Phase III and quality of life trials for numerous cancers, including breast, lung and lymphoma are ongoing.Our clinicians are also involved in state and national-level research organizations, such as the NCI's National Clinical Trials Network. NRG, GRN and the NCI organizations bring together leading medical investigators to pool resources, share data and coordinate clinical trials.The Guardian Research Network is a nationwide consortium of high-performing community health systems, including Baptist Health, which created a breakthrough platform for accelerating cures for cancer. The network's objectives are to identify and place patients into clinical trials as fast as possible, cutting weeks and sometimes months off of enrollment timelines. Its searchable database houses hundreds of thousands of cancer patients' medical records. The Grail Study is the first trial launched by GRN and is designed to determine if a blood test can be created to enable the early detection of cancer. Participating hospitals include Baptist Health Lexington, Baptist Health Louisville and Baptist Health Paducah. The main component of effective clinical research is patient participation. Participation has two significant benefits to the future care of patients. Individual patients often benefit because there are additional treatment options available to them and clinical research expands the knowledge and experience of our physicians and care providers allowing us to better understand and more effectively treat the diseases and conditions that affect the human body. The research studies and procedures of today can become the standard treatments of tomorrow. Medical advancements hinge upon vigorous research programs and the commitment of healthcare organizations like Baptist Health.

Part III, Line 9b:
"COLLECTION PRACTICES:Patients and guarantors who qualify for a ""full"" charity discount will not be billed once the charity determination is made. Patients and guarantors who qualify for a ""partial"" charity discount will be billed only for the non-discounted portion of their account. Guarantors who have an ability to pay for services will be billed based on the following guidelines: - Patients or guarantors may be asked to pay an estimated patient liability at point of service. - BHS facilities will accept and file claims for all insurances assigned to the organization with adequate proof of coverage. This assignment does not relieve the guarantor of responsibility for payment if the insurer fails to pay as prescribed by regulation, statute or patient-insurance contract. Deductibles, co-payments and non-covered services will be the responsibility of guarantors. - Statements will be sent to guarantors once patient liability is determined for insured or uninsured patients and necessary billing follow-up calls will be made by BHS Patient Financial Services and/or a designated external early out vendor over a period of time averaging from 90 to 120 days. All statements will contain information regarding the availability of financial assistance. If applicable, effort will be made to assist uninsured patients to secure coverage through any governmental or other assistance programs. - Patients requesting detailed charge information will be provided an itemized bill. - BHS Patient Financial Services will provide all patients the same information concerning services and charges. - Patient accounts not resolved at the end of this cycle will be considered for placement with external collection agencies. Collection agencies will continue to pursue patient balances while maintaining compliance with the Fair Debt Collection Practices Act and the ACA International's Code of Ethics and Professional Responsibility."

Part VI, Line 2:
NEEDS ASSESSMENT:Baptist Health conducts a tri-annual planning process that is driven by our mission to improve the health of our communities and the strategic vision to be the health care leader in Kentucky and Indiana. Key industry and community issues, (such as prominent health conditions present within each community, underserved areas and underprovided clinical services), are considered and analyzed for their impact on the system, each of our eight hospitals and our patients. Community partners work with each hospital to define immediate and long-term health needs that need to be addressed as well as effective development goals, plans and strategies to improve the health of our communities. These goals are foundational to our patient care focus.The Community Health Needs Assessment and the Strategic Implementation Plans are shared with and approved by the administrative Board of Directors of each hospital and the system Board of Directors.

Part VI, Line 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:The following is a list of various methods/processes used to inform/educate patients on the availability of financial assistance: - Financial counselors advise and/or screen uninsured patients before or during hospital services, - A third party vendor advises and/or screens uninsured patients during hospital services, - Financial counselors provide follow-up contact for patients missed during services, - The State-sponsored DSH form is provided to all ED uninsured patients, - Telephone calls and in-person visits are handled by staff trained to discuss financial assistance, - Information regarding financial assistance is included in patient statements. - The BHS sponsored charity care program policy is posted in key areas of each hospital. - The BHS sponsored charity care program policy is posted on the website of each hospital and the System.

Part VI, Line 5:
PROMOTION OF COMMUNITY HEALTH:The BHS Board of Directors is comprised of local representatives who, along with the hospital's management and employees, understand that they are responsible for providing high quality health care services to the communities they serve. Operating healthcare facilities in today's environment requires a delicate balance between producing a sufficient margin to allow for adequate staffing and investment in new technologies, while also providing enough resources to absorb the cost of care for those patients who do not have the ability to pay for the services. In 2022, Baptist was able to re-invest over $273 million into the communities in new technology, construction, renovation and systems improvement. BHS hospitals reach out to the community in many ways through: - Conducting health fairs for local schools, businesses and churches. - Participating in fund-raising and other events to help local agencies such as the American Heart Association, Metro United Way, American Cancer Society, Big Brothers and Big Sisters and the American Red Cross. - Donating hospital space for community group meetings. - Participating on community health assessment teams that are dedicated to identifying and addressing local health needs in each of the counties we serve. - Hosting educational programs, including our pre-natal classes, CPR, smoking cessation, AED training and safe sitter programs. - Maintaining necessary, but unprofitable services that meet community needs. - Helping to recruit physicians to underserved areas and extending medical staff privileges to all qualified physicians in our community for some or all of our departments and specialties.- Helping patients coordinate services with other healthcare providers. - Providing resources for support groups, such as cancer recovery groups. - Promoting and providing preventive care services. - Monitoring clinical outcomes in order to ensure quality care. - Committing resources to improving safety and processes of care. - Providing services conveniently accessible by patients. In addition, BHS employees volunteer thousands of hours in community services and leadership. BHS's support for community activities underscores its commitment to improving the lives of those served. Because BHS and its employees contribute so much of their time, talent and resources to serve others, communities served by BHS are better places to live and work. Quantification of many of the community benefits is detailed elsewhere in this schedule. However, what the quantifiable amount doesn't measure is the economic benefit derived by the community from BHS being one of the major employers in the area. The economic impact of the wages paid to BHS employees is significant considering the dollars they spend on food, housing, services, and other products. The Internal Revenue Service Revenue Ruling 69-545 provides that a hospital can demonstrate it has met the community benefit standard by having a full-time emergency room open to the public regardless of ability to pay for services received. BHS hospitals operate emergency departments that are open 24 hours a day, 365 days a year and treated over 335,000 emergency patients during fiscal year 2022. BHS and its emergency departments post policies stating that patients will be treated regardless of their ability to pay. Depending on the severity of a patient's condition, as a service to the patient BHS may verify insurance prior to rendering services in the emergency department. Under no circumstances is emergency care delayed by discussions regarding insurance coverage or ability to pay for services. In addition, BHS does not convey or intimate in any way to any emergency medical transportation service an unwillingness to treat any particular patient in need of medical attention.

Part VI, Line 6:
"AFFILIATED HEALTH CARE SYSTEM:Baptist Healthcare System, Inc., (BHS), is a nonprofit, tax-exempt organization that owns and operates eight hospitals. Effective 9/1/2021, Baptist Healthcare System, Inc. and Deaconess Health Kentucky, Inc. formed the joint venture Baptist Health Deaconess, LLC., which owns and operates Baptist Health Deaconess Madisonville Inc. hospital and Baptist Health Deaconess Medical Group, Inc. which operates physician practices and outpatient clinics. Through this joint venture, Baptist Healthcare System, Inc. and Deaconess Health Kentucky, Inc. bring capital and expertise that will provide enhanced health care services to the Madisonville community. (Baptist Health Madisonville, Inc. is a nonprofit, tax-exempt former affiliate of BHS that owns and operates a hospital in Madisonville, KY. Through 8/31/2021, Baptist Health Madisonville was 100% owned and operated by Baptist Healthcare System, Inc.)Baptist Health Medical Group, Inc. is a nonprofit, tax-exempt affiliate that owns and operates physician practices and other healthcare facilities. Baptist Healthcare Foundation, Inc., Baptist Health Foundation of Greater Louisville, Inc., Baptist Health Foundation Corbin, Inc., Baptist Health Foundation Richmond, Inc., Baptist Health Foundation Lexington, Inc., and Baptist Health Foundation Paducah, Inc. are nonprofit, tax-exempt affiliate corporations. Baptist Physicians' Surgery Center is a limited liability corporation, of which Baptist Healthcare System Inc. owns 57%. Baptist Health Surgery Center Eastpoint, (formerly known as Eastpoint Surgery Center, LLC. and owned 84% by BHS),is a non-profit limited liability corporation of which Baptist Healthcare System, Inc. owns 100% after purchasing the remaining interest on 1/1/2020. Baptist Health Surgery Center LLC. is a non-profit limited liability corporation formed in 2020 to purchase an existing surgery center in Lexington, KY. Baptist Healthcare System Inc. was the sole member through December 2021, and now owns 95% of the entity.Baptist Health Network Partners, LLC. (BHNP), (formerly known as Purchase Health Quality Collaborative, LLC ""PHQC""), formed in 2011, is a non-profit limited liability company whose sole member is BHS. BHNP was formed to support a physician/hospital network established by PHP, working with BHPAD to engage in clinical integration activities. Baptist Health Care Partners, LLC. (BHCP), formed in 2015, is a non-profit limited liability company whose sole member is BHS. BHCP was formed to participate in the CMS Medicare Shared Savings Program, (MSSP), as an Accountable Care Organization (ACO).Mercy Regional Emergency Medical System, LLC (""MREMS""), formed in 1996, is a non-profit taxable corporation, which owns and operates an ambulance service in McCracken County, Kentucky in the service area of BH Paducah. BHS owns a 50% interest in MREMS and the remaining 50% interest is owned by Mercy Health System, Inc. D.B.A. Lourdes Hospital. Baptist Health Assurance Group LTD, (BHAG) was formed in July 2022 as an offshore captive insurance company which holds all self-insured liabilities and trusteed assets related to medical malpractice and workers compensation. Baptist Healthcare System, Inc. is the sole member of BHAG. All related entities are located in the Commonwealth of Kentucky or the state of Indiana. All entities described in Schedule H, Part VI, Line 6 contributed a combined community benefit amount as follows: Charity Care at Cost $41,609,000 Unreimbursed Medicaid 5,030,000 Community Health Improvement 3,606,000 Health Professions Education 5,919,000 Subsidized Health Services 163,225,000 Research 1,151,000 Cash and In-Kind Contributions 5,500,000 Total Community Benefit $226,040,000"

Form 990, Schedule H, Impact of Covid-19
"Baptist Health reached out to our state and our communities:Clinical leaders from Baptist Health, the largest health system in the Commonwealth of Kentucky, played a principal role as advisors to the Commissioner for Public Health, the Cabinet for Health and Family Services (""CHFS""), Office of Inspector General, and other state agencies in response to the unprecedented needs of our community during the COVID-19 pandemic. In conjunction with leadership teams from other health systems and the Kentucky Hospital Association, Baptist Health played a lead role in advising and developing the State's COVID-19 policies and its guidelines on multiple matters including: --- Initial planning at the beginning of the COVID-19 pandemic to ensure the safety of patients, first responders and healthcare workers by establishing guidelines for the suspension of elective procedures, non-urgent/emergent radiology, therapy and ambulatory visits. --- Collaboration with the CHFS to help manage the nursing home and post-acute care setting emergencies that became a focal point of the COVID-19 pandemic. Baptist Health worked closely with the State to provide on-site resources in support of facilities that were in crisis, in an effort to help stabilize those facilities and provide care to vulnerable residents. --- Provided critical PPE and other necessary materials to fellow healthcare providers when the State was unable to secure much needed supplies. --- Coordinated key vendor relationships that allowed the State to secure high quality PPE products with fluid deliveries. These products were ultimately made available to nursing homes and other facilities that provided care and aid to indigent members of our community. --- The development of guidelines for restarting all non-emergent clinical services including the appropriate phasing and criteria required of hospitals to resume elective care, both in ambulatory and acute care settings.Baptist Health ensured the safety of patients, providers and employees:Baptist Health acted swiftly and efficiently to the COVID-19 pandemic by responding to the needs of our communities, our patients and our staff members through implementing disaster readiness protocols and the following: --- In early March 2020, Baptist Health began to secure PPE to meet the expected COVID-related demand throughout each of its markets and developed system-wide warehousing and logistics plans to manage and distribute critical equipment and PPE to ensure that all facilities had adequate supplies at all times.--- Established local incident command operations in each market, with hospital and medical groups coordinating in to a single unit. The System Crisis Management Team coordinates efforts and all communications across the System to ensure safety, best practices and consistency of implementation.--- Baptist Health hospitals created respiratory evaluation centers to triage patients to specific COVID-19 testing sites away from emergency room and other facility entryways. --- Baptist Health created a central, system-wide respirator inventory to serve as a supply source in order to deploy equipment to specific locations based on need in the event of COVID-19 surge activity. At no time during the COVID-19 pandemic was any Baptist Health hospital without adequate respirator equipment.--- Baptist Health secured additional testing supplies and more rapid testing capabilities, and developed specific screening, testing and treatment protocols. --- Baptist Health continues to make a concerted effort to support our communities by providing frequent education and assistance to community members and local businesses who have questions regarding operating in a COVID-19 environment.--- Our quick pivot to enhanced digital/virtual healthcare solutions, with the creation of new processes and procedures and the enhancement of existing services, allowed us to provide healthcare services for patients to address their immediate medical needs, all while ensuring the safety of patients, staff and physicians. Video teleconferencing services proved to be a valuable tool as it became a lifeline for our behavioral health patients. Remote patient monitoring technology has been used extensively to support patients with COVID-19 recovering at home, patients with chronic obstructive pulmonary disease and patients suffering from congestive heart failure. A telestroke program that links specialists at Baptist Health's two stroke-certified centers to patients in other locations has also been a lifesaving tool. In a short span of time, we advanced digital health services by years and have seen our patients embrace this change. Telehealth, telemedicine and digital health solutions continue to be utilized effectively to reach patients who otherwise may not seek care and to improve patient experience. Navigating the COVID-19 pandemic has accelerated the growth and development of innovations in the delivery of healthcare services that will positively affect how care is provided in the future. Baptist Health continuously monitors COVID-19 health data, statistics, trends, clinical information and research in order to reevaluate and reassess current policies and procedures so that we can maintain the highest safety standards and provide peak levels of care to our patients. Through 8/31/2022, Baptist Health facilities administered nearly 474,000 COVID-related diagnostic tests and screenings; nearly 250,000 COVID vaccines and treated over 66,000 COVID-19 patients."