4A (Expenses $ 227883501 including grants of $ 0) (Revenue $ 234686929)
ANCILLARY SERVICES: INCLUDES CARDIOLOGY, RADIOLOGY, PHYSICAL THERAPY, LABORATORY, NUCLEAR CARE, NUCLEAR MEDICINE, ENDOSCOPY, AND DIALYSIS. THERE WERE 55,255 CARDIOLOGY NON-INVASIVE PROCEDURES, 2,761 ENDOSCOPY PROCEDURES, 1,021,555 LABORATORY UNITS OF SERVICE, AND 50,813 PHYSICAL THERAPY RELATIVE VALUE UNITS.

4B (Expenses $ 66289392 including grants of $ 0) (Revenue $ 28955529)
GENERAL/SURGICAL HEALTHCARE DELIVERY: INCLUDES SUCH SERVICES AS OBSTERICS, INTENSIVE CARE AND CORONARY CARE, AND NEONATAL NURSERY, TOTAL ADMISSIONS (EXCLUDING SPECIALTY UNITS): 11,238 TOTAL PATIENT DAYS (EXCLUDING SPECIALTY UNITS): 58,280, TOTAL SURGICAL HOURS: 15,592, THERE WERE 997 NEWBORN DELIVERIES.

4C (Expenses $ 22868307 including grants of $ 0) (Revenue $ 20481492)
EMERGENCY SERVICES; INCLUDES AMBULANCES SERVICES, AND FULL EMERGENCY ROOM CARE, INCLUDING TRAUMA. IN 2021, THERE WERE 45,311 EMERGENCY ROOM VISITS. TOTAL ADMISSIONS (EXCLUDING SPECIALTY UNITS): 11,238 TOTAL PATIENT DAYS (EXCLUDING SPECIALTY UNITS): 58,280.

4D (Expenses $ 11099303 including grants of $ 0) (Revenue $ 24507939)
SPECIALTY CARE AND OTHER: INCLUDES SERVICES SUCH AS PSYCHIATRY, REHABILITATION, AND SKILLED NURSING FACILITIES. IT ALSO INCLUDES CONVENIENCE SERIES SUCH AS WELLNESS FACILITIES. IN 2021, THERE WERE 3,146 PSYCHIATRIC DAYS, 4,179 REHAB PATIENT DAYS, AND 5,651 SKILLED NURSING DAYS.

LCMC HEALTH HOLDINGS
PART V, SECTION B, LINE 2: EFFECTIVE OCTOBER 1, 2020, LCMC HEALTH HOLDINGS, INC. (D/B/A EAST JEFFERSON GENERAL HOSPITAL) EXECUTED AN ASSET PURCHASE AGREEMENT WITH JEFFERSON PARISH HOSPITAL SERVICE DISTRICT NO. 2, PARISH OF JEFFERSON, STATE OF LOUISIANA, TO PURCHASE THE ASSETS OF EAST JEFFERSON GENERAL HOSPITAL. THE AGGREGATE CONSIDERATION TO BE PAID UPON CLOSING FOR THE PURCHASED ASSETS INCLUDES THE BASE CONSIDERATION OF $90,000,000, MINUS ASSUMED LIABILITIES AND TRANSACTION EXPENSES FOR ITS PURCHASE PRICE. THE ASSET PURCHASE AGREEMENT PROVIDES FOR THE POTENTIAL OF UP TO $15,000,000 OF ADDITIONAL CONSIDERATION, PAYABLE OVER THREE YEARS OF $5,000,000 EACH, BEGINNING IN 2021. THE CONDITION TO PAYMENT IS TIED TO A MEASURE OF INDIGENT CARE COSTS. OVER THE PERIOD OF FIVE YEARS, EFFECTIVE OCTOBER 1, 2020, LCMC HEALTH HOLDINGS, INC., AND/OR ONE OF ITS AFFILIATES, SHALL EXPEND OR COMMIT TO EXPEND A MINIMUM OF ONE HUNDRED MILLION DOLLARS ($100,000,000) ON QUALIFIED EXPENDITURES TO SUPPORT AND IMPROVE HEALTH CARE ACCESS AND DELIVERY THAT BENEFITS THE RESIDENTS OF A DEFINED RESTRICTED AREA.

LCMC HEALTH HOLDINGS
PART V, SECTION B, LINE 5: DATA COLLECTION AND ANALYSIS LPHI UTILIZED MIXED METHODS TO UNDERSTAND AND DOCUMENT COMMUNITY FEEDBACK AND PERSPECTIVES BY TRIANGULATING PRIMARY QUALITATIVE DATA FROM INTERVIEWS AND FOCUS GROUPS, SECONDARY QUANTITATIVE DATA FROM EXISTING DATA SOURCES, AND ADDITIONAL QUANTITATIVE AND QUALITATIVE DATA COLLECTED THROUGH AN ONLINE COMMUNITY SURVEY. DUE TO SAFETY PROTOCOLS DURING THE COVID-19 PANDEMIC, ALL DATA COLLECTION AND ENGAGEMENT EFFORTS OCCURRED VIRTUALLY DURING JUNE, JULY, AND AUGUST 2021. HEALTH EQUITY WAS CENTRAL TO BOTH THE DATA COLLECTION AND ANALYSIS PROCESSES. SECONDARY DATA WERE ANALYZED BY RACE WHENEVER POSSIBLE. PRIMARY DATA COLLECTION FOCUSED ON GATHERING VOICES OF POPULATIONS OF INTEREST FOR HOSPITALS INCLUDING AGING AND NON-ENGLISH SPEAKING. FINDINGS FROM THESE COMMUNITIES WERE INCORPORATED THROUGHOUT THE CHNA. HEALTH CONCERNS REGARDING CHILDREN IN THE GNO AREA WERE HIGHLIGHTED SINCE THEY ARE THE MAIN COMMUNITY SERVED BY CHILDRENS HOSPITAL.SECONDARY DATASECONDARY DATA FROM NATIONAL AND STATEWIDE DATABASES, SUCH AS AMERICAN COMMUNITY SURVEY (ACS) AND BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), WERE COMPILED AND ANALYZED TO IDENTIFY KEY CONCERNS IN THE GNO AREA AND SUPPLEMENT FINDINGS FROM PRIMARY DATA SOURCES. THE INDICATOR LIST FOR SECONDARY DATA WAS DEVELOPED TO ALIGN WITH THE COUNTY HEALTH RANKINGS INDICATOR MODEL. DATA WERE EXTRACTED AT THE PARISH-LEVEL AND LOUISIANA AVERAGES WERE USED AS A BASELINE FOR COMPARISON. ADDITIONALLY, DATA WAS DISAGGREGATED BY RACE/ETHNICITY WHERE POSSIBLE. A FULL LIST OF DATA INDICATORS AND SOURCES CAN BE FOUND IN THE CHNA'S APPENDIX G: SECONDARY DATA SOURCES.COMMUNITY SURVEYBETWEEN JULY 13 AND AUGUST 23, 2021, MHCNO PARTNER HOSPITALS, LPHI, AND THE LOUISIANA DEPARTMENT OF HEALTH (LDH) DISTRIBUTED AN ONLINE SURVEY THROUGH THEIR NETWORKS TO COMMUNITY MEMBERS RESIDING IN SOUTHEAST LOUISIANA. THE SURVEY WAS AVAILABLE IN ENGLISH, SPANISH, AND VIETNAMESE AND DISTRIBUTED IN ALL THREE LANGUAGES VIA EMAIL, SOCIAL MEDIA, AND RADIO. HOSPITAL FACILITIES FOCUSED ON DISTRIBUTING THE SURVEY TO THEIR PATIENTS THROUGH SOCIAL MEDIA AS WELL AS THROUGH CLINICS, WAITING AREAS, AND COVID TESTING/VACCINATION SITES. LPHI AND LDH DISTRIBUTED THE TOOL THROUGH VIRTUAL NETWORKS SERVING THE GNO AREA. THE SURVEY WAS CONDUCTED IN COLLABORATION WITH THE LDHS STATEWIDE HEALTH ASSESSMENT SURVEY, WHICH TOOK PLACE SIMULTANEOUSLY, TO BOOST RESPONSE RATES AND REDUCE SURVEY FATIGUE. THE SURVEY TOOL WAS GROUNDED IN HEALTH EQUITY AND INFORMED BY EVIDENCE-BASED MATERIALS (SUCH AS PREVENTION INSTITUTES MEASURING WHAT WORKS TO ACHIEVE HEALTH EQUITY: METRICS FOR THE DETERMINANTS OF HEALTH). IT INCLUDED QUESTIONS DESIGNED TO MEASURE RESPONDENTS PERCEPTIONS OF DETERMINANTS OF HEALTH, HEALTH BEHAVIORS AND EXPOSURES, AND HEALTH OUTCOMES, AS WELL AS OPEN-ENDED QUESTIONS ON LOCAL ASSETS AND RECOMMENDATIONS TO IMPROVE COMMUNITY HEALTH. ALL SURVEY RESPONSES FROM PARISHES SERVED BY MHCNO HOSPITALS WERE COMPILED FOR ANALYSIS IN STATA. IN THE GNO AREA, 3,005 COMMUNITY MEMBERS PARTICIPATED IN THE SURVEY. AS SURVEY RESPONSES WERE COLLECTED VIA CONVENIENCE SAMPLING, THESE FINDINGS MAY NOT BE GENERALIZABLE TO THE ENTIRE COMMUNITY AND SHOULD BE INTERPRETED IN CONCERT WITH QUALITATIVE AND SECONDARY DATA FINDINGS. DEMOGRAPHIC INFORMATION OF SURVEY RESPONDENTS AS WELL AS A SUMMARY OF RESPONSES TO SURVEY QUESTIONS CAN BE FOUND IN THE CHNA'S APPENDIX E: ADDITIONAL SURVEY DATA.FOCUS GROUPSLPHI FACILITATED EIGHT FOCUS GROUPS IN AUGUST 2021 WITH PARTICIPANTS FROM ORLEANS, JEFFERSON, ST. JOHN THE BAPTIST, ST. CHARLES, ST. BERNARD, AND PLAQUEMINES PARISHES. FOCUS GROUPS LASTED APPROXIMATELY 60-90 MINUTES AND WERE CONDUCTED VIA ZOOM. FOCUS GROUP PARTICIPANTS INCLUDED PARENTS, MEMBERS OF SPANISH SPEAKING COMMUNITIES, RURAL COMMUNITY MEMBERS, OLDER ADULTS, MENTAL HEALTH AND SUBSTANCE USE PROVIDERS, AND DISABILITY ADVOCATES. FOCUS GROUP DISCUSSIONS ADDRESSED HEALTH CONCERNS OF THE COMMUNITY, RESOURCES, AND ASSETS OF THE COMMUNITY, HOW PEOPLE CHOOSE/ACCESS PROVIDERS, AND RECOMMENDATIONS ON HOW TO IMPROVE THE HEALTH OF RESIDENTS. INCENTIVES WERE PROVIDED TO THOSE THAT WERE ELIGIBLE AS A TOKEN FOR THEIR TIME. ALL TRANSCRIPTIONS WERE UPLOADED INTO DEDOOSE, CODED, AND ANALYZED.KEY STAKEHOLDER INTERVIEWSTHIRTY-SEVEN INTERVIEWS WERE CONDUCTED WITH KEY STAKEHOLDERS ACROSS THE GNO AREA VIA ZOOM BETWEEN JUNE 24 AND AUGUST 24, 2021. MOST KEY STAKEHOLDERS WERE RECOMMENDED BY PARTICIPATING HOSPITALS. QUALITATIVE FINDINGS IN THIS REPORT DO NOT INCLUDE INPUT FROM ST. TAMMANY PARISH PARTICIPANTS, AS THOSE ARE MORE PERTINENT TO HOSPITALS SERVING PREDOMINANTLY THE NORTHSHORE COMMUNITY. INTERVIEWEES INCLUDED: PUBLIC HEALTH AND HEALTH DEPARTMENT LEADERS LEADERS AND/OR MEMBERS OF MEDICALLY UNDERSERVED, LOW INCOME, AND/OR MINORITY COMMUNITIES LEADERS AND SERVICE PROVIDERS FROM LOCAL COMMUNITY-FOCUSED ORGANIZATIONS SUCH AS FOOD BANKS, CBOS, SCHOOLS, HUMAN SERVICE AUTHORITIES, NEIGHBORHOOD ASSOCIATIONS, UNIVERSITIES, ADVOCACY GROUPS, ETC.INTERVIEWS AVERAGED 45 MINUTES AND FOCUSED ON HEALTH CONCERNS WITHIN THE COMMUNITY, COMMUNITY RESOURCES AND ASSETS, AND RECOMMENDATIONS ON HOW TO IMPROVE THE HEALTH OF RESIDENTS. MONETARY INCENTIVES WERE PROVIDED TO ELIGIBLE PARTICIPANTS FOR THEIR TIME AND INPUT. TRANSCRIPTS WERE LOADED INTO DEDOOSE AND CODED BASED ON KEY THEMES. A THEMATIC ANALYSIS WAS THEN CONDUCTED TO SYNTHESIZE FINDINGS. QUALITATIVE PARTICIPANTS FROM THE GNO COMMUNITYBY USING THESE PRIMARY DATA COLLECTION AND ANALYSIS METHODS, THE HOSPITAL FACILITIES AND LPHI TEAM CONDUCTED OUTREACH THROUGH VIRTUAL PLATFORMS TO SOLICIT INPUT FROM PERSONS REPRESENTING BROAD INTERESTS OF THE GNO COMMUNITY. THROUGH INTERVIEWS THE TEAM INCORPORATED INPUT FROM 14 PUBLIC HEALTH EXPERTS 2 WORKING FOR STATE, REGIONAL, OR LOCAL HEALTH DEPARTMENT, AND 32 MEMBERS, REPRESENTATIVES, OR LEADERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS.GNO AREA ORGANIZATIONS PARTICIPATING IN INTERVIEWS AND FOCUS GROUPS INCLUDED, BUT NOT LIMITED TO: 504 HEALTHNET, AMERICAN CANCER SOCIETY, BAYOU DISTRICT FOUNDATION, BOYS AND GIRLS CLUB WESTBANK, CANCER ASSOCIATION OF GREATER NEW ORLEANS, CHILDRENS HOSPITAL, CITY OF KENNER, CITY OF NEW ORLEANS HEALTH DEPARTMENT, COVENANT HOUSE, CRESCENT CITY FAMILY SERVICES, DELGADO COMMUNITY COLLEGE, EAST NEW ORLEANS NEIGHBORHOOD ADVISORY COMMISSION, GOLDEN OPPORTUNITY, JEFFERSON CHAMBER OF COMMERCE, JEFFERSON PARISH GOVERNMENT, JEFFERSON PARISH SCHOOLS, JEWISH COMMUNITY CENTER, KENNER DISCOVERY HEALTH SCIENCES ACADEMY, LCMC HEALTH, LOUISIANA DEPARTMENT OF HEALTH, METROPOLITAN HUMAN SERVICES DISTRICT, NEW ORLEANS COUNCIL ON AGING, NEW ORLEANS FAMILY JUSTICE CENTER, NEW ORLEANS HEALTH DEPARTMENT, NOLA BABY CAFE, NOLA PUBLIC SCHOOLS, NOLA VILLAGE, OCHSNER HEALTH (INCLUDING RESOURCE GROUPS), OCHSNER HEALTHY SCHOOLS, ODYSSEY HOUSE, SOCIAL HEALTH BRIDGE / OPERATION PATHWAYS, ST. JOHN THE BAPTIST PARISH JUSTICE COURT, STEM NOLA, THE PARENTING CENTER, TULANE SCHOOL OF MEDICINE, VAYLA, AND YOU NIGHT

LCMC HEALTH HOLDINGS
PART V, SECTION B, LINE 6A: THE METROPOLITAN HOSPITAL COUNCIL OF NEW ORLEANS (MHCNO) CONTRACTED WITH THE LOUISIANA PUBLIC HEALTH INSTITUTE (LPHI) TO DEVELOP COMMUNITY HEALTH NEEDS ASSESSMENT (CNHA) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) REPORTS FOR PARTICIPATING HOSPITALS IN THE AREA. THIS REPORT SUMMARIZES THE FINDINGS OF THE JOINT CHNA FOR THE GREATER NEW ORLEANS (GNO) AREA AND DESCRIBES THE COMMUNITY HEALTH NEEDS IDENTIFIED AS TOP PRIORITIES BY EACH OF THE 10 PARTICIPATING HOSPITALS. THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITIES: CHILDRENS HOSPITAL NEW ORLEANS EAST JEFFERSON GENERAL HOSPITAL NEW ORLEANS EAST HOSPITAL OCHSNER MEDICAL CENTER - NEW ORLEANS OCHSNER BAPTIST - A CAMPUS OF OCHSNER MEDICAL CENTER OCHSNER MEDICAL CENTER - WEST BANK CAMPUS OCHSNER MEDICAL CENTER - KENNER OCHSNER REHABILITATION HOSPITAL RIVER PLACE BEHAVIORAL HEALTH HOSPITAL TOURO INFIRMARY UNIVERSITY MEDICAL CENTER NEW ORLEANS WEST JEFFERSON MEDICAL CENTER

LCMC HEALTH HOLDINGS
PART V, SECTION B, LINE 11: THE TOP NEEDS IDENTIFIED BY THE CHNA AND PRIORITIZED BY EJGH ARE ACCESS TO AND CONTINUITY OF CARE, EDUCATION AND HEALTH LITERACY, HEALTH EQUITY AND DISCRIMINATION IN HEALTH CARE, AND INFRASTRUCTURE. TO ADDRESS THE NEED OF INCREASED ACCESS TO AND CONTINUITY OF CARE, EJGH WILL INCREASE CARE COORDINATION TO ENSURE CONTINUITY OF CARE AND WILL UTILIZE INTERNAL AND EXTERNAL RESOURCES TO REMOVE BARRIERS TO CARE. EJGH'S PLAN TO ACCOMPLISH THESE GOALS INCLUDES THE FOLLOWING: INCREASING THE AMOUNT OF MEETINGS BETWEEN OUTPATIENT ONCOLOGY INFUSION PATIENTS AND THE FINANCIAL NAVIGATOR PRIOR TO BEGINNING TREATMENT BY 50% FROM 2022 - 2024 TO PROVIDE MORE FINANCIAL ASSISTANCE; HEART AND VASCULAR SUPPORT GROUPS WILL BE OFFERED ON A QUARTERLY BASIS WITH AT LEAST 10 OR MORE COMMUNITY MEMBERS IN ATTENDANCE; INCREASE PATIENT CONTACT TO IMPLEMENT POPULATION HEALTH BY INCREASING PATIENT POST-DISCHARGE TELEPHONIC CALLS WITHIN 48 HOURS OF DISCHARGE TO 75%; INCREASE HEART FAILURE APPOINTMENT SCHEDULING TO 90% OF HEART FAILURE DISCHARGES TO INCREASE FOLLOW UP CARE WITH PROVIDER; INCREASE NUMBER OF COPD AND/OR PNEUMONIA POST DISCHARGE FOLLOW UP CALLS BY 5%; AND IMPROVE ACCESS OF MEDICAL SERVICES TO UNINSURED AND UNDERINSURED PATIENTS. TO ADDRESS THE NEED OF EDUCATION AND HEALTH LITERACY, EJGH WILL DELIVER EDUCATION AND SUPPORTIVE RESOURCES TO IMPROVE HEALTH LITERACY WITHIN THE COMMUNITY BY PROVIDING THE COMMUNITY WITH EDUCATION, SCREENING EVENTS, PUBLIC SOCIAL MEDIA POSTS, AND SUPPORT GROUPS TO ACHIEVE POSITIVE HEALTHY OUTCOMES. EJGH'S PLAN TO ACCOMPLISH THESE GOALS INCLUDES THE FOLLOWING: EJGH OUTPATIENT ONCOLOGY WILL HOST AT LEAST ONE QUARTERLY CANCER SUPPORT GROUP FROM 2022 - 2024; EJGH WILL HOST ONE ANNUAL CANCER SCREENING EVENT FROM 2022 - 2024; EJGH OUTPATIENT ONCOLOGY WILL CREATE A MINIMUM OF 12 SOCIAL MEDIA POSTS ANNUALLY THROUGHOUT 2022 TO 2024 TO EDUCATE THE PUBLC ON CANCER TOPICS; PROVIDE HEART AND VASCULAR HEALTH SCREENING AND/OR EDUCATION AT AT LEAST ONE EVENT QUARTERLY WITH AT LEAST 5 COMMUNITY MEMBERS IN ATTENDANCE; OFFER COMPLIMENTARY BREASTFEEDING SUPPORT GROUPS EVERY MONTH; OFFER COMPLIMENTARY PRENATAL COMMUNITY CLASSES EVERY OTHER MONTH; OFFER SMOKING CESSATION SUPPORT GROUP MEETINGS AT LEAST QUARTERLY WITH AT LEAST 5 COMMUNITY MEMBERS IN ATTENDANCE; OFFER BETTER BREATHERS CLUB (BBC) PULMONARY SUPPORT GROUP AT LEAST QUARTERLY WITH AT LEAST 8 COMMUNITY MEMBERS IN ATTENDANCE; AND PULMONARY SERVICES WILL HOST AT LEAST ONE PULMONARY SCREENING EVENT ANNUALLY. TO ADDRESS THE CHALLENGES POSED BY DISCRIMINATION IN HEALTHCARE, EJGH WILL ENHANCE ALL EMPLOYEES' CULTURAL COMPENTENCY OF OUR DIVERSE POPULATION AND REMOVE COMMUNICATION BARRIERS TO SUPPORT OUR GOAL OF PROVIDING NON-DISCRIMINATORY HEALTHCARE TO OUR DIVERSE PATIENT POPULATION. EJGH'S PLAN TO ACCOMPLISH THESE GOALS INCLUDES THE FOLLOWING: TRAINING FOR ALL STAFF, AT ALL LEVELS, ON THE TOOLS ON LEADING DIVERSE TEAMS AS WELL AS CREATING EQUITABLE AND INCLUSIVE WORK ENVIRONMENTS; DEVELOP TRAINING FOR ALL HOSPITAL STAFF ON HOW TO COLLECT INFORMATION, SUCH AS STANDARDIZATION METHODOLOGY FOR COLLECTING SEXUAL ORIENTATION AND GENDER IDENTITY, THAT WILL ASSIST IN CREATING STRATEGIES TO ENSURE HEALTH EQUITY; AND THROUGHOUT 2022 TO 2024, EJGH WILL REPORT ANNUALLY ON AMN HEALTHCARE VIDEO REMOTE INTERPRETING DEVICE, WHICH ASSISTS WITH REAL-TIME VERBAL TRANSLATION, USAGE FOR NON-ENGLISH-SPEAKING PATIENTS WITHIN THE OUTPATIENT ONCOLOGY INFUSION CENTER. FINALLY, TO ADDRESS THE CHALLENGES POSED BY INFRASTRUCTURE, EJGH WILL ASSIST PATIENTS WITH STRESSORS THAT COULD POTENTIALLY INHIBIT RECEIVING CARE BY WORKING WITH COMMUNITY RESOURCES AND PARTNERS TO ADDRESS COMMUNITY NEEDS THAT WOULD IMPACT PATIENTS' ABILITY TO ACCESS CARE. EJGH'S PLAN TO ACCOMPLISH THESE GOALS INCLUDES THE FOLLOWING: ELIGIBLE EJGH OUTPATIENT ONCOLOGY PATIENTS WILL RECEIVE FREE HOUSING AT HOPE LODGE DURING CANCER TREATMENTS THROUGHOUT 2022 TO 2024 UNLESS RESIDENCE MEETS MAXIMUM OCCUPANCY; PROVIDE FAMILIES WITH NUTRITIONAL MEALS DURING HOLIDAY SEASON; AND ELIGIBLE EJGH OUTPATIENT ONCOLOGY PATIENTS WILL RECEIVE TRANSPORTATION ASSISTANCE THROUGH FREE CAB RIDES UNLESS FUNDS ARE DEPELETED THROUGHOUT 4/1/22 THROUGH 3/31/23.

SCHEDULE H, PART V, SECTION B, LINE 9
"EAST JEFFERSON GENERAL HOSPITALDISCLOSURES IN ACCORDANCE WITH REV. PROC. 2015-21, SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION BAS PART OF THE LCMC HEALTH SYSTEM, THE HOSPITAL PARTICIPATED IN A SYSTEM WIDE INITIATIVE TO DEVELOP AND IMPLEMENT A COMMUNITY HEALTH NEEDS ASSESSMENT. AS PART OF THE INITIATIVE, THE HOSPITAL BOARD APPROVED THE PLAN PRIOR TO THE 12/31/2021 DEADLINE. AN IMPLEMENTATION PLAN WAS DEVELOPED AND IMPLEMENTED, HOWEVER, DURING THE PREPARATION OF THE FORM 990, THE HOSPITAL BECAME AWARE THAT THE IMPLEMENTATION PLAN OF THE 2021 HAD NOT BEEN APPROVED AND WAS SUBSEQUENTLY DONE SO ON AUGUST 17, 2022. WHILE THE HOSPITAL WAS DELAYED IN HAVING THE IMPLEMENTATION PLAN APPROVED BY THE BOARD, IT HAD BEGUN ACTIVITIES TO MEET THE GOALS FOR THE PLAN PRIOR TO THAT TIME. HIGHLIGHTS OF THOSE EFFORTS THAT ARE IN PROCESS THROUGHOUT THE YEAR INCLUDE:PRIORITY 1: ACCESS AND CONTINUITY OF CARETO ASSIST IN REDUCING CHALLENGES WITHIN THE FIRST 48 HOURS AFTER DISCHARGE, THE CARE MANAGEMENT TEAM IS WORKING TO INCREASE THE OUTREACH TO PATIENTS WITHIN THAT TIME PERIOD TO 75%. YEAR TO DATE, 68% OF PATIENTS HAVE BEEN CONTACTED WITHIN THE FIRST 48 HOURS. THIS INITIATIVE STARTED APRIL 26TH.THE HOSPITAL HAS INITIATED PROCESSES TO PROACTIVELY SCHEDULE POST DISCHARGE APPOINTMENTS FOR HEART FAILURE PATIENTS TO ENSURE ACCESS TO PREVENTATIVE CARE IS AT THE FOREFRONT. CURRENTLY, 81% OF HEART FAILURE PATIENTS HAVE BEEN SCHEDULED FOR APPOINTMENTS WITH PROVIDERS.PRIORITY 2: HEALTH LITERACY AND EDUCATIONEAST JEFFERSON'S ONCOLOGY TEAM HAS COMMITTED TO POSTING A MINIMUM OF 12 SOCIAL MEDIA POSTS ANNUALLY TO EDUCATE THE COMMUNITY ABOUT CANCER TOPICS. THUS FAR, THERE HAVE BEEN 14 POSTS FOR 2022 WHICH STARTED FEBRUARY 15, 2022.PRIORITY 3: DISCRIMINATION IN HEALTHCARETHE HOSPITAL HAS TRANSITIONED TO A NEW TRANSLATION SERVICES PROVIDER IN 2022 TO ASSIST IN TRANSLATION WITH PATIENTS THAT ARE NON-ENGLISH SPEAKINGALL MEMBERS OF THE HOSPITAL'S SENIOR LEADERSHIP TEAM HAVE ATTENDED HEALTH EQUITY LEADERSHIP MATTERS (AT THE H.E.L.M.) TRAINING SESSIONS DURING VARIOUS POINTS IN 2022. THIS TRAINING WAS DESIGNED BY TO BUILD THE KNOWLEDGE LEVELS AND SKILL SETS OF ORGANIZATIONAL LEADERS BY GAINING INCREASED UNDERSTANDING AND STRATEGIES TO MITIGATE HEALTH EQUITY, DISCRIMINATIONS IN HEALTHCARE AND HEALTH LITERACY. THIS TRAINING'S CONTENT AND THE PREVIOUS IDENTIFIED ACTIVITIES ALIGN WITH THE HOSPITAL'S IDENTIFIED CHIP TOPICS. THIS PART OF A THREE-YEAR PROGRAM THAT WILL BE DISSEMINATED TO ALL EMPLOYEES.PRIORITY 4: INFRASTRUCTURETHE ONCOLOGY TEAM HAS PRIORITIZED IMPROVING INFRASTRUCTURE NEEDS IN THE COMMUNITY. TO REDUCE THE STRESS OF ATTENDING MULTIPLE APPOINTMENTS ASSOCIATED WITH LONG DISTANCE TRAVEL, EAST JEFFERSON HAS PARTNERED WITH HOPE LODGE TO ALLOW PATIENTS TO STAY NEAR WHERE THEIR CARE IS OCCURRING. AS OF 2022, TEN PATIENTS HAVE STAYED AT HOPE LODGE FOR A TOTAL OF 389 NIGHTS. THE FIRST PATIENT STAYED AT HOPE LODGE ON JANUARY 6, 2022. EAST JEFFERSON HAS PROVIDED FOR 534 ONE-WAY RIDES TO 21 PATIENTS TO PATIENTS ACROSS THE HOSPITAL'S SERVICE AREA.THE HOSPITAL'S CHNA PROCESS HAS HISTORICALLY BEEN LED AT THE SYSTEM LEVEL TO DEVELOP AND IMPLEMENT THE ASSESSMENT AND INCLUDED A HAND OFF TO OUR VARIOUS FACILITIES FOR BOARD ADOPTION OF THE ASSESSMENT, DEVELOPMENT OF THE IMPLEMENTATION PLAN, AND ADOPTION OF THE IMPLEMENTATION PLAN BY THE BOARD. FROM AN OPERATIONAL STANDPOINT, WE ARE ADJUSTING OUR POLICIES TO ENSURE THAT /FUTURE HANDOFFS INCLUDE SPECIFIC DATES FOR DEVELOPMENT AND ADOPTION OF THE ASSESSMENT AND IMPLEMENTATION AND INCLUDE SYSTEM-LEVEL INCLUSION AND FOLLOW-UP TO ENSURE ALL TIMELINES ARE MET. IN ADDITION, WE ARE ADJUSTING OUR FINANCE PROCEDURES TO INCLUDE CHECKS OF SUCH ADOPTION DATES WHEN FILING OUR 990 EXTENSIONS TO ADD ANOTHER LAYER OF COMPLIANCE CHECKING.THE HOSPITAL CONSIDERS THIS ERROR IN HAVING DELAYED BOARD APPROVAL OF THE IMPLEMENTATION PLAN TO BE A ""MINOR"" OMISSION AND EITHER INADVERTENT OR DUE TO REASONABLE CAUSE UNDER APPLICABLE 501(R) REGULATIONS AND INTERPRETATIONS. ACCORDINGLY, HOSPITAL HAS NOT FILED AN EXCISE TAX RETURN OR PAID ANY RELATED TAX IMPOSED UNDER IRC SECTION 4959. HOSPITAL HAS NEW ADMINISTRATIVE OVERSIGHT IN PLACE AND HAS PUT PROCEDURES IN PLACE TO ADDRESS AND MONITOR ITS COMPLIANCE WITH REQUIREMENTS OF IRC SECTION 501(R)."

PART I, LINE 3C:
UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, TO BE ELIGIBLE FOR A 100% REDUCTION OF CHARGES (I.E FULL WRITE OFF), THE PATIENT'S FAMILY INCOME MUST BE AT OR BELOW 100% OF FEDERAL POVERTY GUIDELINES (FPL) AND CRITERIA FOR THE LCMC FINANCIAL ASSISTANCE PROGRAM: VERIFIED 0-200% OF FPL FOR APPLICANT AND PROOF OF FAMILY INCOME. THE ADEQUACY OF THAT PROOF IS AT THE DISCRETION OF LCMC. UNCOMPENSATED CARE APPLICANTS WILL BE REQUIRED TO SUBMIT SUPPORTING FINANCIAL AND MEDICAL INFORMATION IN ORDER TO MAKE A DETERMINATION OF ELIGIBILITY. PATIENTS WHO DO NOT MEET THE CRITERIA FOR FREE CARE (I.E FULL WRITE OFF) BUT MEET FEDERAL POVERTY GUIDELINES, AND WITHOUT ANY SOURCE OF INSURANCE COVERAGE WILL BE ELIGIBLE FOR A SLIDING SCALE UNINSURED DISCOUNT.

PART I, LINE 7:
BAD DEBT EXPENSE OF $18,435,273 WAS REMOVED FOR PURPOSES OF CALCULATING THE NET COMMUNITY BENEFIT EXPENSE REPORTED IN PART I, LINE 7.

PART III, LINE 2:
PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED.

PART III, LINE 3:
AMOUNTS DEEMED AS CHARITY CARE ARE FOR PATIENTS WHO ARE IDENTIFIED AS MEETING THE REQUIREMENTS FOR CHARITY CARE IN ACCORDANCE WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE ORGANIZATION ESTIMATES THAT APPROXIMATELY >5% OF THE BAD DEBT EXPENSES COULD BE TREATED AS CHARITY CARE.

SCHEDULE H, PART II
LCMC HEALTH HOLDINGS, INC. SUPPORTS COMMUNITY HEALTH BY PROVIDING STAND BY AMBULANCE SERVICES FOR MANY PUBLIC EVENTS, FAIRS, FESTIVALS, AND PARADES TO ENSURE THAT HEALTH ISSUES OF EVENT ATTENDEES THAT ARISE ARE ADDRESSED.EJGH SUPPORT COMMUNITY BUILDING THROUGH TRAINING CLASSES OFFERED TO VARIOUS MEMBERS OF THE COMMUNITY INCLUDING, BUT NOT LIMITED TO, EXPECTANT MOTHERS, NEW MOTHERS, BABYSITTERS, AND THE ELDERLY. CLASSES OFFERED RANGE IN TYPE AND FREQUENCY BASED ON THE NEED ASSESSED BY THE HOSPITAL.

PART III, LINE 4:
FROM NOTE 2 OF THE AUDIT REPORT: THE SYSTEM DETERMINES THE TRANSACTION PRICE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO PATIENTS IN ACCORDANCE WITH POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED TO PATIENTS. EXPLICIT PRICE CONCESSIONS ARE BASED ON CONTRACTUAL AGREEMENTS, DISCOUNT POLICIES, AND HISTORICAL EXPERIENCE. IMPLICIT PRICE CONCESSIONS REPRESENT DIFFERENCES BETWEEN AMOUNTS BILLED AND THE ESTIMATED CONSIDERATION THE SYSTEM EXPECTS TO RECEIVE FROM PATIENTS, WHICH ARE DETERMINED BASED ON HISTORICAL COLLECTION EXPERIENCE, CURRENT MARKET CONDITIONS, AND OTHER FACTORS. GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR PATIENT RESPONSIBILITY BALANCES, INCLUDING DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE SYSTEM ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY EXPLICIT PRICE CONCESSIONS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS.

PART III, LINE 8:
THE COST FOR PROVIDING MEDICARE SERVICES WAS DETERMINED BY USING THE COST TO CHARGES RATIOS DEVELOPED FROM THE FILED 2021 MEDICARE COST REPORT.

PART III, LINE 9B:
FOR PATIENTS IDENTIFIED AS FINANCIAL ASSISTANCE POLICY ELIGIBLE, THE ENCOUNTER DOES NOT PROCEED THROUGH THE COLLECTION PROCESS AND IS WRITTEN OFF TO CHARITY CARE.

PART VI, LINE 2:
LCMC HEALTH HOLDINGS ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES BY MAINTAINING RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CARE IT PROVIDES. COMMUNITY BENEFIT SERVICES REPRESENT THE COST OF PROVIDING SERVICES SUCH AS AMBULANCE SERVICE, AND PUBLIC SPEECHES ON HEALTH CARE ISSUES. LCMC HEALTH HOLDINGS COUNCILS AND EDUCATES PATIENTS AND GUESTS BY DISCUSSING ELIGIBILITY OF CHARITY ASSISTANCE BY MEETING AND MONITORING THE PATIENTS AND GUESTS DURING THE ENTIRE STAY AT LCMC HEALTH HOLDINGS.

PART VI, LINE 3:
LCMC HEALTH HOLDINGS, UPON REQUEST, SHALL PROVIDE ANY MEMBER OF THE PUBLIC OR STATE GOVERNMENTAL ENTITY A COPY OF ITS FINANCIAL ASSISTANCE/CHARITY CARE POLICY. THE POLICY WILL ALSO BE AVAILABLE ON THE LCMC HEALTH HOLDINGS WEBSITE. IN ADDITION, NOTIFICATION ABOUT LCMC HEALTH HOLDINGS' FINANCIAL ASSISTANCE/CHARITY CARE POLICY, WHICH SHALL INCLUDE A CONTACT NUMBER, SHALL BE DISSEMINATED BY LCMC HEALTH HOLDINGS BY VARIOUS MEANS, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, THE PUBLICATION OF NOTICES IN PATIENT BILLS AND BY POSTING NOTICES IN EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES, AND PATIENT FINANCIAL SERVICES OFFICES THAT ARE LOCATED ON FACILITY CAMPUSES, AND AT OTHER PUBLIC PLACES AS LCMC HEALTH HOLDINGS MAY ELECT. INFORMATION SHALL ALSO BE INCLUDED ON FACILITY WEBSITES AND IN THE CONDITIONS OF ADMISSION FORM. SUCH INFORMATION SHALL BE PROVIDED IN THE PRIMARY LANGUAGES SPOKEN BY THE POPULATION SERVICES BY LCMC HEALTH HOLDINGS. REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE LCMC HEALTH HOLDINGS STAFF OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.

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WITH RESPECT TO EAST JEFFERSON GENERAL HOSPITAL, THE COMMUNITY SERVED IS DEFINED ACROSS 8 DIFFERENT PARISHES. THIS AREA INCLUDES JEFFERSON, ORLEANS, PLAQUEMINES, ST. BERNARD, ST. CHARLES, ST. JAMES, ST. JOHN THE BAPTIST, AND ST. TAMMANY PARISHES. IN DISCUSSING DEMOGRAPHIC DATA, EJGH SERVICES PATIENTS FROM ACROSS SOUTH LOUISIANA, STATE WIDE AND BEYOND. THIS COMMUNITY INCLUDES MEDICALLY UNDESERVED, LOW-INCOME, AND MINORITY POPULATIONS. THE INFORMATION BELOW IS GLEAMED FROM EJGH'S COMMUNITY HEALTH NEEDS ASSESSMENT PERFORMED IN 2021. IN 2021, THE TOTAL POPULATION OF EJGH'S SERVICE AREA IS 1,267,777. BY COMPARISON, THE TOTAL POPULATION OF ORLEANS AND JEFFERSON PARISH, THE TWO LARGEST PARISHES SERVED BY EJGH, WERE 390,845 AND 434,850, RESPECTIVELY. THE OVERALL 2021 POPULATION OF THE STATE OF LOUISIANA WAS 4,664,362.EJGH'S POPULATION IS COMPRISED 48% MALES AND 52% FEMALES.THE AGE DISPERSION FOR EJGH'S SERVICE AREA IS AS FOLLOWS: UNDER 18 YEARS OLD: 22%, 18 - 64: 63%, 65+: 15%. THIS DISPERSION IS CONSISTENT, FOR THE MOST PART, WITH JEFFERSON PARISH, ORLEANS PARISH, AND THE STATE OF LOUISIANA AS A WHOLE.RACIALLY, THERE ARE SIGNIFICANT DIFFERENCES WITHIN EJGH'S SERVICE AREA. IN ORLEANS PARISH, 30.7% OF THE POPULATION IS WHITE/NON-HISPANIC, 58.9% IS BLACK/NON-HISPANIC, AND 5.5% IS HISPANIC. BY COMPARISON, JEFFERSON PARISH'S BREAKDOWN IS 52.6%, 26.4%, AND 14.5%. IN PLAQUEMINES PARISH, 63.9% OF THE POPULATION IS WHITE/NON-HISPANIC, 19.9% IS BLACK/NONHISPANIC, AND 7.3% IS HISPANIC. ST. BERNARD PARISH IS COMPRISED OF 62.3% WHITE/NON-HISPANIC, 22.7% BLACK/NON-HISPANIC, AND 10.1% HISPANIC. ST. CHARLES PARISH IS COMPRISED OF 65.1% WHITE/NON-HISPANIC, 26.3% BLACK/NONHISPANIC, AND 6.1% HISPANIC. ST. JAMES PARISH IS COMPRISED OF 48.2% WHITE/NON-HISPANIC, 49.6% BLACK/NON- HISPANIC, AND 1.7% HISPANIC. ST. JOHN THE BAPTIST PARISH IS COMPRISED OF 34.3% WHITE/NON-HISPANIC, 56.1% BLACK/NON- HISPANIC, AND 6.1% HISPANIC. IN ST. TAMMANY PARISH, 78.6% OF THE POPULATION IS WHITE/NON- HISPANIC, 12.0% IS BLACK/NON-HISPANIC, AND 5.6% IS HISPANIC. AS A STATE, LOUISIANA IS COMPRISED OF 58.7% WHITE/NON-HISPANICS, 32.0% BLACK/NON-HISPANIC, AND 5.1% HISPANICS. THE AVERAGE ANNUAL HOUSEHOLD INCOME FOR ORLEANS PARISH IS $45,092. THEAVERAGE HOUSEHOLD INCOME FOR JEFFERSON PARISH IS $55,909. THE AVERAGE FORTHE STATE OF LOUISIANA AS A WHOLE IS $51,108. INTERNATIONAL AND NATIONALRESEARCH CONNECTS POVERTY TO ILL-HEALTH. QUALITATIVE PARTICIPANTS ANDSURVEY RESPONDENTS INDICATED THAT ECONOMIC DIVIDES AS WELL AS A LACK OFECONOMIC OPPORTUNITY ARE KEY FACTORS DRIVING ADVERSE HEALTH OUTCOMES.QUALITATIVE PARTICIPANTS DESCRIBED PEOPLE STRUGGLING TO FIND EMPLOYMENT,WORKING MINIMUM WAGE JOBS, AND WORKING MULTIPLE JOBS JUST TO MAKE ENDSMEET. THIS IS SUPPORTED BY SECONDARY DATA, WHICH SHOWS THAT 42-59% OFHOUSEHOLDS IN THE GNO AREA EARN LESS THAN THE BASIC COST OF LIVING. THEPOVERTY RATES BY PARISH ARE AS FOLLOWS: ST. BERNARD PARISH 59%, ORLEANSPARISH 57%, PLAQUEMINES PARISH 54%, ST. JOHN THE BAPTIST PARISH 50%,JEFFERSON PARISH, 48%, ST. JAMES PARISH 45%, ST. TAMMANY PARISH 43%, ANDST. CHARLES PARISH 42%. THE POVERTY RATE FOR LOUISIANA AS A WHOLE IS 51%.FROM A HEALTH RANKINGS PERSPECTIVE, LOUISIANA RANKS 50TH OVERALL,ACCORDING TO THE 2020 AMERICA'S HEALTH RANKING REPORT.

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ALL REVENUES GENERATED BY THE HOSPITAL ARE IN FURTHERANCE OF OUR EXEMPT PURPOSE. IN ADDITION, LCMC HEALTH HOLDINGS PROVIDES A FREE AND BELOW COST CARE PROGRAM ON ITS OWN AMBULANCE SERVICE AT NO CHARGE, VARIOUS CONTRIBUTIONS TO PARISH PROGRAMS SUCH AS PRISON MEDICAL UNIT, COMMUNITY EDUCATION, COMPREHENSIVE EARLY DETECTION PROGRAMS, FACILITIES FOR VARIOUS COMMUNITY GROUPS, AND NUMEROUS OTHER SERVICES TO THE COMMUNITY. THE PROGRAM SERVICE REVENUE GENERATED ALLOWS US TO PROVIDE QUALITY, DEPENDABLE HEALTH CARE IN OUR COMMUNITY.THE ORGANIZATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND THE ESTIMATED COST OF THOSE SERVICES AND SUPPLIES. ALTHOUGH NOT ACCOUNTED FOR AS CHARITY CARE, THE ORGANIZATION CONSIDERS THE CONTRACTUAL ADJUSTMENT EXPENSE RELATED TO THE MEDICAID SERVICES AS CHARITY CARE. COMMUNITY BENEFIT SERVICES REPRESENT THE COST OF PROVIDING SERVICES SUCH AS AMBULANCE SERVICES AND PUBLIC SPEECHES ON HEALTH CARE ISSUES TO PARISH ORGANIZATIONS.ADDITIONALLY, THE MEDICAL STAFF IS OPEN TO ALL PHYSICIANS, PROVIDED THEY MEET THE REQUIREMENTS AS ESTABLISHED IN THE APPLICATION PROCESS.

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"LCMC HEALTH HOLDINGS, INC. IS 501(C)(3) HOSPITAL UNDER 170(B)(1)(A)(III) WHOSE SOLE MEMBER IS LOUISIANA CHILDREN'S MEDICAL CENTER (LCMC). LCMC IS ALSO THE PARENT ORGANIZATION OF TOURO INFIRMARY, CHILDREN'S HOSPITAL, WEST JEFFERSON MEDICAL CENTER AND UNIVERSITY MEDICAL CENTER MANAGEMENT CORPORATION.LCMC IS A LOUISIANA NON-STOCK, NOT-FOR-PROFIT CORPORATION THAT WAS INCORPORATED IN 2009. LCMC IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL INC. (""CHILDREN'S"") ALSO BECAME THE SOLE MEMBER OF TOURO INFIRMARY (""TOURO"") IN 2009 TO CREATE A TWO-HOSPITAL MEDICAL SYSTEM PROVIDING A COMPLETE CONTINUUM OF CARE FROM BIRTH TO GERIATRICS. CHILDREN'S PROVIDES COMPREHENSIVE PEDIATRIC HEALTHCARE THAT MEETS THE SPECIAL NEEDS OF CHILDREN THROUGH EXCELLENCE AND CONTINUOUS IMPROVEMENT OF PATIENT CARE, EDUCATION, AND RESEARCH. TOURO, FOUNDED IN 1852, SERVES THE GREATER NEW ORLEANS COMMUNITY AS A PREMIER, DIVERSE, MULTI-SPECIALTY HOSPITAL, CARING FOR THE SICK REGARDLESS OF RACE, COLOR, CREED, RELIGIOUS AFFILIATION, OR ABILITY TO PAY.IN TAX YEAR 2013, FOLLOWING STATE BUDGET REDUCTIONS THAT CAUSED SEVERE CUTS TO THE LOUISIANA PUBLIC HOSPITAL SYSTEM, AND AT THE REQUEST OF STATE OFFICIALS, LCMC EMBARKED ON A COOPERATIVE ENDEAVOR WITH THE STATE OF LOUISIANA (""STATE"") FOR THE PURPOSE OF CREATING AN ACADEMIC MEDICAL CENTER (1) TO SERVE THE STATE AND ITS CITIZENS AS A PREMIER SITE FOR GRADUATE MEDICAL EDUCATION AND (2) TO FULFILL THE STATE'S HISTORICAL MISSION OF ASSURING ACCESS TO SAFETY NET SERVICES FOR ALL CITIZENS OF THE STATE, INCLUDING ITS MEDICALLY INDIGENT, HIGH-RISK MEDICAID, AND STATE INMATE POPULATIONS. UNDER THIS AGREEMENT, LCMC AGREED TO ASSUME RESPONSIBILITY FOR THE MANAGEMENT AND OPERATIONS OF THE INTERIM LSU PUBLIC HOSPITAL (ILH) AND THE UNIVERSITY MEDICAL CENTER. THROUGH THIS ENDEAVOR, LCMC AND ITS AFFILIATES ARE FULFILLING THEIR MISSIONS TO ENHANCE THE HEALTH OF THE GREATER NEW ORLEANS COMMUNITY BY DELIVERING HIGH QUALITY HEALTH CARE SERVICES TO ALL PATIENTS THROUGH A COMMITMENT TO CLINICAL EXCELLENCE, EDUCATION, TECHNOLOGY, RESEARCH, AND COMMUNITY OUTREACH.IN TAX YEAR 2015, LCMC AND WEST JEFFERSON HOLDINGS ENTERED INTO A COOPERATIVE ENDEAVOR WITH JEFFERSON PARISH HOSPITAL SERVICE DISTRICT NO. 1 TO LEASE AND OPERATE THE FACILITY KNOWN AS WEST JEFFERSON MEDICAL CENTER (""FACILITY""). THIS WAS DONE TO (1) TRANSFORM THE HEALTH CARE DELIVERY LANDSCAPE IN NEW ORLEANS THROUGH THE CREATION OF AN INTEGRATED HEALTHCARE DELIVERY NETWORK, (2) ALLOW FOR AN ENHANCED INTEGRATED DELIVERY SYSTEM WELL-POSITIONED FOR THE CHALLENGES OF HEALTHCARE REFORM AND POPULATION HEALTH MANAGEMENT IN THE FUTURE, (3) ENHANCE PHYSICIAN RECRUITMENT AND ENGAGEMENT AT THE FACILITY THROUGH DEVELOPMENT OF HIGH-QUALITY, OPEN MEDICAL STAFFS WITH SIGNIFICANT COMMUNITY INVOLVEMENT, A COMMITMENT TO MEDICAL RESEARCH AND EDUCATION, THE ESTABLISHMENT OF A PHYSICIAN NETWORK THAT MAY PARTICIPATE IN CLINICAL INTEGRATION, AND A COMMITMENT TO PLURALISTIC PHYSICIAN ALIGNMENT MODELS, AND (4) ACHIEVE FOR THE FACILITY THE BENEFITS OF SCALE ACHIEVED BY A LARGER HEALTH SYSTEM BY PROVIDING FOR GREATER STANDARDIZATION AND COST EFFICIENCY, ALLOWING FOR THE ABILITY TO LEVERAGE BEST PRACTICES AND GENERATE OPERATIONAL EFFICIENCIES.IN TAX YEAR 2021, LCMC AND ITS AFFILIATES PROVIDED TOTAL COMMUNITY BENEFIT EXPENSE OF $969.4 MILLION. THIS AMOUNT REPRESENTED 45% OF THE AFFILIATES COMBINED TOTAL EXPENSE. LCMC AND ITS AFFILIATES PROVIDES SERVICES TO MANY LOW-INCOME RESIDENTS OF THE GREATER NEW ORLEANS AREA. IN 2021, $677.9 MILLION IN EXPENSE (31% OF THE AFFILIATES COMBINED TOTAL EXPENSE) WAS INCURRED IN PROVIDING SERVICES FOR MEDICAID RECIPIENTS AND IN PROVIDING FINANCIAL ASSISTANCE."