4A (Expenses $ 653372906 including grants of $ 0) (Revenue $ 949159321)
SEE SCHEDULE O

4B (Expenses $ 734871 including grants of $ 0) (Revenue $ 734873)
LIFEBRIDGE CARDIOLOGY AT QUARRY LAKE LLC PROVIDES CARE TO PATIENTS IN THE HOSPITAL AND IN THE COMMUNITY.

PART V, SECTION B, LINE 5:
SINAI USED A WORK GROUP (TEAM) TO COMPLETE THE CHNA TO ENSURE THAT THE CHNA WAS CONDUCTED IN A WAY THAT BEST IDENTIFIES THE HEALTH NEEDS OF ITS SERVICE AREA AND MEETS THE IRS CHNA REQUIREMENTS FOR NOT-FOR-PROFIT HOSPITALS. THE CHNA TEAM, WHICH HAD REPRESENTATION FROM THE LIFEBRIDGE HEALTH POPULATION HEALTH DEPARTMENT, PARTNERED WITH HEALTH SYSTEMS ACROSS BALTIMORE CITY IN DISSEMINATION OF A COMMUNITY SURVEY (3,170 SURVEY RESULTS) AS WELL AS STAKEHOLDER INTERVIEWS AND FOCUS GROUPS. AS PART OF THE CHNA METHODOLOGY TO IDENTIFY COMMUNITY HEALTH NEEDS, THE TEAM COLLECTED AND ANALYZED BOTH QUALITATIVE AND QUANTITATIVE DATA VIA COMMUNITY INPUT AND REVIEW OF SECONDARY DATA SOURCES. QUANTITATIVE DATA WAS PROVIDED BY THE BALTIMORE CITY HEALTH DEPARTMENT AS WELL AS BALTIMORE NEIGHBORHOOD INDICATORS ALLIANCE - JACOB FRANCE INSTITUTE (BNIA), AND THE CENTERS FOR DISEASE CONTROL. QUALITATIVE DATA COLLECTION METHODOLOGIES INCLUDED STAKEHOLDER INTERVIEWS, FOCUS GROUPS, AND A SURVEY. IN ADDITION TO SOLICITING PUBLIC INPUT VIA SOCIAL MEDIA THE CHNA TEAM CONTACTED COMMUNITY PARTNERS AND ASSOCIATION LEADERS, FAITH ORGANIZATIONS, AND SENIOR HOUSING FACILITIES IN THE SERVICE AREA. STAKEHOLDER INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED BETWEEN AUGUST 2020 AND NOVEMBER 2020. THE STAKEHOLDERS WERE SELECTED BECAUSE THEY HAD SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY SINAI, INCLUDING THE INTERESTS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS WITH CHRONIC DISEASE NEEDS. ALL DATA COLLECTION EFFORTS WERE SIGNIFICANTLY IMPAIRED BY THE COVID-19 VIRUS. HEALTH DEPARTMENT OFFICIALS WERE FOCUSED ON PANDEMIC VIRUS RESPONSES AND UNABLE TO UPDATE THE 2017 NEIGHBORHOOD HEALTH PROFILE REPORTS. AVAILABILITY OF STAFF FOR INTERVIEWS WAS LIMITED. OUTREACH TO POTENTIAL PARTICIPANTS WAS SUBSTANTIALLY CONSTRAINED AND LIMITED TO ELECTRONIC VENUES AND MATERIALS. METHODS WERE BASED ON THE INTENDED TARGET AUDIENCE AND INFORMATION NEEDS.

PART V, SECTION B, LINE 6A:
SINAI HOSPITAL OF BALTIMORE, INC. IS INCLUDED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) OF LIFEBRIDGE HEALTH, INC. LIFEBRIDGE HEALTH, INC.'S CHNA ALSO INCLUDES RELATED HOSPITAL FACILITIES, CARROLL HOSPITAL CENTER, INC., GRACE MEDICAL CENTER, LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL, INC. AND NORTHWEST HOSPITAL CENTER, INC. FOR THE 2020 CHNA THE OTHER BALTIMORE AREA HOSPITALS AND HEALTH SYSTEMS THAT COLLABORATED WITH SINAI HOSPITAL IN GATHERING DATA FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT WERE JOHNS HOPKINS HOSPITAL, UNIVERSITY OF MARYLAND, MEDSTAR HEALTH, ST. AGNES HOSPITAL, MERCY AND MT WASHINGTON PEDIATRIC HOSPITAL.

PART V, SECTION B, LINE 7A:
HTTPS://WWW.LIFEBRIDGEHEALTH.ORG/UPLOADS/PUBLIC/DOCUMENTS/POPULATION%20 HEALTH/SINAI%20CHNA_FINAL%206%2001%2021.PDF

PART V, SECTION B, LINE 7D:
COPIES OF THE CHNA WERE DISTRIBUTED TO KEY COMMUNITY PARTNERS.

PART V, SECTION B, LINE 10A:
HTTP://WWW.LIFEBRIDGEHEALTH.ORG/UPLOADS/PUBLIC/DOCUMENTS/COMMUNITY%20 HEALTH/SINAI/SINAI.PDF

PART V, SECTION B, LINE 11:
"THE BUSINESS INTELLIGENCE TEAM IN LIFEBRIDGE HEALTH'S POPULATION HEALTH DEPARTMENT USED THE DATA FROM ALL 3,170 PUBLIC SURVEYS COLLECTED TO PROVIDE SUMMARIES OF INFORMATION FROM THE RESPONDENTS OVERALL. THESE SUMMARIES IDENTIFIED THE TOP RESPONSES TO EACH OF THE THREE MAJOR QUESTIONS IN THE SURVEY. THE COMPILED PRIORITIZED NEEDS WERE THEN PRESENTED TO THE SINAI HOSPITAL BOARD, LEADERSHIP TEAM, KEY COMMUNITY STAKEHOLDERS AND THE LIFEBRIDGE HEALTH COMMUNITY MISSION COMMITTEE TO PRIORITIZE THE IDENTIFIED NEEDS. FOLLOWING REVIEW OF SECONDARY AND SURVEY DATA, AS WELL AS FINDINGS OF THE INTERVIEWS AND CONDUCTED FOCUS GROUPS, THE PARTICIPANTS WERE ASKED TO SELECT THOSE IDENTIFIED NEEDS FOR WHICH THERE WAS ""HIGH NEED"" (SIGNIFICANCE AND PREVALENCE) AND ""HIGH FEASIBILITY"" (ABILITY TO IMPACT). THE FOLLOWING PRIORITIZED NEEDS WERE IDENTIFIED FOR THE SINAI HOSPITAL COMMUNITY: HEALTH CONCERNS: 1. BEHAVIORAL HEALTH: THE OFFICE OF COMMUNITY HEALTH IMPROVEMENT IMPLEMENTED THE SCREENING AND BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) PROTOCOL IN THE SINAI EMERGENCY DEPARTMENT. THIS PROTOCOL IS DESIGNED TO WORK WITH PATIENTS WHO MAY HAVE SUBSTANCE ABUSE PROBLEMS AND PROVIDE SOME LEVEL OF SUPPORT AND NAVIGATION FOR THEM BEFORE THEY LEAVE THE FACILITY. SINAI HOSPITAL PARTNERED WITH MOSAIC TO TRAIN SUPPORT WORKERS WHO PROVIDE THE INTERVENTIONS AND EMERGENCY DEPARTMENT STAFF WHO COMPLETE THE SCREENING AND TREAT THE PATIENT BEFORE REFERRAL. OF THE 43,342 ED REGISTRATIONS, 35,304 SCREENINGS WERE COMPLETED AND 4,560 OF THOSE PATIENTS SCREENED WERE POSITIVE FOR SUBSTANCE ABUSE. SBIRT STAFF COMPLETED 1,262 BRIEF INTERVENTIONS, 286 REFERRALS TO TREATMENT WERE MADE AND 137 REFERRAL APPOINTMENTS MADE WERE KEPT. 2. CHRONIC DISEASE - DIABETES: IN RESPONSE TO THE PRIORITIZED NEED OF CHRONIC DISEASE, THE OFFICE OF COMMUNITY HEALTH IMPROVEMENT IMPLEMENTED THE DIABETES WELLNESS SERIES. THIS EDUCATION OFFERED EDUCATION ON THE TREATMENT STRATEGIES AND SELF-MANAGEMENT OF DIABETES FOR PATIENTS AND FAMILY MEMBERS. ALSO INCLUDED IN THE CURRICULUM IS INFORMATION ON PRE-DIABETES, MEDICATION MANAGEMENT, FOOD, PHYSICAL ACTIVITY AND HEALTHY LIFESTYLE CHOICES. WE PARTNERED WITH VARIOUS COMMUNITY ORGANIZATIONS, AMERICAN DIABETES ASSOCIATION, MARYLAND DEPARTMENT OF HEALTH, BALTIMORE CITY HEALTH DEPARTMENT, SINAI HOSPITAL'S DIABETES RESOURCE CENTER, AND MANY OTHERS. BETWEEN JULY 2017 AND MARCH 2020, THERE WERE 38 IN-PERSON CLASSES OFFERED SERVING 167 PEOPLE. 93% OF ATTENDEES SURVEYED INDICATED THAT THEY WOULD INSTITUTE LIFESTYLE CHANGES AND BEHAVIORAL CHANGE BASED ON THE INFORMATION HEARD AND RECEIVED DURING EVENTS. 3. CHRONIC DISEASE - HEART DISEASE: IN RESPONSE TO THE PRIORITIZED NEED OF CHRONIC DISEASE, THE OFFICE OF COMMUNITY HEALTH IMPROVEMENT CONTINUED THE CHANGING HEARTS PROGRAM TO MAINTAIN AND IMPROVE BEHAVIORAL AND BIOMETRIC OUTCOMES CONNECTED TO HEART DISEASE. COMPONENTS INCLUDED BUT WERE NOT LIMITED TO PROVIDING ON-GOING SUPPORT TO FACILITATE LIFESTYLE CHANGE; IMPROVE QUALITY OF LIFE, SMOKING STATUS, HEALTHY EATING PRACTICES AND PHYSICAL ACTIVITY. THE PROGRAM ALSO HELD REGULAR EDUCATION SESSIONS AND SHARED MATERIALS TO IMPROVE BIOMETRIC ELEMENTS SUCH AS BLOOD PRESSURE, FASTING BLOOD SUGAR, BODY MASS INDEX, AND CHOLESTEROL LEVELS. WE PARTNERED WITH MANY ORGANIZATIONS THROUGHOUT THE COMMUNITIES INCLUDING THE AMERICAN HEART ASSOCIATION, BALTIMORE CITY HEALTH DEPARTMENT CARDIOVASCULAR DISPARITIES TASK FORCE, AND THE PARK HEIGHTS COMMUNITY HEALTH ALLIANCE. ACCESS TO HEALTH CARE: 1. COMMUNITY HEALTH AND WELLNESS EDUCATION: IN RESPONSE TO THE PRIORITIZED NEEDS OF HEALTH EDUCATION AND THE KNOWLEDGE OF AVAILABLE RESOURCES THE OFFICE OF COMMUNITY HEALTH IMPROVEMENT INCREASED STAFF TO EXPAND REACH INTO SURROUNDING COMMUNITIES. THE ADDITION OF THE COMMUNITY PASTORAL OUTREACH COORDINATOR AND ADDITIONAL HEALTH EDUCATORS ALLOWED FOR THE INCREASE IN HEALTH EVENTS AND EXPANSION OF TOPICS. IN ADDITION TO ILLNESS PREVENTION RELATED TOPICS, INFORMATION WAS ADDED ON THE CONNECTION BETWEEN FAITH AND HEALTH; AND THE INCLUSION OF MORE INFORMATION ON COMMUNITY RESOURCES FACILITATED MORE ACCESS. 2. MEDICAL INSURANCE: ACCESS TO HEALTH CARE IMPACTS OUR OVERALL PHYSICAL, SOCIAL, AND MENTAL HEALTH STATUS AND QUALITY OF LIFE. HEALTH INSURANCE COVERAGE HELPS PATIENTS ENTER THE HEALTH CARE SYSTEM. UNINSURED OR UNDERINSURED INDIVIDUALS ARE MORE LIKELY TO DELAY HEALTHCARE AND TO GO WITHOUT THE NECESSARY HEALTHCARE OR MEDICATION THEY SHOULD HAVE BEEN PRESCRIBED. TRAINING STAFF TO ASSIST PATIENTS WITH NAVIGATING AND APPLYING FOR MEDICAID HEALTH INSURANCE HAS BEEN THE FOCUS OF ONE COMMUNITY HEALTH WORKER'S WORK. NEEDS NOT ADDRESSED BY THE IMPLEMENTATION PLAN: THE NEEDS LISTED BELOW WERE IDENTIFIED AS PRIORITIES DURING THE ASSESSMENT PROCESS, BUT ULTIMATELY WERE NOT CHOSEN AS PRIORITIES FOR ACTION, BECAUSE THE HOSPITAL HAS BEEN ADDRESSING THEM IN OTHER WAYS, THE HOSPITAL DOES NOT HAVE SUFFICIENT RESOURCES TO ADDRESS THEM, OR OTHER ORGANIZATIONS ARE MORE CAPABLE OF MEETING THESE NEEDS. A. LACK OF TRANSPORTATION - LACK OF TRANSPORTATION AROSE IN THE SURVEYS AS AN IMPORTANT REASON FOR WHY PEOPLE DO NOT GET HEALTH CARE. THROUGH THE CARE MANAGEMENT DEPARTMENT AND OTHER PROGRAMS THAT WORK WITH PEOPLE IN THE COMMUNITY, TRANSPORTATION FUNDING IS PROVIDED FOR MANY PATIENTS WHO NEED HELP IN GETTING TO THEIR DOCTORS' APPOINTMENTS. SINCE PATIENTS AND CLIENTS ARE SERVED WELL BY THESE RESOURCES, THIS CONCERN WAS NOT PRIORITIZED FOR FURTHER INVESTMENTS. B. ACCESS TO INSURANCE - SINAI HOSPITAL PROVIDES SIGN-UP ASSISTANCE TO PATIENTS WITHOUT INSURANCE WHEN THEY PRESENT AT THE HOSPITAL. A STAFF PERSON OVERSEES THIS FUNCTION. C. WORKFORCE DEVELOPMENT - SINAI HOSPITAL REFERS RESIDENTS AND PATIENTS WITHOUT EMPLOYMENT TO PARTNER ORGANIZATIONS, PARTICULARLY BON SECOURS COMMUNITY WORKS IN SOUTH AND WEST BALTIMORE, TO ADDRESS THIS PRESSING SOCIAL NEED. SINAI HOSPITAL ALSO SUPPORTS VARIOUS AGENCIES IN ADDRESSING UNDERLYING FACTORS, E.G. FINANCIAL LITERACY AND EDUCATION TO MITIGATE CONDITIONS OF POVERTY. D. ACCESS TO PHYSICIANS - A SYSTEM-WIDE EFFORT HAS BEEN DEVELOPED SINCE THE PREVIOUS CHNA TO ADDRESS NEEDS OF VARIOUS PATIENTS. SPECIALISTS ARE READILY IDENTIFIED AND REFERRALS ARE APPROPRIATELY MADE. DEPARTMENTS AND TEAM MEMBERS CONTINUE IN EFFORTS TO REDUCE APPOINTMENT WAIT TIMES FOR HEALTH CARE SERVICES LACKING COMMUNITY CAPACITY SUCH AS MENTAL HEALTH THERAPY. E. COORDINATION ACROSS SERVICES - SINCE THE LAST CHNA SINAI HOSPITAL DEPARTMENTS, INCLUDING SOCIAL SERVICES AND CARE MANAGEMENT, HAVE WORKED MORE CLOSELY BOTH INTERNALLY AS WELL AS WITH COMMUNITY RESOURCES TO ENABLE PATIENTS TO ACCESS NECESSARY AND VALUABLE RESOURCES IN AS TIMELY A MANNER AS POSSIBLE. INCLUSION OF SOCIAL RESOURCES IN COORDINATION IS INTENDED TO REDUCE REOCCURRENCE OF ACUTE HEALTH EPISODES THAT REQUIRE HOSPITALIZATIONS. F. LANGUAGE BARRIERS - SINAI HOSPITAL HAS INTERPRETIVE SERVICES AVAILABLE AND SIGNS IN MULTIPLE LANGUAGES ARE POSTED IN ER AS WELL AS HARD COPY FORMS IN THE WELCOME PACKET PATIENTS RECEIVE. FORMS ARE AVAILABLE IN SPANISH AS WELL AS OTHER LANGUAGES, E.G. RUSSIAN. CONSENT FORMS ARE TRANSLATED INTO SEVERAL LANGUAGES AS WELL."

PART V, SECTION B, LINE 16A:
WWW.LIFEBRIDGEHEALTH.ORG/SINAI/BILLINGANDFINANCIALCONSIDERATIONS.ASPX

PART V, SECTION B, LINE 16B:
www.lifebridgehealth.org

PART V, SECTION B, LINE 16C:
www.lifebridgehealth.org

PART V, SECTION B, LINE 22C:
CHARGES FOR ALL HOSPITAL PATIENTS ARE STATE REGULATED. SERVICES ARE CHARGED TO ALL HOSPITAL PATIENTS AT THE SAME RATE. CHARGES FOR INDIVIDUALS FOUND ELIGIBLE FOR FAP BASED ON 300% OR LESS OF THE FEDERAL POVERTY LEVEL (FPL) ARE WRITTEN-OFF IN FULL TO FAP (THERE IS NO PATIENT LIABILITY). CHARGES FOR INDIVIDUALS WHOSE PRESUMPTIVE FPL SCORE IS <200 ARE WRITTEN OFF TO FAP IN FULL (THERE IS NO PATIENT LIABILITY). CHARGES FOR INDIVIDUALS FOUND ELIGIBLE FOR FAP BASED ON THE HSCRC'S FINANCIAL HARDSHIP CRITERIA OF 301%-500% OF FPL ARE CHARGED NO MORE THAN 25% OF THE ANNUAL HOUSEHOLD INCOME PER THE HSCRC'S FINANCIAL HARDSHIP CRITERIA. THE DIFFERENCE BETWEEN THE TOTAL CHARGES AND THE CALCULATED 25% OF THE ANNUAL HOUSEHOLD INCOME IS WRITTEN OFF TO FAP.

PART I, LINE 3C:
SINAI HOSPITAL OF BALTIMORE, INC. PROVIDES SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET THE CRITERIA OF ITS CHARITY CARE POLICY. IT DOES NOT PURSUE THE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE AND THOSE AMOUNTS ARE NOT REPORTED AS REVENUE. THE CRITERIA CONSIDERS GROSS INCOME AND FAMILY SIZE ACCORDING TO CURRENT FEDERAL POVERTY GUIDELINES. TO QUALIFY, THE PATIENT MUST HAVE INCOME 300% OR LESS OF THE FEDERAL POVERTY GUIDELINES. A SLIDING SCALE IS USED TO DETERMINE ELIGIBILITY FOR THOSE WHOSE INCOME EXCEEDS 300%. ELIGIBILITY IS CALCULATED BASED ON THE NUMBER OF PEOPLE LIVING IN THE HOUSEHOLD. THE PROGRAM COVERS UNINSURED, UNDER-INSURED AND PATIENT LIABILITY AFTER INSURANCE(S) PAY. APPROVALS ARE GRANTED FOR A TWELVE-MONTH PERIOD OF TIME AND PATIENTS ARE ENCOURAGED TO RE-APPLY FOR CONTINUED ELIGIBILITY.

PART I, LINE 7:
MARYLAND'S REGULATORY SYSTEM CREATES A UNIQUE PROCESS FOR HOSPITAL PAYMENT THAT DIFFERS FROM THE REST OF THE NATION. THE HEALTH SERVICES COST REVIEW COMMISSION (HSCRC) DETERMINES PAYMENT THROUGH A RATE-SETTING PROCESS AND ALL PAYORS, INCLUDING GOVERNMENTAL PAYORS, PAY THE SAME AMOUNT FOR THE SAME SERVICES DELIVERED AT THE SAME HOSPITAL. MARYLAND'S UNIQUE ALL-PAYOR SYSTEM INCLUDES A METHOD FOR REFERENCING UNCOMPENSATED CARE IN EACH PAYORS' RATES, WHICH DOES NOT ENABLE MARYLAND HOSPITALS TO BREAK-OUT ANY OFFSETTING REVENUE RELATED TO UNCOMPENSATED CARE. IN RECENT YEARS, THE STATE OF MARYLAND HAS CLOSED FISCAL GAPS IN THE STATE MEDICAID BUDGET BY ASSESSING HOSPITALS THROUGH THE RATE-SETTING SYSTEM.

PART I, LINE 7A - I:
THE FOLLOWING COSTING METHODOLOGIES WERE USED TO CALCULATE LINES 7A THROUGH 7I ON THE COMMUNITY BENEFIT REPORT. OFFSETTING REVENUE - REVENUE FROM THE ACTIVITY DURING THE YEAR THAT OFFSETS THE TOTAL COMMUNITY BENEFIT EXPENSE OF THAT ACTIVITY, IT INCLUDES ANY REVENUE GENERATED BY THE ACTIVITY OR PROGRAM, SUCH AS A PAYMENT OR REIMBURSEMENT FOR SERVICES PROVIDED TO PROGRAM PATIENTS. OFFSETTING REVENUE INCLUDES RESTRICTED GRANTS OR CONTRIBUTIONS USED TO PROVIDE A COMMUNITY BENEFIT, BUT DOES NOT INCLUDE UNRESTRICTED GRANTS OR CONTRIBUTIONS THAT THE ORGANIZATION USES TO PROVIDE COMMUNITY BENEFIT. DIRECT COSTS - DIRECT COSTS INCLUDE SALARIES, EMPLOYEE BENEFITS, SUPPLIES, INTEREST ON FINANCING, TRAVEL AND OTHER COSTS THAT ARE DIRECTLY ATTRIBUTABLE TO THE SPECIFIC SERVICE AND THAT WOULD NOT EXIST IF THE SERVICE OR EFFORT DID NOT EXIST. INDIRECT COSTS - INDIRECT COSTS ARE COSTS NOT ATTRIBUTED TO PRODUCTS AND/OR SERVICES THAT ARE INCLUDED IN THE CALCULATION OF COSTS FOR COMMUNITY BENEFIT. THESE COULD INCLUDE, BUT ARE NOT LIMITED TO, SALARIES FOR HUMAN RESOURCES AND FINANCE DEPARTMENTS, INSURANCE AND OVERHEAD EXPENSES.

PART I, LINE 7G:
INCLUDED IN THESE EXPENSES ARE DIRECT AND INDIRECT COSTS ATTRIBUTABLE TO PHYSICIANS' CLINICS TOTALING $4,256,607.

PART II, COMMUNITY BUILDING ACTIVITIES:
AS A LARGE EMPLOYER AND PROVIDER OF HEALTH SERVICES IN THE NORTHWEST QUADRANT OF BALTIMORE CITY AND PARTS OF BALTIMORE COUNTY, LIFEBRIDGE HEALTH PROVIDES COMMUNITY BENEFITS THAT ENHANCE THE OVERALL QUALITY OF LIFE IN OUR SURROUNDING COMMUNITIES. THIS IS ACCOMPLISHED THROUGH HOUSING ENHANCEMENT INITIATIVES, BUSINESS DEVELOPMENT AND WORKFORCE DEVELOPMENT. THE COMMUNITY SERVICE CORPS, A GROUP OF EMPLOYEE VOLUNTEERS, STAFFS COMMUNITY SERVICE PROJECTS SUCH AS PAINTING LOCAL SCHOOLS, PARK BEAUTIFICATION, HOME IMPROVEMENT FOR SENIORS, HOLIDAY PARTIES FOR CHILDREN WHOSE MOTHERS ARE IN RESIDENTIAL SUBSTANCE ABUSE TREATMENT AT A NEARBY FACILITY, AND AN ANNUAL THANKSGIVING BASKET DISTRIBUTION TO NEEDY COMMUNITY RESIDENTS. THE BUILDING BRIDGES MENTORING PROGRAM TRAINS LIFEBRIDGE HEALTH STAFF TO SERVE AS ROLE MODELS AND LIFE COACHES FOR STUDENTS IN SELECTED COMMUNITY SCHOOLS. THE MENTORS AND MENTEES MEET REGULARLY TO EXPLORE HEALTHCARE CAREERS AND FOCUS ON THE SKILLS AND ABILITIES FOR SUCCESS AT SCHOOL AND IN THE COMMUNITY. SINAI HOSPITAL PARTNERS WITH HEALTHY NEIGHBORS, INC., AN ORGANIZATION THAT BUILDS STRONG NEIGHBORHOODS IN UNDERVALUED COMMUNITIES, BY OFFERING LOW INTEREST LOANS FOR PURCHASE AND REHAB BY HOMEOWNERS, PROVIDING PROFESSIONAL ADVICE FOR REHABBERS AND FUNDING COMMUNITY PROJECTS THAT SUPPORT POSITIVE IMAGES. SINAI SUPPORTS A STAFF PERSON WHO IMPLEMENTS HEALTHY NEIGHBORHOODS SERVICES IN SINAI'S PERIMETER NEIGHBORHOODS. SINAI HOSPITAL'S VOCATIONAL SERVICES PROGRAM (VSP) OFFERS VOCATIONAL TRAINING SERVICES TO INCREASE EMPLOYMENT OPPORTUNITIES IN HEALTH CARE FIELDS FOR COMMUNITY RESIDENTS, ESPECIALLY IDLE YOUTH. FOR EXAMPLE, THE HEALTHCARE CAREERS ALLIANCE PROVIDES JOB READINESS TRAINING FOR OUT-OF-SCHOOL YOUTH BETWEEN THE AGES OF 18-21 TO PREPARE THEM FOR HEALTHCARE-RELATED CAREERS.

PART III, LINE 2:
BAD DEBT EXPENSE IS ESTIMATED BY USING HISTORICAL RATES FOR EACH PAYOR AND THE LENGTH OF TIME THE RECEIVABLE HAS BEEN OUTSTANDING. THESE RATES ARE REVISITED FROM TIME TO TIME AND ADJUSTED WHEN DEEMED APPROPRIATE. ANY ADDITIONAL RESERVES ARE DETERMINED BY THE HOSPITAL'S EXECUTIVES.

PART III, LINE 8:
COSTING METHODOLOGY/MEDICARE ALLOWABLE COSTS. TOTAL REVENUE RECEIVED FROM MEDICARE (DSH & IME) AND MEDICARE ALLOWABLE COSTS ARE DERIVED FROM THE ANNUAL MEDICARE COST REPORT. THE INPATIENT ROUTINE COSTS ARE DERIVED FROM THE STEP-DOWN METHODOLOGY BASED ON ACCEPTED STATISTICAL ALLOCATION WITH A UNIFORM PER DIEM COST FOR EACH PAYOR TYPE. THE ANCILLARY MEDICARE ALLOWABLE COSTS ARE INITIALLY DERIVED FROM THE STEP-DOWN METHODOLOGY BUT ARE ALLOCATED TO THE PAYOR TYPES BASED ON THE RATIO OF COST TO CHARGE FOR EACH PAYOR.

PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:
MD

PART III, LINE 3:
SINAI HOSPITAL OF BALTIMORE, INC. DETERMINES ELIGIBILITY FOR FINANCIAL ASSISTANCE THROUGH OTHER VARIOUS MEANS SUCH AS ELIGIBLE FOR NON-REIMBURSABLE MEDICAID PROGRAMS, ENROLLED IN MEANS TESTED SOCIAL PROGRAMS, ENROLLED IN STATE OF MARYLAND GRANT FUNDED PROGRAMS WHERE REIMBURSEMENT IS LESS THAN THE CHARGE, ELIGIBLE UNDER THE JEWISH FAMILY AND CHILDREN'S SERVICES, OUT OF STATE MEDICAID PROGRAMS, MARYLAND MEDICAID ELIGIBLE AFTER ADMISSION, MARYLAND MEDICAID 216 AND IF THE PATIENT WAS DENIED MEDICAID FOR NOT MEETING DISABILITY REQUIREMENTS. OF THE REMAINING BAD DEBT EXPENSE, IT IS ESTIMATED THAT $6,330,544 IN COST MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE/CHARITY CARE. AS DESCRIBED ELSEWHERE, THE HOSPITAL ENGAGES IN MULTIPLE EFFORTS TO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE. THIS $6,330,544 WAS BILLED TO PATIENTS ONLY BECAUSE THEY, DESPITE THE HOSPITAL'S EFFORTS, DID NOT REQUEST, OR DID NOT COOPERATE WITH THE HOSPITAL'S EFFORTS TO PROVIDE THEM WITH, THE AVAILABLE FINANCIAL ASSISTANCE.

PART III, LINE 4:
ALL PATIENT ACCOUNTS ARE HANDLED CONSISTENTLY AND APPROPRIATELY TO MAXIMIZE CASH FLOW AND TO IDENTIFY BAD DEBT ACCOUNTS TIMELY. ACTIVE ACCOUNTS ARE CONSIDERED BAD DEBT ACCOUNTS WHEN THEY MEET SPECIFIC COLLECTION ACTIVITY GUIDELINES AND/OR ARE REVIEWED BY THE APPROPRIATE MANAGEMENT AND DEEMED TO BE UNCOLLECTIBLE. EVERY EFFORT IS MADE TO IDENTIFY AND PURSUE ALL ACCOUNT BALANCE LIQUIDATION OPTIONS INCLUDING, BUT NOT LIMITED TO THIRD PARTY PAYOR REIMBURSEMENT, PATIENT PAYMENT ARRANGEMENTS, MEDICAID ELIGIBILITY AND FINANCIAL ASSISTANCE. THIRD PARTY RECEIVABLE MANAGEMENT AGENCIES PROVIDE EXTENDED BUSINESS OFFICE SERVICES AND INSURANCE OUTSOURCE SERVICES TO ENSURE MAXIMUM EFFORT IS TAKEN TO RECOVER INSURANCE AND SELF-PAY DOLLARS BEFORE TRANSFER TO BAD DEBT. CONTRACTUAL ARRANGEMENTS WITH THIRD PARTY COLLECTION AGENCIES ARE USED TO ASSIST IN THE RECOVERY OF BAD DEBT DOLLARS AFTER ALL INTERNAL COLLECTION EFFORTS HAVE BEEN EXHAUSTED. IN SO DOING, THE COLLECTION AGENCIES MUST OPERATE CONSISTENTLY WITH SINAI HOSPITAL'S GOAL OF MAXIMUM BAD DEBT RECOVERY AND STRICT ADHERENCE WITH FAIR DEBT COLLECTIONS PRACTICES ACT (FDCPA) RULES AND REGULATIONS, WHILE MAINTAINING POSITIVE PATIENT RELATIONS. SEE AUDITED FINANCIAL STATEMENTS PAGE 17.

PART III, LINE 9B:
PATIENTS CAN BE DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE (F.A.) PROSPECTIVELY OR RETROSPECTIVELY. THE F.A. ELIGIBILITY PERIOD EXPIRES ONE YEAR FROM THE MONTH ELIGIBILITY IS APPROVED FOR MEDICALLY NECESSARY SERVICES. THE PATIENT IS ASKED TO PROVIDE THE F.A. APPROVAL LETTER FOR SERVICES PROVIDED WITHIN THE ELIGIBILITY PERIOD. THE HOSPITAL WILL MAKE EVERY EFFORT TO IDENTIFY PATIENTS ELIGIBLE FOR F.A. BY UPDATING A USER-DEFINED FIELD IN CERNER TO IDENTIFY PATIENTS RETURNING FOR SERVICE WHO ARE ALREADY QUALIFIED FOR FINANCIAL ASSISTANCE. BALANCES APPROVED FOR FINANCIAL ASSISTANCE ARE WRITTEN-OFF TO A ZERO BALANCE AND THEREFORE NOT PURSUED BY INTERNAL COLLECTION PROCESSES OR THIRD-PARTY AGENCIES. BALANCES ALREADY PLACED WITH THIRD PARTY AGENCIES ARE WRITTEN-OFF TO A ZERO BALANCE AND THE ACCOUNTS ARE CLOSED AND RETURNED BY THE THIRD-PARTY AGENCY.

PART VI, LINE 2:
SINAI HOSPITAL OF BALTIMORE, INC. IS INVOLVED WITH THE BALTIMORE CITY HEALTH DEPARTMENT'S ACCOUNTABLE HEALTH COMMUNITIES PROJECT, IDENTIFYING AREAS OF SIGNIFICANT SOCIAL NEED AND TARGETING EFFORTS AROUND THESE AREAS. SINAI ALSO WORKS REGULARLY WITH A GROUP OF BALTIMORE CITY HOSPITALS LOOKING CONTINUALLY AT NEEDS OF OUR SURROUNDING COMMUNITIES AND ADDRESSING THOSE NEEDS. THROUGH OUR CARE COORDINATION PROGRAMS, SINAI USES ASSESSMENTS AND DATA ANALYTICS TO IDENTIFY NEEDS AND DEVELOP TARGETED POPULATION HEALTH PROGRAMS AS WELL AS INDIVIDUAL CARE GOALS. SINAI'S M. PETER MOSER COMMUNITY INITIATIVES DEPARTMENT PROVIDES SERVICES THAT RESPOND TO MORE THAN THE SPECIFIC MEDICAL CONDITION, TAKING INTO ACCOUNT THE SOCIAL DETERMINANTS OF HEALTH THAT MAY CONTRIBUTE TO AN INDIVIDUAL'S OR A COMMUNITY'S POOR HEALTH STATUS. SUCH SERVICES ARE BASED ON AN UNDERSTANDING THAT PERSONS WHO EXPERIENCE AN ACUTE MEDICAL CONDITION MAY WELL HAVE MUCH GREATER OBSTACLES TO POSITIVE HEALTH OUTCOMES THAN THE SPECIFIC DIAGNOSIS, AND THAT THE MEDICAL PRESENTATION MAY HAVE BEEN CAUSED OR AT LEAST EXACERBATED BY THE PERSON'S PSYCHOSOCIAL SITUATION THAT RESULTS FROM POVERTY AND INEQUALITIES THAT EXIST IN THE STRUCTURE OF OUR SOCIETY. THESE PROGRAMS INVOLVE A MEDICAL ASSESSMENT BY THE CLINICAL TEAM COORDINATOR NURSE AND AN ENROLLMENT ASSESSMENT. BOTH ASSESSMENTS ARE ESSENTIAL TO THE ENROLLMENT PROCESS; THE MEDICAL ASSESSMENT DETERMINES MEDICAL RISK AND ELIGIBILITY ACCORDING TO MEDICAL CRITERIA, AND THE COMMUNITY HEALTH WORKER DETERMINES READINESS AND POTENTIAL FOR BEHAVIOR CHANGE RELATED TO HEALTH BEHAVIORS AND SELF HELP. SINAI OFTEN USES INFORMATION GATHERED DURING OUR EDUCATIONAL PROGRAM EVALUATIONS (DONE BY SURVEY AND INFORMAL CONVERSATION) WHICH ASK IF THERE ARE (1) ANY CHANGES SUGGESTED TO THE PROGRAM; AND (2) ANY TOPICS PEOPLE WOULD LIKE TO SEE COVERED THAT WERE NOT COVERED IN THE PROGRAM. SINAI ALSO WORKS IN CLOSE COLLABORATION WITH THE LOCAL HEALTH DEPARTMENTS (BALTIMORE CITY AND COUNTY) WITH REGARD TO THEIR HEALTH INITIATIVES AND STATISTICS, AND ALSO DIRECTLY WITH ORGANIZATIONS TO MEET THEIR REQUESTS FOR SUBJECT MATTER. SINAI ALSO WORKS WITH INTERNAL SPECIALTIES WITHIN LIFEBRIDGE HEALTH, INC. TO AID IN TARGETED HEALTH EDUCATION AS NEEDED.

PART VI, LINE 3:
THE FOLLOWING DESCRIBES MEANS USED AT SINAI HOSPITAL TO INFORM AND ASSIST PATIENTS REGARDING ELIGIBLITY FOR FINANCIAL ASSISTANCE UNDER GOVERNMENTAL PROGRAMS AND THE HOSPITAL'S CHARITY CARE PROGRAM. FINANCIAL ASSISTANCE NOTICES, INCLUDING CONTACT INFORMATION, ARE POSTED IN THE BUSINESS OFFICE AND ADMITTING, AS WELL AS POINTS OF ENTRY AND REGISTRATION THROUGHOUT THE HOSPITAL. PATIENT FINANCIAL SERVICES BROCHURE 'FREEDOM TO CARE' IS AVAILABLE TO ALL INPATIENTS. BROCHURES ARE ALSO AVAILABLE IN ALL OUTPATIENT REGISTRATION AND SERVICE AREAS. SINAI HOSPITAL EMPLOYS A FINANICAL ASSISTANCE LIAISON WHO IS AVAILABLE TO ANSWER QUESTIONS AND TO ASSIST PATIENTS AND FAMILY MEMBERS WITH THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE. A PATIENT INFORMATION SHEET IS MADE AVAILABLE TO ALL INPATIENTS PRIOR TO DISCHARGE. SINAI HOSPITAL'S UNINSURED (SELF-PAY) AND UNDER-INSURED (MEDICARE BENEFICIARY WITH NO SECONDARY) MEDICAL ASSISTANCE ELIGIBILITY PROGRAM SCREENS, ASSISTS WITH THE APPLICATION PROCESS AND ULTIMATELY CONVERTS PATIENTS TO VARIOUS MEDICAL ASSISTANCE COVERAGE AND INCLUDES ELIGIBILITY SCREENING AND ASSISTANCE WITH COMPLETING THE FINANCIAL ASSISTANCE APPLICATION AS PART OF THAT PROCESS. SINAI HOSPITAL PARTICIPATES WITH LOCAL ASSOCIATED JEWISH CHARITIES TO PROVIDE FINANCIAL ASSISTANCE ELIGIBLITY FOR QUALIFYING PATIENTS. ALL HOSPITAL STATEMENTS AND ACTIVE ACCOUNTS RECEIVABLE OUTSOURCE VENDORS INCLUDE A MESSAGE REFERENCING THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR THOSE WHO ARE EXPERIENCING FINANCIAL DIFFICULTY AND PROVIDES CONTACT INFORMATION TO DISCUSS SINAI'S FINANCIAL ASSISTANCE PROGRAM. COLLECTION AGENCIES' INITIAL STATEMENT REFERENCES THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR THOSE WHO ARE EXPERIENCING FINANCIAL DIFFICULTY AND PROVIDES CONTACT INFORMATION TO DISCUSS SINAI'S FINANCIAL ASSISTANCE PROGRAM. ALL HOSPITAL PATIENT FINANCIAL SERVICES STAFF, ACTIVE ACCOUNTS RECEIVABLE OUTSOURCE VENDORS, COLLECTION AGENCIES AND MEDICAID ELIGIBILITY VENDORS ARE TRAINED TO IDENTIFY POTENTIAL FINANCIAL ASSISTANCE ELIGIBILITY AND ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. FINANCIAL ASSISTANCE APPLICATION AND INSTRUCTIONS COVER SHEET IS AVAILABLE IN RUSSIAN AND SPANISH. SINAI HOSPITAL HOSTS AND PARTICIPATES IN VARIOUS DEPARTMENT OF HEALTH AND MENTAL HYGIENE AND MARYLAND HOSPITAL ASSOCIATION SPONSORED CAMPAIGNS LIKE COVER THE UNINSURED WEEK.

PART VI, LINE 4:
SINAI HOSPITAL OF BALTIMORE IS LOCATED IN THE NORTHWEST QUADRANT OF BALTIMORE CITY, SERVING BOTH ITS IMMEDIATE NEIGHBORS AND OTHERS FROM THROUGHOUT THE BALTIMORE CITY AND COUNTY REGION. THE NEIGHBORHOODS SURROUNDING SINAI ARE IDENTIFIED BY THE BALTIMORE NEIGHBORHOOD INDICATORS ALLIANCE (BNIA) AS SOUTHERN PARK HEIGHTS (SPH) AND PIMLICO/ARLINGTON/HILLTOP (PAH). TOGETHER THEY CONSTITUTE AN AREA THAT IS PREDOMINANTLY AFRICAN AMERICAN WITH A BELOW AVERAGE MEDIAN FAMILY INCOME, BUT ABOVE AVERAGE RATES FOR UNEMPLOYMENT AND OTHER SOCIAL DETERMINANTS OF POOR HEALTH. SPH AND PAH'S MEDIAN HOUSEHOLD INCOME WAS $26,015 AND $32,410 RESPECTIVELY. THIS IS COMPARED TO BALTIMORE CITY'S MEDIAN HOUSEHOLD INCOME OF $41,819. THE PERCENTAGE OF FAMILIES EARNING LESS THAN THE FEDERAL SELF-SUFFICIENCY STANDARD IN SPH WAS 46.4% AND IN PAH 28.4%. THE UNEMPLOYMENT RATE FOR BALTIMORE CITY WAS 13.1%. SPH AND PAH HAD UNEMPLOYMENT RATES OF 23.6% AND 17.1%, RESPECTIVELY. THE SEVEN ZIP CODES THAT REPRESENT THE PRIMARY SERVICE AREA IN FISCAL YEAR 2022 WERE 21215, 21207, 21208, 21209, 21216, 21117, AND 21071. THE BALTIMORE CITY HEALTH DEPARTMENT USES COMMUNITY STATISTICAL AREAS (CSAS) WHEN ANALYZING HEALTH OUTCOMES AND RISK FACTORS. THE CSAS REPRESENT CLUSTERS OF NEIGHBORHOODS BASED ON CENSUS TRACT DATA RATHER THAN ZIP CODE AND WERE DEVELOPED BY THE CITY'S PLANNING DEPARTMENT BASED ON RECOGNIZABLE CITY NEIGHBORHOOD PERIMETERS. WE IDENTIFIED CSAS CONTAINED WITHIN THE ZIP CODES OF THE PRIMARY SERVICE AREAS THAT BEST REPRESENT THE COMMUNITIES SERVED BY THE COMMUNITY BENEFIT ACTIVITIES AT SINAI HOSPITAL. ONE ZIP CODE (21207) SPANS CITY/COUNTY LINES. BALTIMORE COUNTY DOES NOT PROVIDE CSAS. THE RACIAL COMPOSITION AND INCOME DISTRIBUTION OF THE ABOVE-INDICATED ZIP CODES REFLECT THE RACIAL SEGREGATION AND INCOME DISPARITY CHARACTERISTIC OF THE BALTIMORE METROPOLITAN REGION. FOR EXAMPLE, PAH AND SPH HAVE A PREDOMINANTLY AFRICAN AMERICAN POPULATION AT 94.5% AND 96.3% RESPECTIVELY. THIS IS IN CONTRAST TO THE NEIGHBORING MOUNT WASHINGTON/COLDSPRING COMMUNITY IN WHICH THE MEDIAN HOUSEHOLD INCOME IS $76,263 AND THE UNEMPLOYMENT RATE WAS 4.5%. THE RACIAL/ETHNIC COMPOSITION OF THE MW/C COMMUNITY IS MUCH MORE COMPLEX BUT THE POPULATION IS PREDOMINANTLY (65.8%) WHITE.

PART VI, LINE 5:
THE M. PETER MOSER COMMUNITY INITIATIVES PROGRAM AT SINAI HOSPITAL PROVIDES SERVICES THAT SEEK TO IMPROVE THE HEALTH AND WELL-BEING OF PERSONS AND FAMILIES WHOSE HEALTH IS NEGATIVELY IMPACTED BY THE SOCIAL DETERMINANTS OF HEALTH. FOCUS IS ON INDIVIDUALS AND FAMILIES WHO COME TO THE HOSPITAL SEEKING SERVICES FOR SPECIFIC CONDITIONS SUCH AS HIGH-RISK PREGNANCY, HIV INFECTION, PERINATAL MOOD DISORDERS OR ADDICTION, INTIMATE PARTNER VIOLENCE, ETC. BUT WHOSE SOCIAL CONDITIONS MAY FURTHER IMPAIR HEALTH BEYOND THE ACUTE MEDICAL EPISODE. PSYCHOSOCIAL INTERVENTIONS ARE PROVIDED BY LICENSED SOCIAL WORKERS AND PARA-PROFESSIONAL OUTREACH WORKERS IN HOMES AND COMMUNITY LOCATIONS. SERVICES INCLUDE OUTREACH, HOME VISITING, HEALTH, LIFE-SKILLS AND SAFETY EDUCATION, COUNSELING, INFORMATION AND REFERRALS, SERVICES COORDINATION, AND NENTORING OF YOUTH IN COMMUNITY SCHOOLS. SINAI'S DEPARTMENT OF PSYCHIATRY, IN RECOGNITION OF POOR NUTRITION AND ACCESSIBILITY TO CARE FOR MENTALLY ILL PATIENTS LIVING IN POVERTY, PROVIDES FREE HOT LUNCHES AND TRANSPORTATION TO PATIENTS ENROLLED IN THE INTENSIVE OUTPATIENT/PARTIAL HOSPITALIZATION PROGRAM. IN ADDITION, THE SINAI HOSPITAL ADDICTIONS RECOVERY PROGRAM (SHARP), AN ADULT OUTPATIENT SUBSTANCE ABUSE PROGRAM, PROVIDES INDIVIDUAL, GROUP, AND FAMILY COUNSELING TO OPIATE-ADDICTED PATIENTS. SHARP ALSO OFFERS PRIMARY CARE SERVICES AS WELL AS INTEGRATED PSYCHIATRIC CARE FOR THOSE PATIENTS WITH A CO-EXISTING DISORDER. SINAI PROVIDES A VARIETY OF SUPPORT GROUPS THAT OFFER SOCIAL AND EMOTIONAL SUPPORT TO THOSE WHO SHARE A COMMON EXPERIENCE OR MEDICAL CONCERN. A DEPARTMENT OF COMMUNITY HEALTH EDUCATION PROVIDES FREE HEALTH PROMOTION EDUCATION ON A WIDE RANGE OF TOPICS AND COORDINATES FREE OR LOW-COST HEALTH SCREENINGS FOR THE COMMUNITY.

PART VI, LINE 6:
AS A TEACHING HOSPITAL WITH ITS OWN ACCREDITED, NON-UNIVERSITY-AFFILIATED RESIDENCY TRAINING PROGRAMS, SINAI HOSPITAL EMPLOYS A FACULTY OF APPROXIMATELY 140 PHYSICIANS IN NUMEROUS SPECIALTIES INCLUDING THE PRIMARY CARE FIELDS OF INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, AND PEDIATRICS. FACULTY PHYSICIANS PROVIDE SERVICES TO PATIENTS THROUGH A FACULTY PRACTICE PLAN. WHEN PATIENTS REQUEST APPOINTMENTS IN THE FACULTY PRACTICE OFFICES, THEY ARE NOT SCREENED ON THE ABILITY TO PAY FOR SERVICES. PHYSICIAN FEES FOR UNINSURED PATIENTS ARE DETERMINED ON A SLIDING SCALE BASED ON INCOME. FEES MAY BE WAIVED IF A PATIENT HAS NO FINANCIAL RESOURCES. ADDITIONALLY, IN MANY SPECIALTIES IN WHICH THE HOSPITAL DOES NOT HAVE A FACULTY, SUCH AS DENTISTRY, OTOLARYNGOLOGY, AND VASCULAR, WE CONTRACT WITH SPECIALISTS IN ORDER TO PROVIDE CONTINUOUS CARE FOR PATIENTS ADMITTED TO THE HOSPITAL THROUGH THE EMERGENCY DEPARTMENT. IN THESE CASES, THE HOSPITAL COVERS THESE SPECIALISTS' CONSULTATION FEES AND FEES FOR PROCEDURES FOR INDIGENT PATIENTS. BECAUSE OF THESE TWO ARRANGEMENTS FOR PROVIDING SPECIALTY CARE FOR UNINSURED PATIENTS, WE ARE NOT ABLE TO DOCUMENT GAPS IN SPECIALIST CARE FOR UNINSURED PATIENTS. SINAI HOSPITAL IS A COMPONENT OF LIFEBRIDGE HEALTH, A NONPROFIT HEALTH SYSTEM THAT PROVIDES A WIDE VARIETY OF HEALTH CARE AND RELATED SERVICES TO THE RESIDENTS OF CENTRAL MARYLAND. THE COMPONENTS OF THE LIFEBRIDGE SYSTEM WORK TOGETHER CLOSELY TO ENSURE THAT AS MANY AS POSSIBLE OF THE COMMUNITY'S NEEDS ARE MET IN AN INTEGRATED NONDUPLICATIVE MANNER.