4A (Expenses $ 54705442 including grants of $ 0) (Revenue $ 96516013)
IN FY 2023, FREDERICK HEALTH HOSPITAL'S INPATIENT MEDICAL-SURGICAL DEPARTMENTS PROVIDED QUALITY, PATIENT-CENTERED CARE, REGARDLESS OF ABILITY TO PAY, TO APPROXIMATELY 17,573 INPATIENTS AND OBSERVATION PATIENTS. MAJOR MEDICAL AND SURGICAL SERVICES INCLUDE CARDIOLOGY, CONGESTIVE HEART FAILURE, POST-CARDIAC CATHETERIZATION, CENTER FOR CHEST PAIN, HEMODIALYSIS, PERITONEAL DIALYSIS,NEUROLOGY, NEUROSURGERY, PULMONOLOGY, ONCOLOGY, ORTHOPEDICS, GENERAL MEDICINE AND SURGICAL CARE. INPATIENT CARE IS SUPPORTED BY A TEAM OF BOARD-CERTIFIED PHYSICIAN HOSPITALISTS. IN ADDITION, FHH IS DESIGNATED AS A PRIMARY STROKE CENTER BY THE MARYLAND INSTITUTE OF EMERGENCY MEDICAL SERVICE SYSTEMS (MIEMSS) AND IS RECOGNIZED WITH THE STROKE CENTER GOLD PERFORMANCE AWARD BY THE AMERICAN HEART ASSOCIATION. OUR BARIATRIC SURGICAL PROGRAM IS ACCREDITED BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY AS A BARIATRIC SURGERY CENTER OF EXCELLENCE. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED HERE, FHH INCURRED $58.6 MILLION OF GENERAL AND ADMINISTRATIVE EXPENSES IN MEETING THE HEALTH NEEDS OF OUR PRIMARY SERVICE AREA.

4B (Expenses $ 35861733 including grants of $ 0) (Revenue $ 70730646)
FREDERICK HEALTH HOSPITAL'S PERIOPERATIVE SERVICES PROVIDED HIGH QUALITY CARE TO 7,602 SURGICAL AND ENDOSCOPY PATIENTS IN FISCAL YEAR 2023. PROCEDURES WERE PERFORMED IN OUR STATE OF THE ART FACILITY WHICH INCLUDES A DEDICATED IMAGING ROOM FOR VASCULAR AND OTHER PROCEDURES. WE HAVE PARTICIPATED IN THE SCIP QUALITY IMPROVEMENT PROJECT FOR CONTINUAL IMPROVEMENTS IN CARE FOLLOWING EVIDENCE BASED MEDICINE. WE TRACKED OUR PATIENT SATISFACTION THROUGH PRESS GANEY TO BENCHMARK OUR RESULTS TO THE NATIONAL DATA BASE. IN ADDITION TO THE PROGRAM SERVICES EXPENSE LISTED HERE, FHH INCURRED $58.6 MILLION OF GENERAL AND ADMINISTRATIVE EXPENSES IN MEETING THE HEALTH NEEDS OF OUR PRIMARY SERVICE AREA.

4C (Expenses $ 20014119 including grants of $ 0) (Revenue $ 49397182)
FREDERICK HEALTH HOSPITAL'S CLINICAL LABORATORY PLAYS A VITAL ROLE ACROSS THE ENTIRE CONTINUUM OF HEALTH CARE BOTH WITHIN THE HOSPITAL AND THE COMMUNITY. CLINICAL LABORATORY TESTING HEAVILY IMPACTS CLINICAL DECISION MAKING BY PROVIDING PHYSICIANS, NURSES AND OTHER HEALTH CARE PROVIDERS WITH IMPORTANT INFORMATION NEEDED FOR THE PREVENTION, DIAGNOSIS, TREATMENT AND MANAGEMENT OF DISEASE. UP TO 85 PERCENT OF DIAGNOSIS AND TREATMENT DECISIONS ARE BASED ON LABORATORY RESULTS. LABORATORY TEST RESULTS COMPRISE ABOUT 70 PERCENT OF THE AVERAGE PATIENT'S MEDICAL RECORD. VIRTUALLY EVERY PRACTICING PHYSICIAN DEPENDS UPON THE CLINICAL LABORATORY FOR THE CARE OF HIS OR HER PATIENT. FREDERICK HEALTH HOSPITAL LABORATORY PERFORMED OVER 1.6 MILLION BILLABLE LABORATORY TESTS. IN ADDITION TO THE PROGRAM SERVICE EXPENSES LISTED HERE, FHH INCURRED $58.6 MILLION OF GENERAL AND ADMINISTRATIVE EXPENSES IN MEETING THE HEALTH NEEDS OF OUR PRIMARY SERVICE AREA.

4D (Expenses $ 242310400 including grants of $ 0) (Revenue $ 176117909)
OTHER PROGRAM SERVICES INCLUDE BEHAVIORAL HEALTH, CARDIOLOGY, SLEEP, HOSPICE & HOME CARE, IMAGING, WOMEN AND CHILDREN AND WOUND CARE. THE PROGRAM SERVICES EXPENSE LISTED HERE INCLUDE $58.6 MILLION OF GENERAL AND ADMINISTRATIVE EXPENSES IN MEETING THE HEALTH NEEDS OF OUR PRIMARY SERVICE AREA.

FREDERICK HEALTH HOSPITAL, INC.
PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED BY THE FREDERICK COUNTY HEALTH CARE COALITION, WITH SUPPORT FROM FREDERICK HEALTH HOSPITAL AND THE FREDERICK COUNTY HEALTH DEPARTMENT. THE COALITION IS A NONPROFIT ORGANIZATION FORMED IN 2006 IN RESPONSE TO A NEED TO COORDINATE EFFORTS TO ADDRESS BARRIERS TO HEALTH CARE ACCESS. THE COALITION IS LED BY A COMMUNITY ADVISORY BOARD COMPRISED OF ORGANIZATIONS AND INDIVIDUALS WITH EXPERTISE IN HEALTH SERVICE DELIVERY, EVALUATION AND PUBLIC HEALTH ISSUES. FREDERICK HEALTH HOSPITAL IS A FOUNDING MEMBER OF THE COALITION AND SERVES ON THE BOARD. A PRIMARY RESPONSIBILITY OF THE COALITION IS TO CONDUCT PERIODIC HEALTH STATUS ASSESSMENTS, AND TO CONVENE INTERESTED PARTIES AND THE PUBLIC TO ESTABLISH A LOCAL HEALTH IMPROVEMENT PLAN TO ADDRESS THE TOP HEALTH PRIORITIES.A HEALTH IMPROVEMENT PRIORITY PLANNING SUMMIT WAS HELD ON JANUARY 19, 2022 WITH MORE THAN 140 COMMUNITY PARTICIPANTS. THE SUMMIT INCLUDED REPRESENTATIVES OF COMMUNITY ORGANIZATIONS, BUSINESS, GOVERNMENT, ADVOCATES AND CITIZENS WHO PROVIDED INPUT INTO THE CHNA PRIORITIES.PARTICIPANTS INCLUDED:- HEALTH CARE (INCLUDING PROVIDERS OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES) - FREDERICK HEALTH, MISSION OF MERCY, MENTAL HEALTH ASSOCIATION OF FREDERICK COUNTY, CORELIFE, DANY INSTITUTE/CENTRAL EAST MENTAL HEALTH TECHNOLOGY GROUP, ENCOMPASS INTEGRATIVE WELLNESS, LLC, HOME CENTRIS PERSONAL CARE, SHEPPARD PRATT FREDERICK INSURANCE INDUSTRY - AETNA BETTER HEALTH OF MARYLAND, NCI/NIH,- LOCAL GOVERNMENT/LAW ENFORCEMENT - OFFICE OF THE FREDERICK COUNTY EXECUTIVE, FREDERICK COUNTY GOVERNMENT (INCLUDING CITIZENS & SENIOR SERVICES, HEALTH DEPARTMENT DEVELOPMENT CENTER, TRANSIT, FIRE AND RESCUE SERVICES, FAMILY PARTNERSHIP, CHILDREN AND FAMILIES), FREDERICK COUNTY COUNCIL, MARYLAND DEPARTMENT OF HEALTH, OFFICE OF SENATOR VANHOLLEN - SOCIAL SERVICES ORGANIZATIONS - FREDERICK CITY DEPARTMENT OF HOUSING AND HUMAN NEEDS (ALSO A FEDERALLY QUALIFIED HEALTH CENTER), FREDERICK COUNTY DEPARTMENT OF SOCIAL SERVICES- NONPROFIT ORGANIZATIONS - ASIAN AMERICAN CENTER OF FREDERICK, CHILDREN OF INCARCERATED PARENTS PARTNERSHIP, COMMUNITY COLLABORATION CENTER, CORE SERVICE AGENCY, THE FREDERICK CENTER, THE RANCH, WELLS HOUSE, YMCA OF FREDERICK COUNTY, COMMUNITY ENGAGEMENT AND CONSULTATIVE GROUP, FREDERICK COUNTY HEALTH CARE COALITION, GOLDEN MILE ALLIANCE, HEALTHCARE IS A HUMAN RIGHT FREDERICK CHAPTER, MARYLAND HUNGER SOLUTIONS, NIGERIAN IN FREDERICK, ON OUR OWN- EDUCATIONAL INSTITUTIONS - FREDERICK COUNTY PUBLIC SCHOOLS (INCLUDING NUTRITION SERVICES AND SCHOOL HEALTH COUNCIL), HOOD COLLEGE, UNIVERSITY OF MARYLAND EXTENSION SERVICE, FREDERICK COMMUNITY COLLEGE, GEORGE WASHINGTON UNIVERSITY, UNIVERSITY OF MARYLAND SPH HOROWITZ CENTER FOR HEALTH LITERACY, ZERO TO THREE- PHILANTHROPY - THE UNITED WAY OF FREDERICK COUNTY, THE COMMUNITY FOUNDATION OF FREDERICK, AUSHERMAN FAMILY FOUNDATION, HELEN J. SERINI FOUNDATION, LISTEN LOVE PRAY FOUNDATION, LOVE FOR LOCHLIN FOUNDATION,- BUSINESS - FREDERICK COUNTY CHAMBER OF COMMERCE, LEIDOS BIOMEDICAL RESEARCH, THE FREDERICK NEWS POST, RESTORATION FAMILY CHIROPRACTIC, ANALYTIC-COMMUNICATIONS LLC, CURA STRATEGIES,- RELIGIOUS ORGANIZATIONS - SETON CENTER NATIONAL ACADEMIES/QUINN CHAPEL AMC CHURCH,- SENIOR CARE- ADVOCATES FOR THE AGING IN FREDERICK COUNTY, FREDERICK COUNTY SENIOR SERVICES DIVISION, SENIOR SERVICES ADVISORY BOARD- COMMUNITY REPRESENTATIVES - GENERAL PUBLIC, FREDERICK NEWS POST, ONE FREDERICK COLLABORATIVE, DR. RACHEL MANDEL, SENIOR SERVICES ADVISORY BOARD,- SERVICE/CARE PROVIDERS - COMMUNITY LIVING, INC

FREDERICK HEALTH HOSPITAL, INC.
PART V, SECTION B, LINE 11: THREE CHNA PRIORITIES WERE IDENTIFIED IN THE 2019 ASSESSMENT:- DIABETES- ADVERSE CHILDHOOD EXPERIENCES- MENTAL HEALTHFREDERICK HEALTH HOSPITAL HAS ADOPTED IMPLEMENTATION STRATEGIES AROUND THESE INITIATIVES, AS DESCRIBED BELOW.1.DIABETES: THE GOALS ARE (1) TO INCREASE AWARENESS OF WHAT PRE-DIABETES AND DIABETES IS, INCLUDING MODIFIABLE RISK FACTORS, PARTICULARLY IN POPULATIONS EXPERIENCING A HEALTH DISPARITY, (2) INCREASE SCREENING FOR PRE-DIABETES RISK, ESPECIALLY IN PRIORITY POPULATIONS, TO REDUCE THE INCIDENCE OF DIABETES, (3) IMPROVE THE MANAGEMENT OF INDIVIDUALS WITH DIABETES, ESPECIALLY IN PRIORITY POPULATIONS, OR POPULATIONS EXPERIENCING A HEALTH DISPARITY. FREDERICK HEALTH'S IMPLEMENTATION STRATEGY INCLUDES: (1) CONDUCTING LISTENING SESSIONS AND GATHER INPUT FROM PRIORITY POPULATIONS, (2) PROVIDE HEALTH LITERACY TRAINING, (3) LAUNCH A PRE-DIABETES/DIABETES AWARENESS CAMPAIGN, (4) EDUCATE PROVIDERS AND COMMUNITY ORGANIZATIONS, ENGAGE THEM IN RECRUITMENT AND REFERRAL OF PATIENTS/CLIENTS TO PROGRAMS INCLUDING DIABETES PREVENTION AND DIABETES SELF-MANAGEMENT WORKSHOPS, (5) CONDUCT COOKING/MEAL PREP CLASSES, (6) CONDUCT AT LEAST ONE GROCERY STORE TOUR PER MONTH, (7) CONDUCT AT LEAST ONE 5K FUN RUN WITH WALKING OPTIONS.2.ADVERSE CHILDHOOD EXPERIENCES: THE GOALS ARE (1) INCREASE AWARENESS REGARDING ACES - ALL SECTORS OF FREDERICK COUNTY WILL RECOGNIZE THE IMPACT OF TRAUMA ON HEALTH FROM PRECONCEPTION ONWARD AND PROVIDE OR SUPPORT SERVICES FOR RAISING HEALTHY CHILDREN IN SAFE, STABLE AND NURTURING ENVIRONMENTS (2) PREVENTION: ALL FREDERICK COUNTY RESIDENTS WILL HAVE ACCESS TO EVIDENCE BASED OR RESEARCH-INFORMED PROGRAMS, RESOURCES, INFORMATION, AND SKILLS TO RAISE HEALTHY CHILDREN IN SAFE, STABLE AND NURTURING ENVIRONMENTS (3) TREATMENT AND INTERVENTION: AN EQUITABLE COMMUNITY-WIDE SYSTEM FOR TRAUMA-INFORMED CARE PROVIDES ACCESSIBLE EVIDENCE-BASED TREATMENTS FROM TRAINED, KNOWLEDGEABLE, AND CULTURALLY LITERATE SPECIALIST IN ADEQUATE SUPPLY. FREDERICK HEALTH'S IMPLEMENTATION STRATEGY INCLUDES: (1) PROMOTE TRAININGS AND WORKSHOPS PROVIDING CMES AND CEUS AS ABLE, (2) PLAN AND IMPLEMENT THE FAMILY CONNECTS UNIVERSAL HOME VISITING PROGRAM, (3) COLLABORATE WITH THE ADVERSE CHILDHOOD EXPERIENCES WORKGROUP TO OUTREACH AND ENGAGE PEDIATRIC PRACTICES TO ENSUE KNOWLEDGE AND UNDERSTANDING OF ACES AND THE IMPORTANCE OF PREVENTION, TREATMENT AND INTERVENTION.3.MENTAL HEALTH: THE GOALS ARE: (1) REDUCE THE NUMBER OF PEOPLE THAT DIE BY SUICIDE IN FREDERICK COUNTY, (2) REDUCE THE STIGMA ABOUT MENTAL HEALTH ISSUES AND SERVICES, (3) FREDERICK COUNTY RESIDENTS WILL BE ABLE TO ACCESS THE FULL CONTINUUM OF CULTURALLY COMPETENT, TRAUMA-INFORMED, HIGH QUALITY MENTAL HEALTH TREATMENT SERVICES IN A TIMELY MANNER, THROUGH AN INCREASED CAPACITY FOR MENTAL HEALTH PROFESSIONALS AND OTHER TRAINED SUPPORT PERSONS. FREDERICK HEALTH IMPLEMENTATION STRATEGY INCLUDES: (1) ACTIVELY ENGAGE IN SUICIDE PREVENTIONS COALITION, (2) COLLABORATE WITH THE LHIP WORKGROUP IN A SUSTAINABLE CAMPAIGN THAT REDUCES MENTAL HEALTH STIGMA THROUGH EDUCATION ABOUT THEIMPORTANCE OF NORMALCY OF MENTAL HEALTH NEEDS AND SERVICES, (3) PROVIDE EDUCATION FROMTHE ANTI-STIGMA CAMPAIGN TO STAFF AND PATIENTS FROM A PERSONAL AND PROFESSIONAL PERSPECTIVE, (4) EXPLORE OPPORTUNITIES TO EXPAND BEHAVIORAL HEALTH AVAILABILITY AT THE COMPREHENSIVE CARE CENTER TO ASSIST WITH MEDICATION MANAGEMENT AND TO BRIDGE SERVICES TO COMMUNITY BASED MENTAL HEALTH PROVIDERS, (5) PROVIDE OPPORTUNITIES FOR COMMUNITY HEALTH WORKERS AND PEER RECOVERY SPECIALIST TO ASSIST PROVIDERS IN ALLEVIATING THE BARRIERS TO CARE AND ASSIST WITH ADDRESSING SOCIAL DETERMINANTS OF HEALTH, (6) EXPLORE PARTNERSHIPS WITH ORGANIZATIONS ENROLLED IN HRSA PROGRAMS THAT MAY PROVIDE OPPORTUNITIES FOR PAID INTERNSHIPS AND OR CREATE A PROFESSIONAL PIPELINE FOR INDIVIDUALSINTERESTED IN MENTAL HEALTH PROFESSIONS.

FREDERICK HEALTH HOSPITAL, INC.
PART V, SECTION B, LINE 13H: FACILITY NAME:FREDERICK HEALTH HOSPITAL, INC.DESCRIPTION:STATE REGULATIONS.

FREDERICK HEALTH HOSPITAL, INC.
"PART V, SECTION B, LINE 16J: FACILITY NAME:FREDERICK HEALTH HOSPITAL, INC.DESCRIPTION:FHH REVIEWS THE FINANCIAL ASSISTANCE POLICY (FAP) AND THE COMMUNICATION METHODOLOGY WE EMPLOY ON A REGULAR BASIS TO MAKE SURE OUR PATIENTS HAVE EASY ACCESS TO THIS INFORMATION IN A VARIETY OF FORMATS AND THAT IT IS CULTURALLY AND LINGUISTICALLY SENSITIVE. WE REVIEW THE FAP TO MAKE SURE THE READING COMPREHENSION LEVEL IS APPROPRIATE FOR OUR AUDIENCE AND WE PROVIDE ENGLISH AND SPANISH VERSIONS TO MEET THE NEEDS OF OUR CBSA. WE HAVE SERVICES AVAILABLE TO PROVIDE ANY OTHER LANGUAGES WHEN NEEDED. THE FAP IS SHOWN ON OUR WEBSITE (HTTPS://WWW.FREDERICKHEALTH.ORG/ABOUT/BILLING-FINANCIALASSISTANCE/) AND IS OFFERED TO PATIENTS AS PART OF THE INTAKE PROCESS AT TIME OF REGISTRATION IN THE HOSPITAL AND IN THE EMERGENCY DEPARTMENT. OUR BILLING STATEMENTS REFERENCE OUR FINANCIAL ASSISTANCE POLICY AND INCLUDE THE URL FOR THE ONLINE VERSION. THE BILLING STATEMENTS INCLUDE DETAILED EXPLANATION OF THE FAP. FHH PROVIDES ASSISTANCE TO OUR PATIENTS WHO NEED TO APPLY FOR GOVERNMENT BENEFITS WHEN APPROPRIATE. MOST COMMON EXAMPLES ARE ""SELF-PAY"" INPATIENTS WHO ADMIT THROUGH THE EMERGENCY DEPARTMENT AND PATIENTS WHO COME TO OUR PRENATAL CLINIC. WE HAVE A DEPARTMENT OF SOCIAL SERVICES REPRESENTATIVE ONSITE AT OUR PRENATAL CLINIC TO WORK DIRECTLY WITH THE PATIENTS. ALL PATIENTS RECEIVE THE PATIENT INFORMATION SHEET, AVAILABLE IN ENGLISH AND SPANISH, WHICH INCLUDES INFORMATION ABOUT FINANCIAL ASSISTANCE."

SCHEDULE H, PART V SECTION B, LINE 7 HOSPITAL FACILITY'S WEBSITE
YES, THE CHNA IS WIDELY AVAILABLE TO THE PUBLIC ON THE HEALTH SYSTEM WEBSITE HTTPS://WWW.FREDERICKHEALTH.ORG/DOCUMENTS/PAGE%20LINKS/COMMUNITY%20HEALTH/2022-FREDERICK-COUNTY-CHNA-FINAL_202204290701407122.PDF AND THE FREDERICK COUNTY HEALTH DEPARTMENT WEBSITES. FORUMS WERE CONDUCTED IN SEVERAL LOCATIONS WITHIN FREDERICK COUNTY TO REVIEW THE STUDY FINDINGS AND TO ADDRESS PUBLIC QUESTIONS. ADDITIONALLY, THE INTERIM CHNA REPORT WAS POSTED ON THE HEALTH SYSTEM AND FREDERICK COUNTY HEALTH DEPARTMENT WEBSITES FOR PUBLIC COMMENT PRIOR TO FINALIZATION.

PART I, LINE 3C:
IF THE PATIENT/GUARANTOR'S MONETARY ASSETS ARE ABOVE $25,000, LESS THAN 100% FINANCIAL ASSISTANCE MAY BE PROVIDED. THE FINANCIAL ASSISTANCE COMMITTEE WILL REVIEW THESE CASES AND DETERMINE THE FINANCIAL ASSISTANCE AMOUNT. UP TO $150,000 OF PRIMARY RESIDENCE EQUITY IS EXEMPT FROM CONSIDERATION.

PART I, LINE 6A:
THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY THE FREDERICK COUNTY HEALTH CARE COALITION (COALITION) TO IDENTIFY HEALTH ISSUES IN FREDERICK COUNTY AND TO PROVIDE CRITICAL INFORMATION TO THOSE IN A POSITION TO TAKE POSITIVE STEPS THAT WILL IMPACT THE HEALTH OF AREA RESIDENTS.THE COALITION IS A NONPROFIT ORGANIZATION FORMED IN 2006 IN RESPONSE TO A NEED TO COORDINATE EFFORTS TO ADDRESS BARRIERS TO HEALTH CARE ACCESS. THE COALITION'S MISSION IS TO PROMOTE QUALITY HEALTH CARE IN FREDERICK COUNTY THROUGH COLLECTIVE IMPACT EFFORTS THAT ENGAGE LOCAL ORGANIZATIONS AND CITIZENRY. A CORE RESPONSIBILITY OF THE COALITION IS THE COMPLETION OF A PERIODIC ASSESSMENT THAT INFORMS AND ENGAGES THE COMMUNITY IN HEALTH IMPROVEMENT INITIATIVES. THE ASSESSMENT PROCESS IS REPEATED EVERY THREE YEARS TO REFLECT CHANGING LOCAL CONDITIONS.

PART III, LINE 3:
BAD DEBT VALUATION WAS CALCULATED USING THE COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. WE ESTIMATE APPROXIMATELY 7.5% OF BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. WE CONTINUE OUR EFFORTS TO QUALIFY PATIENTS FOR FREE OR REDUCED CARE.

PART III, LINE 8:
MEDICARE PS&R REPORTS USED AS SOURCE OF COSTS AND PAYMENTS.

PART III, LINE 9B:
PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE SPECIFICALLY EXCLUDED FROM THE COLLECTION PROCESS.

PART VI, LINE 2:
THE CHNA WAS CONDUCTED BY THE FREDERICK COUNTY HEALTH CARE COALITION, WITH SUPPORT FROM FREDERICK HEALTH HOSPITAL AND FREDERICK COUNTY HEALTH DEPARTMENT. THE HEALTH CARE COALITION IS LED BY A COMMUNITY ADVISORY BOARD COMPRISED OF ORGANIZATIONS AND INDIVIDUALS WITH EXPERTISE IN HEALTH SERVICE DELIVERY, EVALUATION AND PUBLIC HEALTH. A PRIMARY RESPONSIBILITY OF THE COALITION IS TO CONDUCT PERIODIC HEALTH STATUS ASSESSMENTS USING APPROPRIATE PLANNING METHODOLOGIES AND SUBJECT MATTER EXPERTS TO GUIDE THE PLANNING PROCESS.THE CHNA PROCESS INCLUDED THE COLLECTION OF QUANTITATIVE AND QUALITATIVE DATA TO UNDERSTAND THE HEALTH HABITS, PRIORITIES AND ACCESS TO CARE BARRIERS OF THE COMMUNITY AT LARGE, AND AMONG VULNERABLE AND HEALTH DISPARITY POPULATIONS WITHIN FREDERICK COUNTY. THE DATA COLLECTION PROCESS WAS DESIGNED TO SOLICIT INPUT FROM REPRESENTATIVE SAMPLES OF DEMOGRAPHICS, GEOGRAPHIC DISTRIBUTION AND TARGETED POPULATIONS. PUBLIC INPUT WAS OBTAINED THROUGH TWO FORMAL MECHANISMS - COMMUNITY SURVEY AND POPULATION-SPECIFIC FOCUS GROUPS.THE COMMUNITY SURVEY WAS CONDUCTED VIA WEB, WITH AN OPTION TO COMPLETE A WRITTEN SURVEY FOR THOSE WITHOUT INTERNET ACCESS. THE SURVEY CONSISTED OF 50 QUESTIONS, WHICH INCLUDED DEMOGRAPHICS, PERCEPTIONS OF COMMUNITY HEALTH STATUS, BARRIERS TO ACCESSING HEALTH CARE, OPPORTUNITIES TO INCREASE ACCESS TO HEALTH CARE, ENGAGEMENT WITH HEALTH CARE, PERSONAL HEALTH, AND EXPERIENCES WITH SOCIAL DETERMINANTS OF HEALTH. THE WEB SURVEY WAS AVAILABLE IN ENGLISH AND SPANISH; WRITTEN SURVEYS WERE AVAILABLE IN ENGLISH, SPANISH. THE SELECTION OF LANGUAGE OPTIONS WAS BASED ON COUNTY DEMOGRAPHICS AS REPORTED TO LOCAL GOVERNMENT. PARTNER ORGANIZATIONS WERE ENGAGED TO PROMOTE THE SURVEY AND TO PROVIDE ASSISTANCE TO THOSE WHO HAD LITERACY OR LANGUAGE BARRIERS. PRESS RELEASES, AS WELL AS WEB AND SOCIAL MEDIA OUTLETS WERE ALSO UTILIZED TO PROMOTE THE SURVEY TO THE COMMUNITY, YIELDING A STATISTICALLY RELEVANT SAMPLE OF 4,094 RESPONSES. OVERALL, SURVEY RESPONDENTS REFLECTED THE RACIAL AND ETHNICITY COMPOSITION OF THE POPULATION OF FREDERICK COUNTY.FOUR FOCUS GROUPS WERE CONDUCTED ON POPULATIONS FOR WHICH THERE WAS HEALTH DISPARITY OUTCOME DATA. TWO OF THE FOCUS GROUP POPULATIONS WERE IDENTIFIED IN THE PRIOR CHNA AS HAVING ACCESS CONCERNS. THE FOCUS GROUPS INCLUDED AFRICAN AMERICAN WOMEN (PREGNANT/CHILDBEARING), HISPANIC/LATINO WOMEN, VULNERABLE NEIGHBORHOOD (BASED ON SOCIAL VULNERABILITY INDEX SCORES VIA CENSUS TRACT DATA), LOW-INCOME/ALICE SENIORS. THE GOAL OF THE FOCUS GROUPS WS TO UNDERSTAND THE TARGET POPULATIONS' HEALTH PRIORITIES AND UNDERLYING REASONS, IDENTIFY PERCEIVED/ACTUAL BARRIERS TO CARE, ASSESS POPULATION KNOWLEDGE OF PREVENTATIVE SCREENINGS AND SELF-CARE, UNDERSTAND THE RELATIONSHIP OF HEALTH LITERACY TO PERSONAL HEALTH MANAGEMENT, AND IDENTIFY UNIQUE CULTURAL BELIEFS OR BEHAVIORS THAT AFFECT HEALTH OUTCOMES AND HEALTH EQUITY. IN GENERAL, FOCUS GROUP PARTICIPANTS WERE LOWER INCOME, OLDER, AND OF POORER HEALTH THAN THE COMMUNITY POPULATION.FINALLY, A HEALTH EQUITY SURVEY WAS CONDUCTED TO CAPTURE FURTHER INFORMATION ON POTENTIAL VULNERABLE OR OTHER SUB-POPULATIONS IN THE COMMUNITY FOR WHICH HEALTH OUTCOME DATA WAS LIMITED. EIGHT RESPONDENTS PARTICIPATED IN THE HEALTH EQUITY SURVEY WITH INSIGHTS ON ACCESS TO CARE AND SUGGESTIONS FOR IMPROVING THE HEALTH OF THE COMMUNITIES THEY SERVE. THE ADVOCATES REPRESENTED ALICE (ASSET LIMITED, INCOME CONSTRAINED, EMPLOYED), DISABLED, HISPANIC, HOMELESS, LBGTQ, SENIORS AND YOUTH POPULATIONS.

PART VI, LINE 4:
FREDERICK HEALTH HOSPITAL'S SERVICE AREA IS DEFINED IN A WRITTEN AGREEMENT WITH THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION, THE DESIGNATED STATE ENTITY CHARGED WITH OVERSIGHT OF COMMUNITY BENEFIT. THE SERVICE AREA IS DETERMINED BASED ON HISTORICAL FACILITY UTILIZATION BY ZIP CODE. THE SERVICE AREA DEFINITION FOR FREDERICK HEALTH HOSPITAL IS ALL ZIP CODES IN FREDERICK COUNTY. THEREFORE, FOR CHNA PLANNING PURPOSES, FREDERICK COUNTY IS THE POPULATION SERVED.

PART VI, LINE 5:
"DURING FY 2023, FREDERICK HEALTH HOSPITAL PROMOTED COMMUNITY HEALTH THROUGH THE FOLLOWING INITIATIVES: (TAKEN FROM THE FY 2023 HSCRC COMMUNITY BENEFIT REPORT) - CARE TRANSITIONS PROGRAM - THIS PROGRAM PROVIDES INTENSIVE COMMUNITY-BASED CARE MANAGEMENT SERVICES TO INDIVIDUALS WITH CHRONIC CONDITIONS AND THOSE WITH LIMITED ACCESS TO CARE, LOW HEALTH LITERACY AND OTHER SOCIAL DETERMINANTS OF HEALTH TO REDUCE UNNECESSARY HOSPITAL UTILIZATION AND IMPROVE INDIVIDUAL HEALTH STATUS. BY PROVIDING INFRASTRUCTURE TO SUPPORT SOME OF THE MOST CHRONICALLY ILL, FRAGILE AND SOCIALLY COMPLEX PATIENT POPULATIONS, HOSPITAL READMISSION RATES CAN BE REDUCED. HISTORICALLY, THESE PATIENTS RECEIVED LITTLE OR NO GUIDANCE RELATIVE TO FOLLOW-UP WITH PHYSICIANS, FILLING AND TAKING THEIR PRESCRIBED MEDICATIONS, AND MAKING APPOINTMENT FOR OTHER SERVICES. PATIENTS IDENTIFIED AS HIGH EMERGENCY DEPARTMENT UTILIZERS, AND/OR PATIENTS RETURNING TO THE HOSPITAL WITHIN 30 DAYS OF DISCHARGE MEET WITH AN RN OR SOCIAL WORK CASE MANAGER IN AN EFFORT TO UNDERSTAND WHY THEY HAVE RETURNED TO THE HOSPITAL FOR CARE. AN INDIVIDUALIZED COMPREHENSIVE POST DISCHARGE PLAN IS CREATED TO MEET THE SPECIFIC PATIENT NEEDS. THE SERVICES OFTEN INCLUDE FINANCIAL SUPPORT OF MEDICATIONS, TRANSPORTATION AND VARIOUS OTHER MEDICAL AND SOCIAL SUPPORT SERVICES IN THE COMMUNITY. THE HEALTH CARE TEAM PROVIDING SERVICES TOTHESE INDIVIDUALS CONSISTS OF REGISTERED NURSES, SOCIAL WORKERS, PHARMACISTS, DIETITIANS AND A NURSE PRACTITIONER.- COLORECTAL CANCER SCREENING - THIS PROGRAM FOCUSED ON IDENTIFIED DISPARITY COMMUNITIES WITHIN FREDERICK COUNTY, PRIMARILY THE AFRICAN-AMERICAN COMMUNITY. THE GOAL OF THE PROGRAM WAS TO INCREASE THE NUMBER OF PERSONS SCREENED AND TREATED FOR COLORECTAL CANCER THROUGH ENGAGEMENT OF COMMUNITY PROVIDERS AND HOSTING AWARENESS EVENTS IN THE COMMUNITY TO RESULT IN AN OVERALL INCREASE IN LONG TERM FOLLOW-UP RATES IN DISPARITY COMMUNITIES. ENGAGEMENT OF COMMUNITY PHYSICIANS IN THE PROCESS WAS A KEY COMPONENT OF THE PROGRAM AND INCLUDED EDUCATION ON CURRENT CANCER SCREENING RECOMMENDATIONS, LOCAL DISPARITY DATA, CULTURAL BARRIERS/BIAS AND LOCAL REFERRAL PROCESS AND TREATMENT OPTIONS. PERIODIC SCREENING OF ""AT RISK"" INDIVIDUALS IS VITAL; IN ORDER TO DO THIS, A BASELINE POPULATION WAS ESTABLISHED IN FY2020 THROUGH INITIAL SCREENING. FUTURE EFFORTS INCLUDE THE PROVISION OF PERIODIC EDUCATION AND SCREENING TO HIGH-RISK INDIVIDUALS AS A MEANS OF TRACKING THESE PEOPLE OVER TIME. AS A RESULT OF THE PANDEMIC A GOAL WAS NOT SET FOR CANCER SCREENINGS DUE TO THE UNCERTAINTY OF COMMUNITY ACCESS POINTS. WE DID HOWEVER CONTINUE TO PROVIDE EDUCATION AND AWARENESS MATERIALS IN AN EFFORT TO ENCOURAGE CONVERSATIONS WITH PROVIDERS. ADDITIONALLY, A NEW PROCESS WAS ESTABLISHED TO STREAMLINE RESPONSES TO ONLINE OUTREACH, SOCIAL MEDIA ANNOUNCEMENTS, AND LIVE EVENTS WITH INFORMATION, REFERRALS AND NO-COST FIT KITS WHEN APPROPRIATE. TO DATE, NO CANCER DIAGNOSIS HAVE BEEN MADE, BUT HIGH-RISK INDICATORS SUCH AS PRE-CANCEROUS LESIONS AND POLYPS HAVE BEEN IDENTIFIED. THESE PATIENTS ARE TARGETED FOR CONTINUED FOLLOW-UP IN THE COMING YEAR.- HEALTHY EATING - 5-2-1-0 IS A BEHAVIOR AWARENESS APPROACH TO MAKING KEY LIFESTYLE CHANGES THAT WILL LEAD TO HEALTHY EATING HABITS. THIS PROGRAM FOCUSES ON INCREASING FRUIT AND VEGETABLE CONSUMPTION, REDUCING INGESTION OF SUGAR ADDED BEVERAGES, REDUCING RECREATION SCREEN TIME AND INCREASING PHYSICAL ACTIVITY. A DESIGNATED 5-2-1-0 COORDINATION IS A GRANT FUNDED EMPLOYEE OF FREDERICK HEALTH HOSPITAL AND WORKS WITH THE FREDERICK COUNTY SCHOOL HEALTH COUNCIL TO IMPLEMENT THE PROGRAM THROUGH THE FREDERICK COUNTY PUBLIC SCHOOL SYSTEM. ACTIVITIES INCLUDE ESTABLISHING STUDENT WELLNESS GOALS AT EACH SCHOOL, ONGOING EDUCATION EVENTS AND ONLINE RESOURCES FOR STUDENTS, PARENTS AND EDUCATORS. 6 FREDERICK COUNTY PUBLIC SCHOOLS RECEIVED GRANTS TO IMPLEMENT PROGRAMMING TARGETING AT LEAST ONE HEALTHY BEHAVIOR (INCREASED ACTIVITY, INCREASED WATER CONSUMPTION, REDUCED SCREEN TIME, INCREASED CONSUMPTION OF FRUITS AND VEGETABLES)- DIABETES - FREDERICK HEALTH PROVIDED PREDIABETES AND DIABETES SCREENING AT A VARIETY OF LOCAL EVENTS. SUCCESSFULLY TRAINED A TOTAL OF 22 DPP (CDC DIABETES PREVENTION PROGRAM COACHES) AND LAUNCHED 8 SEPARATE DIABETES PREVENTION PROGRAM COHORTS (IN ENGLISH AND SPANISH). FREDERICK HEALTH SUCCESSFULLY LAUNCHED A PROVIDER REFERRAL PROCESS AND ESTABLISHED PATIENT REGISTRIES TO SUPPORT NAVIGATION EFFORTS. BEHAVIORAL HEALTH SCREENINGS WERE INTEGRATED INTO THE REFERRAL PROCESS AND WE EXPANDED OUR COMMUNITY HEALTH WORKER WORKFORCE TO SUPPORT TARGETED OUTREACH TO COMMUNITIES EXPERIENCING A HEALTH DISPARITY.- PHYSICIAN SUBSIDIES - FREDERICK HEALTH HOSPITAL CONTRACTS FOR HOSPITAL-BASED PHYSICIANS COVERAGE FOR SPECIALIZED CARE. CONTRACTED SERVICES INCLUDE INTENSIVE CARE, OBSTETRICAL/LABOR CARE, NEONATAL INTENSIVE CARE NEUROLOGY/STROKE CARE, INPATIENT PEDIATRICS, PEDIATRIC OPHTHALMOLOGY, ANESTHESIA, EMERGENCY MEDICINE AND INTERVENTIONAL CARDIOLOGY. THE DEMAND FOR THESE SERVICES CANNOT BE MET BY PROVIDERS IN THE FREDERICK COMMUNITY, AS THERE ARE NO COMMUNITY BASED PROVIDERS.- THERE IS AN INSUFFICIENT NUMBER OF PRIMARY CARE PROVIDERS IN FREDERICK COUNTY WHO CARE FOR PATIENTS THAT REQUIRE ACUTE CARE SERVICES. THE MAJORITY OF PRIMARY CARE PHYSICIANS IN THE COMMUNITY DO NOT MAINTAIN HOSPITAL PRIVILEGES; THEREFORE, THE HOSPITAL CONTRACTS FOR HOSPITALIST SERVICES FOR RESIDENTS WHO REQUIRE ACUTE CARE DIAGNOSIS AND MANAGEMENT.- FREDERICK HEALTH HOSPITAL ALSO CONTRACTS WITH SPECIALTY PROVIDERS TO PROVIDE EMERGENCY CARE COVERAGE ON A 24/7 BASIS. CONTRACTUAL SERVICES INCLUDES ANESTHESIOLOGY, BARIATRIC SURGERY, CARDIOLOGY, ENT, GASTROENTEROLOGY, GENERAL DENTISTRY, GENERAL SURGERY, HEMATOLOGY/ONCOLOGY, INTERVENTIONAL CARDIOLOGY, NEPHROLOGY, NEUROLOGY, OPHTHALMOLOGY, ORAL/MAXILLO FACIAL, ORTHOPEDICS, PEDIATRICS, PLASTIC SURGERY, PULMONARY MEDICINE, UROLOGY, VASCULAR SURGERY AND NEUROSURGERY. WITHOUT SUBSIDIES FROM THE ORGANIZATION TO COMPENSATE PROVIDERS FOR THIS COVERAGE, MEDICAL PRACTICES WOULD NOT BE ABLE TO RECRUIT A SUFFICIENT NUMBER OF PERSONNEL TO PROVIDE COVERAGE TO THE EMERGENCY DEPARTMENT."

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FREDERICK HEALTH HOSPITAL, INC. ('FHH') IS A PRIVATE, NON-STOCK, NOT-FOR-PROFIT 501(C)(3) MARYLAND CORPORATION ORGANIZED IN 1897. AS OF JULY 1, 2011, FREDERICK HEALTH, INC. ( F.K.A. FREDERICK REGIONAL HEALTH SYSTEM) BECAME THE PARENT CORPORATION UNDER WHICH THE ENTITIES DESCRIBED BELOW EXIST AND OPERATE.FREDERICK HEALTH, INC. IS GOVERNED BY A 21 MEMBER BOARD OF DIRECTORS. THE BOARD MEETS MONTHLY, WITH ELECTION OF OFFICERS AND MEMBERS OCCURRING AT THE SEPTEMBER MEETING. MUCH OF THE BOARD'S WORK IS ACCOMPLISHED THROUGH STANDING COMMITTEES, INCLUDING THE EXECUTIVE, FINANCE, GOVERNANCE, EXECUTIVE COMPENSATION, JOINT CONFERENCE (WITH MEDICAL STAFF), PLANNING, AND HOSPITAL PERFORMANCE REVIEW COMMITTEES.FREDERICK HEALTH HOSPITAL IS A 314-BED ACUTE CARE HOSPITAL LOCATED IN FREDERICK, MARYLAND, APPROXIMATELY 50 MILES WEST OF BALTIMORE AND 45 MILES NORTHWEST OF WASHINGTON D. C. THE HOSPITAL OPENED IN 1902 AND IS CURRENTLY THE ONLY ACUTE CARE HOSPITAL IN FREDERICK COUNTY AND THE ONLY ACUTE CARE HOSPITAL WITHIN A 25-MILE RADIUS OF THE CITY OF FREDERICK.THE MAIN CAMPUS OF THE HOSPITAL IS LOCATED ON AN APPROXIMATELY 15.85-ACRE SITE IN FREDERICK, MARYLAND. THE TOTAL SQUARE FOOTAGE OF THE HOSPITAL IS APPROXIMATELY 596,000 SQUARE FEET. FHH'S HOSPIT.AL-BASED AND OFF-SITE OUTPATIENT SERVICES ACCOUNT FOR OVER 385,000 VISITS ANNUALLY INCLUDING HOME HEALTH SERVICES, WHICH MAKES APPROXIMATELY 39,000 VISITS PER YEAR. FREDERICK HEALTH HOSPITAL, INC. PROVIDES A FULL RANGE OF ACUTE CARE SERVICES INCLUDING: MEDICINE, SURGERY, OBSTETRICS, GYNECOLOGY, PEDIATRICS, INTENSIVE CARE, CORONARY CARE, INTERVENTIONAL CARDIOLOGY, PRIMARY STROKE PROGRAM, WOUND CARE, JOINT REPLACEMENT PROGRAM, CYBERKNIFE RADIOSURGERY CENTER, PSYCHIATRIC CARE, MEDICAL FITNESS, WELLNESS PROGRAM/CENTER AND EMERGENCY SERVICES. IN ADDITION, FREDERICK HEALTH HOSPITAL, INC. PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT SERVICES, INCLUDING: EMERGENCY MEDICINE, OUTPATIENT SURGERY, HOME HEALTH, RADIATION THERAPY, MRI, PET AND CT SCANNING, MEDICAL ONCOLOGY, AND COMPREHENSIVE WOMEN'S SERVICES. THROUGH THE SATELLITE LOCATIONS AND OUTPATIENT CENTERS, THE HEALTH SYSTEM PROVIDES: URGENT CARE, LABORATORY, DIAGNOSTIC RADIOLOGY, AMBULATORY SURGERY, VASCULAR IMAGING, REHABILITATION SERVICES, PAIN AND PALLIATIVE CARE.