4A (Expenses $ 391870038 including grants of $ 3707467) (Revenue $ 483537382)
St. Vincent's Birmingham is a 439-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2022, St. Vincent's Birmingham treated 18,229 adults and children for a total of 89,934 patient days of service. The hospital also provided services for 145,527 outpatient visits, which included 26,722 outpatient surgeries and 39,227 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. As part of the Ascension Catholic health ministry, the filing organization served in support of Ascension's commitment to both care for patients and communities and support caregivers and other associates through the challenges of the COVID-19 global pandemic in FY22.

Schedule H, Part V, Section B, Line 3E
TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED.

Schedule H, Part V, Section B, Line 5 Facility , 1
Facility , 1 - St. Vincent's Birmingham. A CONCERTED EFFORT WAS MADE TO ENSURE THAT THE INDIVIDUALS AND ORGANIZATIONS REPRESENTED THE NEEDS AND PERSPECTIVES OF: 1) PUBLIC HEALTH PRACTICE AND RESEARCH; 2) INDIVIDUALS WHO ARE MEDICALLY UNDERSERVED, ARE LOW-INCOME, OR CONSIDERED AMONG THE MINORITY POPULATIONS SERVED BY THE HOSPITAL; AND 3) THE BROADER COMMUNITY AT LARGE AND THOSE WHO REPRESENT THE BROAD INTERESTS AND NEEDS OF THE COMMUNITY SERVED. MULTIPLE METHODS WERE USED TO GATHER COMMUNITY INPUT, INCLUDING KEY STAKEHOLDER/INFORMANT INTERVIEWS, KEY COMMUNITY PARTNER FOCUS GROUPS, AND COMMUNITY SURVEYS. A SERIES OF FIVE FOCUS GROUP PRESENTATIONS WERE CONDUCTED BY ASCENSION ST. VINCENT'S COMMUNITY BENEFIT STAFF TO GATHER FEEDBACK FROM KEY COMMUNITY PARTNERS ON THE HEALTH NEEDS AND ASSETS OF JEFFERSON COUNTY AND CENTRAL ALABAMA (HELD BETWEEN OCTOBER-DECEMBER 2021). A SURVEY WAS CONDUCTED BY THE UAB-ASCENSION ST. VINCENT'S ALLIANCE TO GATHER THE PERCEPTIONS, THOUGHTS, OPINIONS, AND CONCERNS OF THE COMMUNITY REGARDING HEALTH OUTCOMES AND BEHAVIORS, SOCIAL DETERMINANTS OF HEALTH, AND CLINICAL CARE FOR JEFFERSON COUNTY AND SURROUNDING AREAS (HELD BETWEEN OCTOBER 2021-FEBRUARY 2022). THE SURVEY WAS AVAILABLE IN ENGLISH AND SPANISH AND DISTRIBUTED TO COMMUNITY MEMBERS THROUGH TEXT, EMAIL, AND SOCIAL MEDIA PLATFORMS. SPECIFIC GROUPS SURVEYED INCLUDED: GREATER BIRMINGHAM PROJECT ACCESS, LOCAL FEDERALLY QUALIFIED HEALTH CENTERS, CATHOLIC DIOCESE OF BIRMINGHAM, CENTRAL ALABAMA FIRE CHIEFS, FORGE BREAST CANCER SURVIVOR CENTER, THE JEFFERSON COUNTY DEPARTMENT OF HEALTH, LOCAL COMMUNITY COLLEGES, LOCAL CHURCHES, MEDICAL STAFF MEMBERS, THE ST. VINCENT'S FOUNDATION, AND THE FIREHOUSE SHELTER. A SERIES OF TWENTY-SIX (26) ONE-ON-ONE INTERVIEWS WERE CONDUCTED BY THE UAB-ASCENSION ST. VINCENT'S ALLIANCE TO GATHER FEEDBACK FROM KEY STAKEHOLDERS ON THE HEALTH NEEDS AND ASSETS OF JEFFERSON COUNTY AND SURROUNDING AREAS (HELD BETWEEN OCTOBER 2021-FEBRUARY 2022). SECTORS REPRESENTED BY PARTICIPANTS INCLUDED HEALTH EXPERTS AT THE STATE AND COMMUNITY LEVELS AND LOCAL CIVIC LEADERS. HISTORICALLY COMMUNITY FORUMS HAVE BEEN HELD AS PART OF THE CHNA PROCESS. DUE TO THE PANDEMIC, THE DECISION WAS MADE NOT TO HOLD PUBLIC FORUMS AS A WAY TO PROTECT THE COMMUNITY. THE UAB-ASCENSION ST. VINCENT'S ALLIANCE OBTAINED THE NECESSARY INFORMATION THROUGH ALTERNATIVE STRATEGIES SUCH AS THE COMMUNITY SURVEYS, KEY INFORMANT INTERVIEWS AND KEY COMMUNITY PARTNER FOCUS GROUPS.

Schedule H, Part V, Section B, Line 6a Facility , 1
"Facility , 1 - St. Vincent's Birmingham. ST. VINCENT'S BIRMINGHAM COMPLETED ITS 2022 CHNA IN COLLABORATION WITH ASCENSION ST. VINCENT'S AND UNIVERSITY OF ALABAMA BIRMINGHAM MEDICINE (UAB) (KNOWN AS ""THE ALLIANCE'') WHICH PROVIDES A UNIFIED APPROACH TO HEALTHCARE WITHIN JEFFERSON COUNTY AND SURROUNDING AREA(S). THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED IN THE ALLIANCE: ST. VINCENT'S BIRMINGHAM ST. VINCENT'S EAST ST. VINCENT'S ST. CLAIR ST. VINCENT'S CHILTON ST. VINCENT'S BLOUNT UNIVERSITY OF ALABAMA HOSPITAL UAB CALLAHAN EYE HOSPITAL AUTHORITY MEDICAL WEST HOSPITAL AUTHORITY"

Schedule H, Part V, Section B, Line 6b Facility , 1
"Facility , 1 - St. Vincent's Birmingham. ST. VINCENT'S BIRMINGHAM COMPLETED ITS 2022 CHNA IN COLLABORATION WITH ASCENSION ST. VINCENT'S AND UNIVERSITY OF ALABAMA BIRMINGHAM (UAB MEDICINE) (KNOWN AS ""THE ALLIANCE'') WHICH PROVIDES A UNIFIED APPROACH TO HEALTHCARE WITHIN JEFFERSON COUNTY AND SURROUNDING AREA(S). THE FOLLOWING NON-HOSPITAL FACILITIES ARE INCLUDED IN THE ALLIANCE: ST. VINCENT'S ONE NINETEEN ST. VINCENT'S TRUSSVILLE ASCENSION MEDICAL GROUP PRACTICES PRIMARY CARE AND URGENT CARE NETWORK ST. VINCENT'S MEDICAL GROUP UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION UAB GARDENDALE FREESTANDING EMERGENCY DEPARTMENT (FED) AND CLINICS CALLAHAN EYE CLINICS AND OPHTHALMOLOGY SERVICES FOUNDATION MEDICAL WEST FREESTANDING EMERGENCY DEPARTMENT"

Schedule H, Part V, Section B, Line 11 Facility , 1
"Facility , 1 - St Vincent's Birmingham. THE PRIORITIZED HEALTH NEEDS FROM ST. VINCENT'S BIRMINGHAM'S PREVIOUS CHNA WERE: 1. ACCESS TO HEALTHCARE 2. MENTAL HEALTH AND SUBSTANCE ABUSE 3. HEALTHY LIVING THE STRATEGIES FOR ACCESS TO HEALTHCARE WERE: *ALL INPATIENTS CONNECTED TO PCP PRIOR TO DISCHARGE, MEDICATION ASSISTANCE PROGRAM, CLINIC FOR THE UNDER-INSURED, UNINSURED. ASCENSION ST. VINCENT'S ACCESS TO CARE PROGRAM JOINED WITH THE DEPARTMENT OF PUBLIC HEALTH PROJECT ACCESS PROGRAM IN JUNE 2021 TO FORM GREATER BIRMINGHAM PROJECT ACCESS. * RESULTS OF THESE STRATEGIES WERE 100% OF PATIENTS CONNECTED TO PCP PRIOR TO DISCHARGE, PROVIDING PRESCRIPTIONS TO COMMUNITY MEMBERS, AND AN INCREASE IN PROGRAM INSURANCE ENROLLMENT. THERE WERE TWO STRATEGIES IMPLEMENTED TO ADDRESS MENTAL HEALTH: *COMMUNITY COLLABORATIVE EFFORTS AROUND ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE PROGRAMS/SERVICES AND A COMMUNITY-WIDE TRAINING TO REDUCE DRUG-INDUCED DEATHS. *RESULTS FOR THE FIRST STRATEGY WERE COORDINATION OF THE COMMUNITY MENTAL HEALTH ROUNDTABLE, ASCENSION MEDICAL GROUP TRACKING PHQ-9 SCORES AND REFERRING FOR MENTAL HEALTH EVALUATION AS APPROPRIATE, AND MENTAL HEALTH OUTPATIENT CLINIC SERVES AS A BRIDGE FOR PATIENTS AWAITING CONNECTION TO PERMANENT MENTAL HEALTH PROVIDER(S). MENTAL HEALTH FIRST AID TRAINING FOR THE COMMUNITY AT LARGE WAS PUT ON HOLD DUE TO THE PANDEMIC. ALTERNATIVE EDUCATION PROVIDED VIA SOCIAL MEDIA REGARDING MENTAL HEALTH. THE COMMUNITY-WIDE TRAINING STRATEGY IS ON-HOLD DUE BECAUSE OF COVID-19. THE STRATEGIES FOR HEALTHY LIVING WERE: *COMMUNITY EDUCATION AROUND SIGNS AND SYMPTOMS OF A HEART ATTACK, ENSURE THE COMMUNITY HAS ACCESS TO SCREENING AND TREATMENT, DEVELOPMENT OF FIRST 1,000 DAYS OF LIFE PROGRAM, AND PROVIDE WORKFORCE TRAINING AND EMPLOYMENT ASSISTANCE IN COLLABORATION WITH JEFFERSON STATE COMMUNITY COLLEGE. *RESULTS FOR THIS STRATEGY ARE: TRAINING IN AMERICAN HEART ASSOCIATION HANDS ONLY CPR PROVIDED VIA SOCIAL MEDIA. LUNG CANCER SCREENINGS AT THE BRUNO CANCER CENTER, FIRST 1,000 DAYS OF LIFE PROGRAM DEVELOPED, AND COMMUNITY MEMBERS COMPLETED HEALTHCARE CERTIFICATIONS. IN THE HOSPITAL'S MOST RECENT CHNA, ST. VINCENT'S BIRMINGHAM IN COLLABORATION WITH THE UAB-ASCENSION ST. VINCENT'S ALLIANCE WILL ADDRESS ALL OF THE PRIORITIZED NEEDS AS OUTLINED BELOW FOR ITS 2022 CHNA IMPLEMENTATION STRATEGY. ASCENSION HAS DEFINED ""PRIORITIZED NEEDS,"" AS THE SIGNIFICANT NEEDS WHICH HAVE BEEN PRIORITIZED BY THE HOSPITAL TO ADDRESS THROUGH THE THREE-YEAR CHNA IMPLEMENTATION STRATEGY: 1. ACCESS TO HEALTHCARE - THIS NEED WAS SELECTED BECAUSE OF THE OVERWHELMING IDENTIFICATION OF THE ISSUE BY COMMUNITY MEMBERS AS WELL AS KEY LEADERSHIP PERSONNEL; 3. MENTAL HEALTH - THIS NEED WAS SELECTED BECAUSE THE COVID-19 PANDEMIC HAS HIGHLIGHTED THE NEED AND EXPANSION OF MENTAL HEALTH SERVICES AVAILABLE FOR BOTH THE MEMBERS OF THE COMMUNITY AS WELL AS THE HEALTHCARE WORKFORCE; 3. CHRONIC DISEASE PREVENTION/MANAGEMENT - THIS NEED WAS SELECTED BECAUSE THE MANAGEMENT OF CANCER, DIABETES, AND HEART DISEASE ARE TOP PRIORITIES FOR BOTH THE COMMUNITY AS WELL AS THE PROVIDERS. BY FOCUSING ON THE MANAGEMENT OF CHRONIC DISEASES, THE UAB-ASCENSION ST. VINCENT'S ALLIANCE CAN HELP THE COMMUNITY ACHIEVE A HEALTHIER LIFESTYLE THROUGH CONSISTENT COMMUNITY ENGAGEMENT AND RESOURCE ALLOCATION. BASED ON THE PRIORITIZATION CRITERIA, ALL TOP NEEDS, IDENTIFIED BY THE COMMUNITY, WILL BE ADDRESSED AS PART OF THIS IMPLEMENTATION STRATEGY."

Schedule H, Part I, Line 3c FACTORS OTHER THAN FPG
"IN ADDITION TO FPG, THE ORGANIZATION USES MEDICAL INDIGENCY, ASSET TEST, INSURANCE STATUS AND RESIDENCY AS OTHER FACTORS IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE. A Patient may not be eligible for the financial assistance if such Patient is deemed to have sufficient assets to pay pursuant to an ""Asset Test."" The Asset Test involves a substantive assessment of a Patient's ability to pay based on the categories of assets measured in the FAP Application. A Patient with such assets that exceed 250% of such Patient's FPL amount may not be eligible for financial assistance. AN ASSET TEST APPLIES IF A PATIENT HAS ELIGIBLE LIQUID ASSETS THAT EXCEED 250% OF THE PATIENT'S FPG LEVEL FOR CONSIDERATION OF FINANCIAL ASSISTANCE ELIGIBILITY. LIQUID ASSETS INCLUDE ASSETS THAT CAN BE CONVERTED TO CASH WITHIN 1 YEAR. THESE INCLUDE ITEMS SUCH AS CHECKING ACCOUNTS, SAVINGS ACCOUNTS, TRUST FUNDS AND LUXURY ITEMS SUCH AS RECREATIONAL VEHICLES, BOATS, A SECOND HOME, ETC."

Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH PART 2
ASCENSION ST. VINCENT'S AND CHRIST HEALTH CENTER (A LOCAL FEDERALLY QUALIFIED HEALTH CENTER), CREATED A HIGH-LEVEL OF CLINICAL INTEGRATION TO IMPROVE HEALTH EQUITY IN 49 ZIP CODES BY INCREASING ACCESS TO PRIMARY CARE AND MENTAL HEALTH SERVICES FOR ALMOST 12,000 LOW TO MODERATE INCOME INDIVIDUALS. ASCENSION ST. VINCENT'S CONTINUES TO CARE FOR THE COMMUNITY THROUGH EXTENSIVE COLLABORATION SUCH AS WITH THE FORGE INITIATIVE. THIS BREAST CANCER SURVIVORSHIP PROGRAM PROVIDES A 24/7 HOTLINE FOR SUPPORT, PEER MENTORS, SUPPORT GROUPS AND OTHER RESOURCES TO BREAST CANCER SURVIVORS AND THEIR CAREGIVERS. THIS INITIATIVE SUCCESSFULLY BROUGHT TOGETHER ALL THE MAJOR HEALTHCARE PROVIDERS IN THE REGION TO RALLY AROUND ONE CAUSE.

Schedule H, Part I, Line 5a BUDGET AMOUNTS FOR FREE OR DISCOUNTED CARE
THE ORGANIZATION ADMINISTERS ITS FINANCIAL ASSISTANCE POLICY IN ACCORDANCE WITH THE TERMS OF THE POLICY.

Schedule H, Part I, Line 6a Community benefit report prepared by related organization
ST. VINCENT'S BLOUNT REPORTS COMMUNITY BENEFIT INFORMATION AS PART OF THE FOLLOWING RELATED ORGANIZATION'S ANNUAL COMMUNITY BENEFIT REPORT: St. Vincent's Health System, EIN 63-0931008

Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance
"THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION (""CHA"") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED."

Schedule H, Part II Community Building Activities
THERE WERE NO COMMUNITY BUILDING ACTIVITIES TO REPORT THIS YEAR. ALL REPORTED ACTIVITIES QUALIFY AS COMMUNITY BENEFIT AND ARE DESCRIBED IN THE NARRATIVE UNDER SCH H PART PART I LINE 7.

Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount
After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2022 was $15,529,088 at charges, ($3,105,818 at cost).

Schedule H, Part III, Line 3 Bad Debt Expense Methodology
BASED ON THE ORGANIZATION'S ADMINISTRATION OF ITS FINANCIAL ASSISTANCE PROGRAM, NO ESTIMATE FOR BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS IS DEEMED APPLICABLE TO HOSPITAL OPERATIONS.

Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote
THE ORGANIZATION IS PART OFASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSESBAD DEBT (IMPLICIT PRICE CONCESSIONS) EXPENSE IS LOCATED IN FOOTNOTE #2, PAGES 17-20, OF THE AUDITED FINANCIAL STATEMENTS.

Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs
A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE GROSS CHARGES TO CALCULATE MEDICARE COSTS, WHICH ARE THEN COMPARED TO MEDICARE PAYMENTS RECEIVED, TO DETERMINE A MEDICARE GAIN OR LOSS. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT A MEDICARE SHORTFALL (LOSS) IS NOT TREATED AS COMMUNITY BENEFIT, EVEN THOUGH THE HOSPITAL HAS INCURRED LOSSES IN PROVIDING CARE TO MEDICARE PATIENTS. THEREFORE, NONE OF THE AMOUNT ON LINE 7 IS TREATED AS COMMUNITY BENEFIT.

Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance
ST. VINCENT'S BIRMINGHAM FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED IF ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED FOR THE AMOUNTS FOR WHICH THE PATIENT QUALIFIES.

Schedule H, Part V, Section B, Line 16a FAP website
- St. Vincent's Birmingham: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16b FAP Application website
- St. Vincent's Birmingham: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part V, Section B, Line 16c FAP plain language summary website
- St. Vincent's Birmingham: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance;

Schedule H, Part VI, Line 5 Promotion of community health
"St. Vincent's Birmingham's GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF St. Vincent's Birmingham'S GOVERNING BODY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. St. Vincent's Birmingham EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. THIS REPORT ILLUSTRATES THE SIGNIFICANT DEGREE TO WHICH ST. VINCENT'S HEALTH SYSTEM, THROUGH ITS FIVE HOSPITALS AND HEALTH & WELLNESS FACILITIES, CONTRIBUTES TO THE POSITIVE HEALTH STATUS OF THE COMMUNITIES WE SERVE. THE SYSTEM'S FIVE HOSPITALS INCLUDE ST. VINCENT'S BIRMINGHAM, ST. VINCENT'S EAST, ST. VINCENT'S BLOUNT, ST. VINCENT'S CHILTON AND ST. VINCENT'S ST. CLAIR. EACH HOSPITAL HAS A SEPARATE TAX ID NUMBER. EACH MAKES AN IMPORTANT CONTRIBUTION TO CARING FOR THEIR COMMUNITY, INCLUDING THOSE WHO ARE UNDERSERVED. EACH YEAR, ASCENSION ST. VINCENT'S FACILITIES SPONSOR A SCHOOL TO ASSIST WITH COLLECTING PHYSICAL EDUCATION EQUIPMENT TO FOSTER HEALTHY HABITS FOR LOCAL SCHOOL CHILDREN. THIS IS ONE WAY IN WHICH STVHS PROMOTES A HEALTHY LIFESTYLE ACROSS THE SERVICE AREA. AS A MEMBER OF ASCENSION HEALTH, ASCENSION ST. VINCENT'S CONTINUES TO BUILD AND STRENGTHEN SUSTAINABLE COLLABORATIVE EFFORTS THAT BENEFIT THE HEALTH OF INDIVIDUALS, FAMILIES AND THE COMMUNITY AS A WHOLE. THE HEALTH SYSTEM'S MISSION IS TO EXTEND THE HEALING MINISTRY OF CHRIST. THE HOSPITALS OF THE HEALTH SYSTEM FURTHER THE MISSION THROUGH THE DELIVERY OF PATIENT SERVICES, CARE TO THE ELDERLY AND INDIGENT, PATIENT EDUCATION, AND HEALTH AWARENESS PROGRAMS FOR THE COMMUNITY. OUR CONCERN FOR ALL HUMAN LIFE AND COMMITMENT TO THE DIGNITY OF EACH PERSON LEADS US TO PROVIDE MEDICAL SERVICES TO ALL PEOPLE IN THE COMMUNITY WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. BASED ON OUR CORE VALUES AND IN THE SPIRIT OF PRINCIPLES ADOPTED BY ASCENSION HEALTH, OUR HEALTH SYSTEM HAS TAKEN PROACTIVE STEPS TO ADDRESS THOSE ISSUES THAT AFFECT ACCESSIBILITY, THE FINANCING, AND THE DELIVERY OF HEALTH CARE TO ALL PERSONS, ESPECIALLY THE UNINSURED, UNDERINSURED, AND THE UNDERSERVED. THE FOLLOWING CHART DEMONSTRATES THE SIGNIFICANT NUMBER OF PATIENT DAYS AND THE ESTIMATED UNREIMBURSED COST OF SERVICES PROVIDE BY OUR FIVE HOSPITALS TO THE UNINSURED OR UNDERSERVED. FY22 Licensed Beds / Patient Days *St. Vincent's Birmingham 409 / 89,765 *St. Vincent's East 362 / 63,452 *St. Vincent's Blount 25 / 5,059 *St. Vincent's St. Clair 40 / 10,186 *St. Vincent's Chilton 26 / 2,412 *Total 862 / 170,874 ASCENSION ST. VINCENT'S HAS A DEEP COMMITMENT TO SERVING THE COMMUNITY. WE EARMARK A CERTAIN PERCENTAGE OF OUR YEARLY PROFITS FOR CHARITABLE DONATIONS. THROUGH THIS CHARITABLE DONATION PROGRAM, WE ARE ABLE TO SUPPORT LOCAL CHAPTERS OF NATIONAL ORGANIZATIONS SUCH AS THE AMERICAN CANCER SOCIETY, THE AMERICAN HEART ASSOCIATION, MARCH OF DIMES, AND SUSAN G. KOMEN FOR THE CURE, AMONG OTHERS. MANY OF OUR EXECUTIVES SERVE ON THE BOARDS OF THESE AND OTHER CHARITABLE ORGANIZATIONS. WE PROVIDE ESSENTIAL MEDICAL SERVICES TO THE COMMUNITY, TRAIN AND RECRUIT HEALTHCARE PROFESSIONALS TO SERVE THE NEEDS OF THE BROADER COMMUNITY, PROVIDE APPROPRIATE CHARITY SERVICES TO THOSE UNABLE TO PAY FOR THEIR HEALTH CARE NEEDS, AND PROVIDE SERVICES TO OTHER ORGANIZATIONS THAT ALLOW THEM TO PROVIDE QUALITY SERVICES TO THEIR PATIENTS OR CONSTITUENTS. SOME OF THESE SERVICES INCLUDE JEREMIAH'S HOPE ACADEMY, HISPANIC OUTREACH MINISTRY, AND ACCESS TO CARE PROGRAM. EACH OF THESE PROGRAM'S WORKS TO ADDRESS ROOT CAUSES OF POVERTY INCLUDING HEALTH DISPARITIES, BARRIERS TO CARE, EMPLOYMENT, AND HEALTHCARE, AS WELL AS MENTAL HEALTHCARE, COVERAGE. ASCENSION ST. VINCENT'S JEREMIAH'S HOPE ACADEMY, IN PARTNERSHIP WITH JEFFERSON STATE COMMUNITY COLLEGE, FOCUSES ON TRAINING AT-RISK INDIVIDUALS, PARTICULARLY WOMEN, FOR ENTRY LEVEL JOBS IN THE HEALTHCARE INDUSTRY. TODAY, MORE THAN 600 PEOPLE HAVE GRADUATED FROM JEREMIAH'S HOPE, AND MOST ARE STILL WORKING IN THE HEALTHCARE INDUSTRY. EMPLOYMENT IS ONE OF THE MANY SYSTEMIC WAYS TO ASSIST INDIVIDUALS OUT OF POVERTY AND CREATE AN INTERGENERATIONAL IMPACT FOR FAMILIES THAT IS SUSTAINABLE INTO THE FUTURE. PHILANTHROPY ALLOWED THIS REVOLUTIONARY PROGRAM TO BLOSSOM AND IT HAS NOW BECOME A MODEL FOR OTHER HEALTHCARE FACILITIES NATIONWIDE. DURING FY20, JEREMIAH'S HOPE ACADEMY ENTERED INTO A COLLABORATIVE RELATIONSHIP WITH JEFFERSON STATE COMMUNITY COLLEGE TO EXPAND PROGRAM ACCESS AND EXTEND REACH TO OTHER SURROUNDING COMMUNITIES. IN COMING TOGETHER WITH JEFFERSON STATE, THE PROGRAM NOW ALLOWS FOR EVENING CLASSES FOR THOSE CONTINUING TO WORK WHILE OBTAINING THEIR EDUCATION. GREATER BIRMINGHAM PROJECT ACCESS IS A HEALTHCARE OPTION FOR THE ""WORKING POOR"" IN THE BIRMINGHAM AREA, SERVING INDIVIDUALS WHO ARE EMPLOYED BUT LACK HEALTH INSURANCE. THE PROGRAM ASSISTS UP TO 500 UNIQUE PATIENTS EACH YEAR, PROVIDING FOR ALL OF THEIR HEALTHCARE NEEDS WITH MODEST CO-PAYS TO ENGAGE THE PATIENT IN RESPONSIBILITY FOR CARE. ASCENSION ST. VINCENT'S WORKS WITH PATIENTS TO IDENTIFY WAYS TO ACQUIRE INSURANCE AND SCREENS PATIENTS BASED ON A WILLINGNESS TO MAKE LIFE CHANGES CONDUCIVE TO GOOD HEALTH AND ADVANCEMENT TO WORK TOWARDS COVERAGE IN THE FUTURE. PATIENTS IN THIS PROGRAM ARE INTEGRATED INTO THE ASCENSION ST. VINCENT'S CLINIC NETWORK AND TAUGHT HOW TO NAVIGATE HEALTHCARE EFFECTIVELY. AN RN HEALTH COACH WORKS ESPECIALLY WITH PATIENTS WHO HAVE CHRONIC ILLNESS AND NEED ADDITIONAL ASSISTANCE UNDERSTANDING PLANS OF CARE AND MEDICATIONS. St. Vincent's Birmingham FACILITATES COMMUNITY ROUNDTABLE INITIATIVES TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY AS WELL. THE HEALTHCARE PROVIDER ROUNDTABLE CONSISTS OF HEALTHCARE PROVIDERS FROM AROUND THE REGION WHO SERVE UNINSURED OR UNDERINSURED PATIENTS AND MEETS SIX TIMES A YEAR. THE MENTAL HEALTHCARE PROVIDER ROUNDTABLE IS COMPRISED OF PROVIDERS ACROSS THE CONTINUUM WHO PROVIDE CARE TO THE COMMUNITY IN THE MENTAL HEALTH SECTOR. THEY ALSO MEET SIX TIMES A YEAR (ON THE ALTERNATE MONTHS OF THE HEALTHCARE GROUP). A LOW-COST DENTAL PROVIDER ROUNDTABLE NOW MEETS QUARTERLY TO DISCUSS DENTAL NEEDS IN THE COMMUNITY AND IDENTIFY POTENTIAL AREAS FOR COLLABORATION. THE GOAL OF THESE GROUPS IS NOT ONLY TO COORDINATE CARE BUT ALSO TO IDENTIFY GAPS AND NEEDS IN THE COMMUNITY AND COME TOGETHER TO FIND SOLUTIONS TO THE NEEDS THAT ARISE. IT IS ATTENDED BY CLINICS, SOCIAL SERVICE PROVIDERS, PRACTITIONERS, EDUCATIONAL FACILITIES AND MAJOR HEALTH SYSTEM REPRESENTATIVES. St. Vincent's Birmingham'S REPRESENTATIVES ALSO SERVE ON VARIOUS COMMUNITY HEALTH INITIATIVES SUCH AS ALABAMA CARE NETWORK (MID-STATE), JEFFERSON COUNTY HEALTH ACTION PARTNERSHIP, UNITED WAY'S BOLD GOALS AND THE AMERICAN HEART ASSOCIATION BOARD. St. Vincent's Birmingham AND ASCENSION HAVE A STRONG PRESENCE IN ADVOCACY ON BEHALF OF THE POOR AND VULNERABLE AS WELL. WITH A CHIEF ADVOCACY OFFICER FOR ALABAMA, ASCENSION AND ASCENSION ST. VINCENT'S ARE ACTIVELY SEEKING OPPORTUNITIES FOR POLICY CHANGE THAT WILL EXPAND COVERAGE, ASSIST THOSE WHO ARE PROVIDING CARE TO THE UNINSURED AS WELL AS LOOKING AT OTHER WAYS TO PROMOTE THE HEALTH OF THE COMMUNITY. EXAMPLES OF ADVOCACY IN THESE AREAS INCLUDES DEVELOPING NEW AND ENHANCED RELATIONSHIPS WITH COMMUNITY CARE PARTNERS AND WORKING WITH OUR STATE AND FEDERAL LAWMAKERS TO ENSURE ADEQUATE REIMBURSEMENT FOR THE UNINSURED AND UNDERINSURED. WHEN THE NEED ARISES, ST. VINCENT'S IS ALSO QUICK TO RESPOND TO COMMUNITY ISSUES INVOLVING NATURAL DISASTERS. THIS IS EVIDENCED BY COLLECTION AND DONATION OF ITEMS FOR HURRICANE, FLOOD AND TORNADO SURVIVORS AS WELL AS VOLUNTEER EFFORTS TO ASSIST WITH THOSE AFFECTED. IN THE PAST, ST. VINCENT'S HAS PROVIDED COVID-19 VACCINES, TETANUS SHOTS AND BASIC MEDICAL CARE IN AREAS OF NEED. PROMOTION OF HEALTH AND WELLNESS IS AN INTEGRATED PART OF THE ASCENSION ST. VINCENT'S CULTURE. HEALTH SCREENINGS, EDUCATION AND FOLLOW-UP IN THE BROADER COMMUNITY BRING AWARENESS AND LEARNING TO INDIVIDUALS WHO MIGHT NOT OTHERWISE RECEIVE CARE. IN ADDITION TO COMMUNITY SCREENINGS, ASCENSION ST. VINCENT'S HAS TRADITIONALLY FOCUSED OUTREACH ON AREAS FOR SYSTEMIC CHANGE SUCH AS THE IMPLEMENTATION OF COMMUNITY VEGETABLE GARDENS TO PROMOTE HEALTHY EATING AND COLLECTION OF P.E. EQUIPMENT FOR LOCAL SCHOOLS. WITH THE FUNDING OF ATHLETIC TRAINERS, ASCENSION ST. VINCENT'S ASSISTS WITH THE PROMOTION OF SAFE ATHLETICS TO ENSURE STUDENTS DO NOT INJURE THEMSELVES AT SUCH A YOUNG AGE. SPORTS PHYSICALS FOR STUDENTS WHO WOULD NOT OTHERWISE HAVE ACCESS ARE ALSO PART OF THE COMMUNITY HEALTH OUTREACH."

Schedule H, Part VI, Line 2 Needs assessment
St. Vincent's Birmingham uses internal and external data and reports from third parties, including government sources, to assess the healthcare needs of the communities we serve. These reports provide key information about health, socioeconomic, demographic factors that identify areas of need and inform our strategies that help to meet those needs of our community. These reports include, but are not limited to: Local and State Department of Health Reports, US Census Bureau, Sg2 healthcare intelligence, Healthcare claims datasets, State datasets and Internal data sets . St. Vincent's Birmingham utilizes information from these secondary sources to develop programs and provide appropriate services needed throughout the region. In addition, St. Vincent's Birmingham considers the health care needs of the overall community when evaluating internal financial and operational decisions. ANNUALLY, THE STATE OF ALABAMA RELEASES STATE INPATIENT DATA FOR ALL SUBMITTING HEALTHCARE FACILITIES THAT IS UTILIZED TO SHOW USE RATES AND AREAS OF GROWTH FOR CERTAIN SPECIALTIES AND IN CERTAIN REGIONS. WHEN COMBINED WITH DEMOGRAPHIC DATA AND POPULATION GROWTH RATES FROM THE US CENSUS BUREAU, St. Vincent's Birmingham OBTAINS A MORE COMPLETE PICTURE OF HOW THE COMMUNITY IS CHANGING. THESE DATA ARE UTILIZED TO MAKE OPERATION GROWTH DECISIONS TO DISCOVER WHERE THE AREAS OF GREATEST NEED ARE. SG2 AND CLAIMS DATASETS PROVIDE GREAT INSIGHT TO St. Vincent's Birmingham'S LEADERS THAT ALLOW THEM TO PROJECT SERVICE LINE GROWTH RATES INTO THE COMING YEARS, WHICH ASSISTS WITH PHYSICIAN RECRUITMENT AND SERVICE LINE PLANNING.

Schedule H, Part VI, Line 3 Patient education of eligibility for assistance
St. Vincent's Birmingham IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL, IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, St. Vincent's Birmingham'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; ST. VINCENT'S BIRMINGHAM PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. ST. VINCENT'S BIRMINGHAM WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE - https://healthcare.ascension.org/financial-assistance/alabama ST. VINCENT'S BIRMINGHAM MAKES PAPER COPIES OF THE: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION. THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. ST. VINCENT'S BIRMINGHAM INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. ST. VINCENT'S BIRMINGHAM INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS.

Schedule H, Part VI, Line 4 Community information
St. Vincent's Birmingham PRIMARILY SERVICES RESIDENTS OF CENTRAL ALABAMA IN THE FOLLOWING EIGHT COUNTIES: BLOUNT, CHILTON, CULLMAN, JEFFERSON, SHELBY, ST. CLAIR, TALLADEGA, AND WALKER. - OUR PRIMARY SERVICE AREA CONSISTS OF BOTH RURAL AND URBAN COMMUNITIES WITH A POPULATION OF 1,468,411; MEAN INCOME OF $57,400; AND MEDIAN AGE OF 39.9. - AGE OF POPULATION: 22% AGE 0-17, 36% AGE 18-44, 24% AGE 45-64, 18% AGE 65+. - SEX: 52% FEMALE AND 48% MALE. - ETHNICITY: 60.9% WHITE NON-HISPANIC, 27.2% BLACK NON-HISPANIC, 6.1% HISPANIC, 1.9% ASIAN NON-HISPANIC, 3.9% ALL OTHERS. - LANGUAGE: ONLY ENGLISH SPEAKING - 94.2%, NON-ENGLISH (AGE 5+) - 5.8%. - THERE ARE 100 FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS (MUA'S) IN THE STATE AND 25% OF THE POPULATION OF ALABAMA IS ELIGIBLE FOR MEDICAID. - INSURANCE COVERAGE BREAKDOWN IS 54.6% PRIVATE, 16.2% MEDICARE, 19.2% MEDICAID, AND 10.0% UNINSURED. - POVERTY: 11.0% OF FAMILIES IN THE 8 COUNTY SERVICE AREA ARE BELOW FEDERAL POVERTY LEVEL. - HOSPITALS IN SERVICE AREA: 18 TOTAL, 9 NONPROFIT, 8 FOR PROFIT, 1 ACADEMIC MEDICAL CENTER. - LEADING CAUSES OF DEATH: HEART DISEASE, CANCER, STROKE

Schedule H, Part VI, Line 6 Affiliated health care system
ST. VINCENT'S BIRMINGHAM IS A MEMBER OF ASCENSION. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 19 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. ST. VINCENT'S BIRMINGHAM OPERATES HOSPITAL FACILITIES IN CENTRAL ALABAMA and is part of ST. VINCENT'S HEALTH SYSTEM, WHICH OWNS AND OPERATES HEALTH CARE RELATED ENTITIES INCLUDING ST. VINCENT'S BIRMINGHAM, ST. VINCENT'S EAST, ST. VINCENT'S BLOUNT, ST. VINCENT'S ST. CLAIR, AND ST. VINCENT'S CHILTON. THE HEALTH SYSTEM PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF CENTRAL ALABAMA PRIMARILY IN THE FOLLOWING EIGHT COUNTIES: BLOUNT, CHILTON, CULLMAN, JEFFERSON, SHELBY, ST. CLAIR, TALLADEGA, AND WALKER.