4A (Expenses $ 69161042 including grants of $ 64068) (Revenue $ 72148544)
SEE SCHEDULE H

ST. GABRIEL'S HOSPITAL
PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, CHI ST. GABRIEL'S HEALTH TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH. AS A HOSPITAL WITHIN ONE OF THE THREE COUNTIES SERVED BY THE MORRISON-TODD-WADENA COMMUNITY HEALTH BOARD, CHI ST. GABRIEL'S HEALTH ONCE AGAIN TURNED TO COLLEAGUES WITHIN THE HOSPITALS AND PUBLIC HEALTH ORGANIZATIONS IN THIS REGION TO FORM A WORKING COMMITTEE (INFORMALLY KNOWN AS THE MTW COMMITTEE) TO CONDUCT A FORMAL SURVEY OF THE COMMUNITY. MEMBERS OF THE MTW COMMUNITY HEALTH NEEDS ASSESSMENT COMMITTEE INCLUDEDREPRESENTATIVES FROM:*PUBLIC HEALTH PROFESSIONALS FROM MORRISON, TODD, AND WADENA COUNTIES*LAKEWOOD HEALTH SYSTEM, STAPLES (TODD COUNTY)*TRI-COUNTY HEALTH, WADENA (WADENA COUNTY)*CENTRACARE HEALTH -LONG PRAIRIE (TODD COUNTY)*CHI ST. GABRIEL'S HEALTH (MORRISON COUNTY)THE MORRISON-TODD-WADENA COMMITTEE, CHAIRED BY KATHERINE MACKEDANZ, MPH, COMMUNITY HEALTH MANAGER, TODD COUNTY HEALTH AND HUMAN SERVICES, BEGAN MEETING IN THE SUMMER OF 2018 TO PLAN THE 2019 COMMUNITY HEALTH SURVEY. THE COMMITTEE APPROVED A FINAL VERSION OF THE SURVEY IN NOVEMBER 2018 AND SENT IT TO ANNE KINNEY, SENIOR RESEARCH SCIENTIST WITH THE CENTER FOR HEALTH STATISTICS IN THE MINNESOTA DEPARTMENT OF HEALTH, WHO ADVISED THE MTW COMMITTEE ON THE SURVEY AND WORKED WITH CONTRACTORS IN THE PRINTING, MAILING, AND COLLECTION OF THE SURVEYS. THE SURVEY WAS MAILED JANUARY 25, 2019, TO 1,600 HOUSEHOLDS IN EACH OF THE COUNTIES SERVED BY THE MORRISON-TODD-WADENA COMMUNITY HEALTH BOARD, WITH AN EXTRA 400 SURVEYS SENT TO EACH OF THE CITIES IN THE AREA: LITTLE FALLS, STAPLES, LONG PRAIRIE AND WADENA. THE ORIGINAL PLAN WAS TO SEND 1,600 SURVEYS TO RANDOMLY CHOSEN HOUSEHOLDS IN EACH OF THE THREE COUNTIES. HOWEVER, BASED UPON ADVICE FROM THE MINNESOTA DEPARTMENT OF HEALTH, AND IN AN ATTEMPT TO INCREASE THE NUMBER OF COMPLETED SURVEYS FROM PEOPLE AGES 18-30, THE COMMITTEE AGREED TO SEND AN ADDITIONAL 400 SURVEYS TO EACH OF THE ZIP CODES IN THE COUNTIES THAT ARE MORE LIKELY TO BE HOME TO PEOPLE IN THE 18-35 AGE GROUP, WHICH ARE ALSO THE COMMUNITIES IN WHICH HOSPITALS ARE LOCATED.THE MORRISON-TODD-WADENA COMMITTEE PLANNED AND CONDUCTED INTERVIEWS WITH COMMUNITY STAKEHOLDERS AT THE SAME TIME AS PLANNING THE SURVEY AND WAITING FOR THE SURVEY RESULTS. EACH HOSPITAL CONDUCTED ITS OWN STAKEHOLDER INTERVIEWS BASED UPON THE SET OF QUESTIONS DEVELOPED BY THE COMMITTEE MEMBERS IN COLLABORATION, EXPECTING THAT DOING SO WOULD ALLOW THEM TO COMPARE ANSWERS AND INFORMATION AFTER THE INTERVIEWS WERE COMPLETED.IN THE SUMMER OF 2021, THE MTW COMMITTEE RECONVENED TO CONDUCT A FOLLOW UP SURVEY OF THE COMMUNITY. LED BY KATHERINE MACKEDANZ, MPH, MANAGER OF TODD COUNTY PUBLIC HEALTH AND HUMAN SERVICES, TO REVIEW AND MODIFY 2018 SURVEY QUESTIONS FOR THE 2021 SURVEY. 6,400 PAPER SURVEYS WERE MAILED TO HOUSEHOLDS IN MORRISON, TODD AND WADENA COUNTIES BETWEEN OCTOBER AND DECEMBER 2021. AN ELECTRONIC SURVEY WAS ALSO ALSO ADMINISTERED DURING THIS SAME TIMEFRAME AND WAS DISSEMINATED THROUGH MTW MEMBER WEBSITES AND SOCIAL MEDIA OUTLETS. THE DATA COLLECTED INFORMS THE WORK OF THE 2022 CHNA.

ST. GABRIEL'S HOSPITAL
PART V, SECTION B, LINE 6B: MORRISON COUNTY PUBLIC HEALTH AND HUMAN SERVICES

ST. GABRIEL'S HOSPITAL
"PART V, SECTION B, LINE 11: THE MOST RECENT CHNA AND CORRESPONDING IMPLEMENTATION PLAN WAS COMPLETED IN THE TAX REPORTING YEAR 2022. THE FOLLOWING OUTLINES THE CURRENT IMPLEMENTATION PLAN PRIORITIES AND STRATEGIES. THIS PLAN WAS POSTED PUBLICLY ON HTTPS://WWW.CHISTGABRIELS.COM/CHNA THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY AND SECONDARY DATA FROM RESIDENT SURVEYS AND COUNTY PUBLIC HEALTH INFORMATION. TOP HEALTH NEEDS (FROM 2022 CHNA): 1. OBESITY, NUTRITION, AND DIABETES2. ADVERSE CHILDHOOD EXPERIENCES (ACES)3. MENTAL HEALTH4. HIRING HEALTHCARE PROFESSIONALS5. INCREASING CHILDCARE OPPORTUNITIESFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: OBESITY, NUTRITION, AND DIABETESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025:- IMPLEMENT THE TOTAL HEALTH ROADMAP AT FAMILY MEDICAL CENTER (FMC) CLINICS TO SCREEN FOR NUTRITION SECURITY VIA COMMUNITY HEALTH WORKERS. PARTNER WITH EXTENSION SNAP EDUCATORS TO INCREASE ENROLLMENT OF SNAP ELIGIBLE PERSONS.- SUPPORT THE EXPANSION OF A COMMUNITY WELLNESS CALENDAR IN PARTNERSHIP WITH LITTLE FALLS SCHOOLS AND UNIVERSITY OF MINNESOTA.- EXPAND DIABETES EDUCATION. - EXPAND FITNESS OPPORTUNITIES IN THE COMMUNITY THROUGH PUBLIC AND PRIVATE PARTNERSHIPS.PRIORITY HEALTH NEED #2: ACESTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023-2025:- INTEGRATE ACES SCREENING AND REFERRAL IN PRIMARY CARE AT FMC CLINICS.- PROVIDE EDUCATION TO STAFF AND PROVIDERS REGARDING ACES AWARENESS.- PROVIDE COMMUNITY EDUCATION ON ACES.- SUPPORT THE TRAIN THE TRAINER PROGRAM THROUGH MORRISON COUNTY FAMILY SERVICES.- EXPLORE ACES EDUCATION IN AREA SCHOOLS.PRIORITY HEALTH NEED #3: MENTAL HEALTH, INCLUDING SUICIDE PREVENTIONTO ADDRESS THIS NEED THE HOSPITAL WILL IMPLEMENT THE FOLLOWING STRATEGIES IN FISCAL YEARS 2023- 2025:- CONTINUE INVOLVEMENT/SUPPORT FOR MORRISON COUNTY SUICIDE PREVENTION COHORT.- EXPAND EDUCATION AND REACH OF THE NEW 988 RESOURCE.- CONTINUE LEAD SUPPORT FOR MINNESOTA PREVENTION ALLIANCE.- RECRUIT ADDITIONAL MENTAL AND BEHAVIORAL HEALTH PROVIDERS. THE HOSPITAL WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS FOR THE FOLLOWING REASONS: HIRING HEALTHCARE PROFESSIONALS - THE HOSPITAL WILL FOCUS ON ITS OWN PROGRAM FOR RECRUITMENT OF PROVIDERS, NURSES, AND STAFF TO CONTINUE TO PROVIDE EXCELLENT PATIENT CARE IN OUR COMMUNITY.INCREASING CHILDCARE OPPORTUNITIES - THE HOSPITAL IS WORKING WITH COMMONSPIRIT HEALTH AND THE CITY OF LITTLE FALLS TO ADD UP TO 24 ADDITIONAL CHILD CARE OPENINGS IN 2023. ST. GABRIEL'S WILL REMODEL THE FORMER ST. CAMILLUS PLACE AND MAKE IT AVAILABLE FOR DAYCARE PROVIDERS.THE FOLLOWING TOP HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED AS PART OF THE CHNA AND IMPLEMENTATION STRATEGY PLAN APPROVED IN 2019. ALTHOUGH A MORE RECENT CHNA WAS COMPLETED IN 2022, THE RELATED IMPLEMENTATION PLAN WAS NOT APPROVED UNTIL NOVEMBER 2022. THEREFORE THE WORK DESCRIBED BELOW IS TIED TO THE 2019 ASSESSMENT AND PLANS AND REPRESENTS WORK CARRIED OUT BY THE HOSPITAL DURING FISCAL YEAR 2022.THE COMMUNITY IDENTIFIED THE FOLLOWING PRIORITIES AS TOP HEALTH NEEDS THROUGH PRIMARY DATA OBTAINED THROUGH MTW COMMUNITY HEALTH BOARD RESIDENT SURVEYS AND KEY INFORMANT INTERVIEWS AS WELL AS A REVIEW OF SECONDARY DATA ON A VARIETY OF HEALTH INDICATORS.TOP HEALTH NEEDS (FROM 2019 CHNA):1. OBESITY, FOOD SECURITY, AND HEALTHY EATING 2. SUBSTANCE ABUSE3. MENTAL HEALTHFOR THIS PLAN THE HOSPITAL PRIORITIZED THE FOLLOWING HEALTH NEEDS:PRIORITY HEALTH NEED #1: OBESITY, FOOD SECURITY, AND HEALTHY EATINGTO ADDRESS THIS NEED THE HOSPITAL IMPLEMENTED THE FOLLOWING STRATEGIES IN 2019-2021:STRATEGY 1.1. SUPPORT HEALTHY EATING IN LOCAL SCHOOLSFY2022 ACTIONS AND IMPACT: CHI ST. GABRIEL'S HEALTH PROVIDED HEALTHY BREAKFASTS TO LITTLE FALLS PUBLIC SCHOOLS.MEASURES: 3,240 MEALS SERVED IN ACADEMIC YEAR 2021-2022.STRATEGY 1.2. SUPPORT EMERGENCY FOOD ASSISTANCE EFFORTSFY2022 ACTIONS AND IMPACT: PARTNERSHIP WITH THE MORRISON COUNTY FOOD SHELF, DEVELOPED REFERRAL PROCESS WITH CLINIC COMMUNITY HEALTH WORKER TO REFER PATIENTS FOR EMERGENCY FOOD ASSISTANCE TO COUNTY RESOURCES.MEASURES: 20 BOXES, 3 SMALL FOOD BAGS WERE PROVIDED TO PATIENTS OF FAMILY MEDICAL CENTERPRIORITY HEALTH NEED #2: SUBSTANCE ABUSESTRATEGY 2.1. FISCAL HOST AND LEAD AGENCY FOR MINNESOTA PREVENTION ALLIANCE (MPA), A STATEWIDE COALITION OF DRUG FREE COMMUNITY PARTNERS ADDRESSING YOUTH SUBSTANCE ABUSE PREVENTION THROUGH EDUCATION AND ADVOCACY.FY2022 ACTIONS AND IMPACT: CHI ST. GABRIEL'S HEALTH PROVIDED STAFF AND OTHER RESOURCES TO SUPPORT MPA THROUGHOUT FY22.MEASURES: 330 YOUTH SERVED BY MEMBER COALITIONS OF MPA STRATEGY 2.2. MEDICATION ASSISTED TREATMENT (MAT)FY2022 ACTIONS AND IMPACT: FAMILY MEDICAL CENTER OFFERS MAT TREATMENT FOR PATIENTS SERVED IN THE SUBOXONE CLINIC.MEASURES: 35 PATIENTS SERVED BY MATPRIORITY HEALTH NEED #3: MENTAL HEALTHSTRATEGY 3.1. PARTNER WITH MORRISON COUNTY PUBLIC HEALTH TO SUPPORT MENTAL HEALTH FIRST AID AND SUICIDE PREVENTION EFFORTS IN AREA SCHOOLS.FY2022 ACTIONS AND IMPACT: IN FY22, THE MORRISON COUNTY SUICIDE PREVENTION COHORT WAS FORMED BY OVER TWENTY AREA PROFESSIONALS AND ORGANIZATIONS TO PREVENT SUICIDE IN OUR COMMUNITY. CHI ST. GABRIEL'S HEALTH SUPPORTS THIS WORK THROUGH STAFF AND LEADER PARTICIPATION IN THE COHORT.MEASURES: 29.3% OF 9TH GRADERS IN MORRISON COUNTY, ""SERIOUSLY CONSIDERED ATTEMPTING SUICIDE"" IN THE LAST YEAR OR MORE, ACCORDING TO THE MINNESOTA STUDENT SURVEY (2019)."

ST. GABRIEL'S HOSPITAL
PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.

PART V, SECTION B, LINE 3E
THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY. THEY WERE IDENTIFIED THROUGH THE CHNA AND ARE BEING ADDRESSED IN THE HOSPITAL'S MOST RECENT IMPLEMENTATION PLAN.

PART V, SECTION B, LINES 16A-C:
HTTPS://WWW.CHISTGABRIELS.COM/FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE-REVIEW/

PART I, LINE 3C:
UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: - THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF THIRTY-FIVE DOLLARS ($10.00) WITH THE CHI HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW THIRTY-FIVE DOLLARS ($10) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. - THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED [IN THE FAP]. - THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION. FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: - RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; - HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS CLINIC; - PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); - FOOD STAMP ELIGIBILITY; - ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID SPEND-DOWN); - LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR - PATIENT IS DECEASED WITH NO KNOWN ESTATE.

PART I, LINE 7:
"COMMONSPIRIT HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (""CBISA"") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS."

PART III, LINE 2:
THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE COST TO CHARGE RATIO TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED.THE FILING ORGANIZATION PROVIDES FREE CARE TO ANY PATIENT WHOSE FAMILY INCOME IS AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL, OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS WHOSE FAMILY INCOME IS ABOVE 201% BUT LOWER THAN 400% OF THE FEDERAL POVERTY LEVEL. THE FILING ORGANIZATION ALSO PROVIDES OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE.

PART III, LINE 3:
UNITY FAMILY HEALTHCARE MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. UNITY FAMILY HEALTHCARE'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. UNITY FAMILY HEALTHCARE ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, UNITY FAMILY HEALTHCARE DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE.

PART VI, LINE 7:
MN

PART III, LINE 4:
"UNITY FAMILY HEALTHCARE DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 12-13.""PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES."""

PART III, LINE 8:
COMMONSPIRIT HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY COMMONSPIRIT HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. UNITY FAMILY HEALTHCARE'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $3,984,147 REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS.

PART III, LINE 9B:
COMMONSPIRIT HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE COMMONSPIRIT HEALTH FACILITY, OR BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, COMMONSPIRIT HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY COMMONSPIRIT HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, COMMONSPIRIT HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.

PART VI, LINE 3:
INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS EACH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH SERVES. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED AND A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRE THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON-MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKERS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.

PART VI, LINE 4:
RANKING AS THE 30TH MOST RURAL OF MINNESOTA'S 87 COUNTIES, AND MEETING FEDERAL DEFINITIONS OF RURAL WITH NEARLY 75 PERCENT OF ITS PEOPLE LIVING OUTSIDE OF A U.S. CENSUS BUREAU DESIGNATED URBAN AREA, MORRISON COUNTY IS HOME TO JUST MORE THAN 34,000 PEOPLE. MORRISON IS MINNESOTA'S 17TH LARGEST COUNTY BY AREA, ENCOMPASSING 1,124.5 SQUARE MILES. WITH A POPULATION DENSITY OF FEWER THAN 29 PEOPLE IN EACH SQUARE MILE, MORRISON COUNTY RANKS 41ST AMONG MINNESOTA COUNTIES FOR POPULATION DENSITY. IN 2020, MORE THAN 26.8 PERCENT OF MORRISON COUNTY'S RESIDENTS LIVED IN LITTLE FALLS, AN INCREASE OF MORE THAN 1.5 PERCENT OVER 2019 ESTIMATES. THE COUNTY'S OTHER TOWNS COMBINED CONTINUE TO BE HOME TO 18 PERCENT OF THE COUNTY'S RESIDENTS.SOCIODEMOGRAPHICSPEOPLE OVER THE AGE OF 65 REPRESENT A GREATER PORTION OF THE MORRISON COUNTY POPULATION THAN THEY DO IN MINNESOTA AND THE UNITED STATES OVERALL. THE PERCENTAGE OF PEOPLE IN THAT AGE GROUP IS INCREASING IN MORRISON COUNTY FASTER THAN IT IS STATEWIDE. (20% 65 YEARS OF AGE AND OLDER IN MORRISON, COMPARED TO 13.6% IN MINNESOTA). WHILE THE POPULATION IS DIVERSIFYING IN TERMS OF RACE AND ETHNICITY, MORRISON COUNTY RESIDENTS ARE PREDOMINANTLY NON-HISPANIC WHITE (95% OF MORRISON COUNTY RESIDENTS IDENTIFIED AS WHITE IN 2020 AND ONLY 2% OF ALL RESIDENTS IDENTIFIED AS HISPANIC). IN 2021, 3.9% OF RESPONDENTS (WEIGHTED) IDENTIFIED THEMSELVES AS NOT WHITE IN THE MORRISON-TODD WADENA COMMUNITY HEALTH SURVEY; IN 2019, 1.8% IDENTIFIED THEMSELVES AS NOT WHITE. IN 2016, ONLY 0.9% IDENTIFIED THEMSELVES AS NOT WHITE.ACCORDING TO THE U.S. CENSUS BUREAU, IN 2020, THE MEDIAN ANNUAL INDIVIDUAL AND FAMILY INCOME IN MORRISON COUNTY WAS $34,103 AND $57,815, RESPECTIVELY. THE ANNUAL COST OF LIVING FOR AN INDIVIDUAL AND FAMILY OF FOUR WAS $30,402 AND $61,023, RESPECTIVELY. THE PERCENTAGE OF INDIVIDUALS LIVING IN POVERTY IS 10.3%, DOWN FROM 13% IN 2010. THE PROPORTION OF CHILDREN UNDER 18 LIVING IN POVERTY DECREASED FROM 16% IN 2010 TO 13.2%.COMMUNITY DEVELOPMENT MORRISON COUNTY REPORTED THAT IN OCTOBER 2021 THERE WERE 12,536 PEOPLE WORKING IN THE COUNTY (COUNTY UNEMPLOYMENT RATE WAS 5% IN DECEMBER 2022). LEADING EMPLOYER SECTORS INCLUDED: RETAIL TRADE 1,911 (15%) HEALTH CARE AND SOCIAL ASSISTANCE 1,539 (12.3%) PUBLIC ADMINISTRATION 1,474 (11.8%) EDUCATIONAL SERVICES 1,436 (11.5%) THE AVERAGE HOURLY WAGE OF THE WORKERS IN MORRISON COUNTY IN DECEMBER 2021 WAS $15.91, OR $33,093 ANNUALLY FOR A 40-HOUR WORK WEEK, WHILE THE ANNUAL COST OF LIVING FOR A FAMILY OF THREE WAS $49,625, ACCORDING TO THE MINNESOTA DEPARTMENT OF EMPLOYMENT AND ECONOMIC DEVELOPMENT.MEDICALLY UNDERSERVED AREAS (MUA)THE ENTIRETY OF MORRISON COUNTY IS CONSIDERED UNDERSERVED BY MENTAL HEALTH PROFESSIONALS. THIS DESIGNATION WAS ORIGINALLY MADE IN OCTOBER 2002 AND UPDATED IN SEPTEMBER 2021. TWO TOWNSHIPS MORRILL IN THE SOUTHEAST AND SCANDIA VALLEY IN THE NORTHWEST ARE DESIGNATED AS UNDERSERVED BY PRIMARY CARE PRACTITIONERS.HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA)ALL OF MORRISON COUNTY IS DESIGNATED AS A LOW INCOME PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA. ALL BUT THREE OF ITS 30 TOWNSHIPS, AND THE CITIES AND TOWNS WITHIN THEM, RECEIVED THIS DESIGNATION AS A GROUP IN 2003 AND WERE REDESIGNATED IN 2021. MORRISON COUNTY IS ALSO DESIGNATED AS AN HPSA FOR DENTAL HEALTH, RECEIVING THAT DESIGNATION IN 2020. ALL OF MORRISON COUNTY IS CURRENTLY DESIGNATED AS AN HPSA FOR MENTAL HEALTH AS PART OF THE REGION 5 MENTAL HEALTH SERVICE AREA. THIS DESIGNATION WAS FIRST MADE IN 2002 AND UPDATED IN 2021.

PART VI, LINE 5:
FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR THE HOSPITAL TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE.OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS.

PART VI, LINE 6:
THE ORGANIZATION IS AFFILIATED WITH COMMONSPIRIT HEALTH. COMMONSPIRIT HEALTH WAS CREATED BY THE ALIGNMENT OF CATHOLIC HEALTH INITIATIVES AND DIGNITY HEALTH IN EARLY 2019. COMMONSPIRIT HEALTH, A NONPROFIT, FAITH-BASED HEALTH SYSTEM IS COMMITTED TO BUILDING HEALTHIER COMMUNITIES, ADVOCATING FOR THOSE WHO ARE POOR AND VULNERABLE, AND INNOVATING HOW AND WHERE HEALING CAN HAPPEN BOTH INSIDE ITS HOSPITALS AND OUT IN THE COMMUNITY. COMMONSPIRIT HEALTH OWNS AND OPERATES HEALTH CARE FACILITIES IN 21 STATES AND IS THE SOLE CORPORATE MEMBER (PARENT CORPORATION) OF OTHER PRIMARILY NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL AND STATE INCOME TAXES. AS OF JUNE 30, 2022, COMMONSPIRIT HEALTH IS COMPRISED OF APPROXIMATELY 2,200 CARE SITES, CONSISTING OF 142 HOSPITALS, INCLUDING ACADEMIC HEALTH CENTERS, MAJOR TEACHING HOSPITALS, AND CRITICAL ACCESS FACILITIES, COMMUNITY HEALTH SERVICES ORGANIZATIONS, ACCREDITED NURSING COLLEGES, HOME HEALTH AGENCIES, LIVING COMMUNITIES, A MEDICAL FOUNDATION AND OTHER AFFILIATED MEDICAL GROUPS, AND OTHER FACILITIES AND SERVICES THAT SPAN THE INPATIENT AND OUTPATIENT CONTINUUM OF CARE. IN FISCAL YEAR 2022, COMMONSPIRIT HEALTH PROVIDED MORE THAN $3.16 BILLION IN FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT FOR PROGRAMS AND SERVICES FOR THE POOR, FREE CLINICS, EDUCATION AND RESEARCH. FINANCIAL ASSISTANCE AND COMMUNITY BENEFIT TOTALED MORE THAN $4.89 BILLION WITH THE INCLUSION OF THE UNPAID COSTS OF MEDICARE. THE HEALTH SYSTEM, WHICH GENERATED OPERATING REVENUES OF $33.9 BILLION IN FISCAL YEAR 2022, HAS TOTAL ASSETS OF APPROXIMATELY $50.31 BILLION.COMMONSPIRIT HEALTH PROVIDES STRATEGIC PLANNING AND MANAGEMENT SERVICES AS WELL AS CENTRALIZED SERVICES FOR ITS DIVISIONS. THE PROVISION OF CENTRALIZED MANAGEMENT AND SHARED SERVICES INCLUDING AREAS SUCH AS ACCOUNTING, HUMAN RESOURCES, PAYROLL AND SUPPLY CHAIN PROVIDES ECONOMIES OF SCALE AND PURCHASING POWER TO THE DIVISIONS. THE COST SAVINGS ACHIEVED THROUGH COMMONSPIRIT HEALTH'S CENTRALIZATION ENABLE DIVISIONS TO DEDICATE ADDITIONAL RESOURCES TO HIGH-QUALITY HEALTH CARE AND COMMUNITY OUTREACH SERVICES TO THE MOST VULNERABLE MEMBERS OF OUR SOCIETY.