4A (Expenses $ 560306502 including grants of $ 12563113) (Revenue $ 649622622)
ST. JOSEPH'S MEDICAL CENTER (SJMC) OPERATES AND IS LICENSED AT THE SAME LEVEL WITH THE STATE OF CALIFORNIA, SERVING THE COUNTY OF SAN JOAQUIN AND OUTLYING AREAS. SJMC IS A 355-BED LICENSED ACUTE CARE FACILITY, PROVIDING GENERAL MEDICAL/ SURGICAL CARE, OBSTETRICS, NEONATAL ICU, EMERGENCY SERVICES, CANCER SERVICES, WITH SPECIALITIES IN CARDIAC SURGERY AND CARDIOVASCULAR CARE, RESPIRATORY, AND ORTHOPEDICS. THERE ARE NUMEROUS ANCILLARY AND OUTPATIENT SUPPORT SERVICES. PORT CITY IS COMMITTED TO FURTHERING THE CHARITABLE AND COMMUNITY-BASED HEALTH CARE PURPOSES, MISSION, VISION AND CORE VALUES OF DIGNITY HEALTH AND KAISER FOUNDATION HOSPITALS BY PROMOTING HEALTH AND PROVIDING AND EXPANDING ACCESS TO HEALTH CARE SERVICES FOR A BROAD CROSS-SECTION OF THE INDIVIDUALS WHO RESIDE IN STOCKTON, CALIFORNIA AND THE SURROUNDING COMMUNITIES.

4B (Expenses $ 27255369 including grants of $ 0) (Revenue $ 24837923)
ST. JOSEPH'S BEHAVIORAL HEALTH CENTER (BHC) OPERATES AND IS LICENSED AT THE SAME LEVEL WITH THE STATE OF CALIFORNIA, SERVING THE COUNTY OF SAN JOAQUIN AND OUTLYING AREAS. BHC IS A 35 BED ACUTE PSYCHIATRIC AND CHEMICAL DEPENDENCY HOSPITAL, PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES.

4C (Expenses $ 8156695 including grants of $ 0) (Revenue $ 11626597)
ST. JOSEPH'S MEDICAL CENTER HOME HEALTH (SJHHA) OPERATES AND IS LICENSED AS A HOSPITAL BASED HOME HEALTH AGENCY WITH THE STATE OF CALIFORNIA. SJHHA PROVIDES SKILLED NURSING CARE SERVICES, SOCIAL SERVICES, OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPIES, AS WELL AS HOME HEALTH AIDES.

PART V, SECTION A:
PRESENTATION OF HOSPITALS' COMPLETE WEBSITE ADDRESSES:ST. JOSEPH'S MEDICAL CENTER OF STOCKTONWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTONST. JOSEPH'S BEHAVIORAL HEALTH CENTERWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL

PART V, SECTION B
FACILITY REPORTING GROUP A

FACILITY REPORTING GROUP A CONSISTS OF:
- FACILITY 1: ST JOSEPHS MEDICAL CENTER OF STOCKTON, - FACILITY 2: ST JOSEPHS BEHAVIORAL HEALTH CENTER

FACILITY GROUP A PART V, SECTION B, LINE 5:
COMMUNITY INPUT OR CONTRIBUTIONS TO THIS IMPLEMENTATION STRATEGY INCLUDED INTERVIEWS WITH 10 KEY INFORMANTS, 29 FOCUS GROUP DISCUSSIONS WITH 291 DIVERSE COMMUNITY RESIDENTS, AND DATA ANALYSES OF OVER 100 INDICATORS, CREATING A ROBUST PICTURE OF THE ISSUES AFFECTING PEOPLE'S HEALTH WHERE THEY LIVE, WORK, AND PLAY. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM LOCAL GOVERNMENTAL AND PUBLIC HEALTH AGENCIES, COMMUNITY-BASED ORGANIZATIONS, AS WELL AS LEADERS, REPRESENTATIVES, OR MEMBERS OF UNDERSERVED, LOW-INCOME, AND RACIAL/ETHNIC POPULATIONS. ADDITIONALLY, WHERE APPLICABLE, OTHER INDIVIDUALS WITH EXPERTISE ON LOCAL HEALTH NEEDS WERE CONSULTED. BELOW IS THE FULL LIST OF ORGANIZATIONS THAT CONTRIBUTED TO THE DEVELOPMENT OF THE SAN JOAQUIN COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT AND ITS PROCESS: 211 SAN JOAQUIN; ADVENTIST HEALTH, LODI MEMORIAL AND DAMERON HOSPITALS; AMELIA ADAMS WHOLE LIFE CENTER; ASIAN PACIFIC SELF-DEVELOPMENT AND RESIDENTIAL ASSOCIATION (APSARA); BOYS AND GIRLS CLUB; CATHOLIC CHARITIES STOCKTON DIOCESE; CHILD ABUSE PREVENTION COUNCIL; CITY OF STOCKTON - OFFICE OF THE MAYOR & OFFICE OF VIOLENCE PREVENTION; COMMUNITY FOUNDATION OF SAN JOAQUIN; COMMUNITY MEDICAL CENTERS; DATA CO-OP; DELTA HEALTH CARE; CALIFORNIA DEPARTMENT OF HEALTH AND HUMAN SERVICES, REGION 9; DIGNITY HEALTH, ST. JOSEPH'S MEDICAL CENTER AND BEHAVIORAL HEALTH CENTER; EL CONCILIO; EMERGENCY FOOD BANK; FAITH IN THE VALLEY; FIRST 5 OF SAN JOAQUIN; HEALTH FORCE PARTNERS; HEALTH NET; HEALTH PLAN OF SAN JOAQUIN; HISPANIC CHAMBER OF COMMERCE; KAISER PERMANENTE; LITTLE MANILA RISING; LOVE INC. MANTECA; MARY MAGDALENE COMMUNITY SERVICES; PUBLIC HEALTH ADVOCATES; REINVENT SOUTH STOCKTON COALITION; SAN JOAQUIN PRIDE CENTER; SIERRA VISTA HOMES, RESIDENTS COUNCIL; SAN JOAQUIN COUNTY (SJC) BEHAVIORAL HEALTH SERVICES; SJC CHILDREN'S ALLIANCE; SJC CLINICS; SJC COUNCIL OF GOVERNMENTS; SJC OFFICE OF EDUCATION - EARLY CHILDHOOD EDUCATION & COMPREHENSIVE HEALTH PROGRAMS; SJC HEALTH CARE SERVICES AGENCY AND WHOLE PERSON CARE PROGRAM; SJC HUMAN SERVICES AGENCY: AGING AND COMMUNITY SERVICES; SJC PUBLIC HEALTH SERVICES; ST. MARY'S DINING ROOM; STOCKTONIANS TAKING ACTION TO NEUTRALIZE DRUGS (STAND); STOCKTON NAACP; SUTTER HEALTH VALLEY AREA; THIRD CITY COALITION; UNIVERSITY OF THE PACIFIC, SCHOOL OF HEALTH SCIENCES; VISIONARY HOME BUILDERS; WOMEN'S CENTER YOUTH AND FAMILY SERVICES AGENCY.

FACILITY GROUP A PART V, SECTION B, LINE 6A:
ADVENTIST HEALTH; LODI MEMORIAL AND DAMERON HOSPITALS; DIGNITY HEALTH ST. JOSEPH'S MEDICAL CENTER AND BEHAVIORAL HEALTH CENTER; KAISER PERMANENTE; SAN JOAQUIN GENERAL HOSPITAL; SUTTER HEALTH VALLEY AREA

FACILITY GROUP A PART V, SECTION B, LINE 6B:
COMMUNITY FOUNDATION OF SAN JOAQUIN; COMMUNITY MEDICAL CENTERS; FIRST 5 OF SAN JOAQUIN; HEALTH NET; HEALTH PLAN OF SAN JOAQUIN; SAN JOAQUIN COUNTY CLINICS; SAN JOAQUIN COUNTY OFFICE OF EDUCATION; SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES; UNIVERSITY OF THE PACIFIC

FACILITY GROUP A PART V, SECTION B, LINE 7D:
THE 2022 (TY 2021) CHNA REPORT WAS ANNOUNCED AND DISSEMINATED TO OVER 350 CONTACTS VIA AN E-NEWSLETTER HIGHLIGHTING VARIOUS COMMUNITY HEALTH DEPARTMENT UPDATES. RECIPIENTS OF THE INFORMATION INCLUDE BOTH HOSPITAL STAFF, COMMUNITY BASED ORGANIZATION LEADERS, AND OTHER PUBLIC AND PRIVATE STAKEHOLDERS. ADDITIONALLY, ALL OTHER CONTRIBUTING HOSPITALS AND FUNDING PARTNERS HAVE ALSO SHARED WIDELY.

FACILITY GROUP A PART V, SECTION B, LINE 11:
"ST. JOSEPH'S MEDICAL CENTER OF STOCKTONTHE HOSPITAL HAS MANY PROGRAMS AND SERVICES TO HELP ADDRESS ALL IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS. MENTAL HEALTH/BEHAVIORAL HEALTH INCLUDING SUBSTANCE USE: COMMUNITY HEALTH SOCIAL WORKER STAFFED TO ADVANCE MENTAL HEALTH PROGRAMMING; YOUTH OVERCOMING LIFE'S OBSTACLES (YOLO) GROUP (AGES 14-17); MENTAL HEALTH FIRST AID TRAINING; TRAUMA INFORMED SYSTEMS TRAINING THROUGH EMBEDDED LOCAL TRAINERS AND LOCAL COACHES; ESTABLISHED PSYCHIATRY RESIDENCY IN PARTNERSHIP WITH TOURO UNIVERSITY; SUBSTANCE USE NAVIGATOR FUNDING ACQUIRED AND POSITION STAFFED IN THE EMERGENCY DEPARTMENT.ACCESS TO CARE: EXPANSION OF GRADUATE MEDICAL EDUCATION; CONTINUED FOCUS PROGRAMMING TO FULLY INTEGRATE ROUTINE OPT-OUT HEP C, HIV, AND SYPHILIS SCREENING IN THE ED AND ENSURE PATIENT LINKAGES TO CARE THROUGH NAVIGATION SERVICES; CONTINUED THE HOMECOMING PROGRAM IN PARTNERSHIP WITH CATHOLIC CHARITIES TO PROVIDE A SUCCESSFUL POST HOSPITAL RECOVERY THROUGH COMPREHENSIVE CASE MANAGEMENT, ADDRESSING BOTH HEALTH AND HEALTH RELATED SOCIAL NEEDS.INCOME AND EMPLOYMENT: IMPLEMENTATION OF THE CONNECTED COMMUNITY NETWORK (CCN) TO STREAMLINE COMMUNITY RESOURCE CONNECTIONS AND COMMUNICATIONS AMONG SOCIAL SERVICE PROVIDERS; LAUNCH OF COMMUNITY HEALTH ADVOCATE PILOT TO IDENTIFY HEALTH RELATED SOCIAL NEEDS OF PATIENTS IN THE SJMC EMERGENCY DEPT AND REFER THEM TO COMMUNITY RESOURCES (THIS PROGRAM SUPPORTS MANY OTHER HEALTH NEEDS AS WELL); IMPLEMENTATION OF THE PATHWAYS COMMUNITY HUB, AN EVIDENCE BASED, PAY FOR OUTCOMES MODEL, THAT SUPPORTS THE VALUABLE ROLE OF COMMUNITY HEALTH WORKERS. HOUSING: INCREASED INVESTMENTS THROUGH A HOMELESS HEALTH INITIATIVE FUND WHICH EXPANDED MOBILE STREET OUTREACH IN PARTNERSHIP WITH THE SALVATION ARMY OF STOCKTON, INCREASED PERMANENT HOUSING SOLUTIONS IN COLLABORATION WITH STAND AFFORDABLE HOUSING AND SAN JOAQUIN COUNTY WHOLE PERSON CARE, AND COMPREHENSIVE CASE MANAGEMENT SERVICES FOR EMERGENCY DEPARTMENT PATIENTS POST DISCHARGE; CONTINUED COLLABORATION WITH THE GOSPEL CENTER RESCUE MISSION TO ENSURE SAFE PATIENT DISCHARGES THROUGH THE RECUPERATIVE CARE PROGRAM; ACTIVE INVOLVEMENT WITH THE SAN JOAQUIN COUNTY CONTINUUM OF CARE TO COLLECTIVELY FIND SOLUTIONS TO ADDRESS HOMELESSNESS. CHRONIC DISEASE/HEALTHY EATING & ACTIVE LIVING (HEAL): INVESTMENTS TO SUPPORT THE COMMUNITY HEALTH IMPROVEMENT PLAN INCLUDING IMPROVING PARK BEAUTIFICATION & INCREASING PARK ACTIVATION TO ADDRESS COMMUNITY SAFETY, HEALTH AND WELLNESS IN CHNA PRIORITY NEIGHBORHOODS; IMPLEMENTATION OF MULTIPLE DIABETES EDUCATION PROGRAMS, INCLUDING DIABETES NAVIGATION SERVICES, POWER HOUR, DIABETES EMPOWERMENT EDUCATION PROGRAM (DEEP), CERTIFIED DIABETES CARE & EDUCATION SPECIALIST (CDCES) CONSULTATIONS, THE SUGAR FIX SUPPORT GROUP, AND PSYCHO-SOCIAL ASSESSMENTS AND RESOURCE REFERRALS FOR PATIENTS EXPERIENCING SOCIAL BARRIERS TO DIABETES CARE; THE ANNUAL COMMUNITY GRANTS PROGRAM SUPPORTS THE CHNA NEEDS THROUGH A COMPETITIVE APPLICATION PROCESS.COMMUNITY SAFETY: INVESTMENTS TO IMPROVE PARK BEAUTIFICATION & INCREASE PARK ACTIVATION TO ADDRESS COMMUNITY SAFETY, HEALTH AND WELLNESS IN CHNA PRIORITY NEIGHBORHOODS; ACTIVE PARTICIPATION IN THE SAN JOAQUIN HUMAN TRAFFICKING TASK FORCE TO BRING AWARENESS OF, EDUCATION AND SUPPORT TO VICTIMS OF HUMAN TRAFFICKING AND LEADERSHIP IN THE HEALTHCARE WORKGROUP TO SUPPORT RESPONSE PROTOCOLS WITHIN OTHER HEALTHCARE FACILITIES. FAMILY AND SOCIAL SUPPORT: CONNECTED COMMUNITY NETWORK IMPROVE REFERRAL LINKAGES & ENHANCE COMMUNICATION AMONG SOCIAL SERVICE PARTNERS; IMPLEMENTATION OF THE PATHWAYS COMMUNITY HUB, MITIGATES HEALTH RELATED SOCIAL RISK FACTORS, THROUGH THE ASSESSMENT OF CLOSURE OF 21 SPECIFIC ""PATHWAYS; COMMUNITY HEALTH ADVOCATE PROGRAM, OFFERING SOCIAL NEEDS SCREENING AND REFERRALS TO EMERGENCY DEPARTMENT PATIENTS TO PROACTIVELY MITIGATE RISKS THAT INCREASE POOR HEALTH OUTCOMES IF LEFT UNADDRESSED; CONTINUED THE LIFELINE HOME MONITORING SERVICES IN AN EFFORT TO IMPROVE INDEPENDENT LIVING AND SAFETY FOR OLDER ADULTS AND INDIVIDUALS WITH DISABILITIES. EDUCATION: EXPANDED THE CONNECTED COMMUNITY NETWORK INTO THE EDUCATION SECTOR BY ONBOARDING THE SAN JOAQUIN COUNTY OFFICE OF EDUCATION TO IMPROVE EDUCATIONAL ATTAINMENT BY ADDRESSING UNMET SOCIAL NEEDS; ESTABLISHED A RELATIONSHIP WITH LOCAL UNIVERSITIES TO SUPPORT MASTERS LEVEL SOCIAL WORK INTERNSHIPS. TRANSPORTATION: CONNECTED COMMUNITY NETWORK IMPROVE REFERRAL LINKAGES & ENHANCE COMMUNICATION AMONG SOCIAL SERVICE PARTNERS; HOMECOMING PROJECT IN PARTNERSHIP WITH CATHOLIC CHARITIES TO PROVIDE A SUCCESSFUL POST HOSPITAL RECOVERY THROUGH COMPREHENSIVE CASE MANAGEMENT, ADDRESSING BOTH HEALTH AND HEALTH RELATED SOCIAL NEEDS. ST. JOSEPH'S BEHAVIORAL HEALTH CENTER:AS A HOSPITAL EXCLUSIVELY DELIVERING BEHAVIORAL HEALTH SERVICES, NEEDS IDENTIFIED IN THE BROADER CHNA BEYOND MENTAL HEALTH, ACCESS TO CARE, AND FAMILY AND SOCIAL SUPPORTS ARE NOT ONES THAT THE HOSPITAL IS ABLE TO ADDRESS, HOWEVER, IT IS OUR MISSION TO WORK COLLABORATIVELY WITH ST. JOSEPH'S MEDICAL CENTER AND OTHER STAKEHOLDERS TO SUPPORT INITIATIVES BY LENDING OUR EXPERTISE. THE FOLLOWING PROGRAMS ARE SUPPORTING THE IDENTIFIED NEEDS OF MENTAL HEALTH, ACCESS TO CARE, AND FAMILY/SOCIAL SUPPORTS: 24/7/365 BEHAVIORAL EVALUATION SERVICES, WHICH PROVIDES FREE EVALUATION TO INDIVIDUALS WITH BEHAVIORAL HEALTH CONCERNS. MEDICATION ASSISTED THERAPY (MAT) PROGRAM, COMMUNITY SUPPORT GROUPS, AND AFTERCARE SERVICES, WHICH PROVIDE FREE SUPPORT PROGRAMS TO INDIVIDUALS LIVING WITH LIFEAFFECTING SUBSTANCE AND/OR CONTINUING BEHAVIOR HEALTH ISSUES. SUPPORT OF THE GRADUATE MEDICAL EDUCATION PSYCHIATRY PROGRAM PROVIDES RESIDENTS WITH QUALITY EDUCATION AND EXPERIENCE, IN AN EFFORT TO ENCOURAGE CONTINUED PRACTICE IN SAN JOAQUIN COUNTY. ADDITIONALLY, MEETING SPACE IS MADE AVAILABLE TO COMMUNITY GROUPS TO GATHER AND PROVIDE COMMUNITY SERVICES AT NO COST. TRANSPORTATION ASSISTANCE FOR QUALIFIED CLIENTS THAT OTHERWISE WOULD NOT BE ABLE TO ATTEND SJBHC OUTPATIENT SERVICES GROUPS. THROUGH A FORMAL PROCESS, GRANTS ARE ADMINISTERED ANNUALLY TO NON-PROFIT ORGANIZATIONS THAT BEST DEMONSTRATE THEIR ABILITY TO IMPACT COMMUNITY HEALTH NEEDS THROUGH COLLABORATION WITH OTHER ORGANIZATIONS."

FACILITY GROUP A 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. IF APPLICABLE, 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.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.

PART V, SECTION B, LINE 7A
CHNA REPORT WEB SITE LOCATIONS FOR ST JOSEPH'S MEDICAL CENTER OF STOCKTON AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER ARE PROVIDED BELOW.HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/ABOUT-US/COMMUNITY-PROGRAMS/COMMUNITY-HEALTH-NEEDS-ASSESMENTHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/ABOUT-US/COMMUNITY-HEALTHSCHEDULE H, PART V, SECTION B, LINE 7BWWW.HEALTHIERSANJOAQUIN.ORGHTTP://WWW.SJCPHS.ORG/ASSETS/20220817_4%2028%2022%20FINAL%20SJC%20CHNA%20REPORT.PDF

PART V, SECTION B, LINE 10A
THE HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED ATHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/ABOUT-US/COMMUNITY-PROGRAMS/COMMUNITY-HEALTH-NEEDS-ASSESMENTHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/ABOUT-US/COMMUNITY-HEALTH

PART V, SECTION B, LINE 16A, 16B AND 16C
ST. JOSEPH'S MEDICAL CENTER OF STOCKTON:HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEST. JOSEPH'S BEHAVIORAL HEALTH CENTER:HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/PATIENTS-AND-VISITORS/PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE

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 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 COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED IN SCHEDULE H, PART V, SECTION B, LINE 13H, 3RD PARAGRAPH. - THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).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 OR FREE CARE CLINIC; - PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); - FOOD STAMP ELIGIBILITY; - ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID); - LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR - PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY. A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.

PART I, LINE 7:
"PORT CITY OPERATING COMPANY, LLC, (PORT CITY) DBA ST. JOSEPH'S MEDICAL CENTER OF STOCKTON (SJMC) AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER (BHC) FOLLOWS THE METHOD USED BY COMMONSPIRIT HEALTH. FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE, THE ORGANIZATION USES AN ADJUSTED COST TO CHARGE RATIO (CCR) 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 IS USED IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (""CBISA"") SOFTWARE 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 I, LINE 7B, COLUMN (F):BEGINNING IN 2009, THE STATE OF CALIFORNIA ESTABLISHED PROVIDER FEE PROGRAMS. THESE PROGRAMS ARE FUNDED BY QUALITY ASSURANCE FEES PAID BY PARTICIPATING HOSPITALS AND MATCHING FEDERAL FUNDS. PORT CITY'S HOSPITAL FACILITIES RECOGNIZED QUALITY ASSURANCE FEES DURING THE YEAR OF $15 MILLION WHICH ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO UNREIMBURSED MEDICAID (PART I, LINE 7B, COLUMN C), AND RECOGNIZED FEE-FOR-SERVICE SUPPLEMENTAL PAYMENTS OF $37.6 MILLION DURING THE YEAR REFLECTED UNDER THE MEDICAID PROGRAM AS DIRECT OFFSETTING REVENUE (PART I, LINE 7B, COLUMN D). THIS NET GAIN IN THE COST OF THE MEDICAID PROGRAM IS DRIVING THE INCREASE IN THE OVERALL COST OF COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES WHEN COMPARED TO PRIOR YEARS.PART I, LINE 7I:INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $299 THOUSAND IN GRANTS TO A FUND ESTABLISHED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST (""CHFT"") FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA, CONSISTENT WITH CHFT'S MISSION OF SUPPORTING HEALTH CARE, ACCESS TO HEALTH CARE, RESEARCH AND EDUCATION."

PART VI, LINE 6:
PORT CITY IS 80% OWNED BY DIGNITY HEALTH AND THEREFORE AFFILIATED WITH ALL ENTITIES WITHIN COMMONSPIRIT HEALTH. AFFILIATES OF PORT CITY ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN CALIFORNIA, ARIZONA, AND NEVADA AND IN 18 ADDITIONAL STATES THROUGH THE ALLIANCE WITHIN COMMONSPIRIT HEALTH SYSTEM. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES. TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE NET OF OFFSETTING REVENUE FOR COMMONSPIRIT HEALTH AND ITS AFFILIATED CORPORATIONS, WHICH INCLUDES PORT CITY, FOR THE YEAR ENDED JUNE 30, 2022, IS $3.2 BILLION. A SUMMARY OF COMMONSPIRIT'S COMMUNITY BENEFITS CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT HEALTH CONSOLIDATED FINANCIAL STATEMENTS ON PAGE 44.

PART VI, LINE 7, REPORTS FILED WITH STATES
CA

PART II, COMMUNITY BUILDING ACTIVITIES:
"THE HOSPITAL'S WORK TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED EXTENDS BEYOND PROVIDING HEALTH CARE AND COMMUNITY HEALTH IMPROVEMENT SERVICES. THE HOSPITAL TAKES A PROACTIVE APPROACH TO ADDRESSING THE SOCIAL, ECONOMIC AND ENVIRONMENTAL BARRIERS TO GOOD HEALTH, AND SUPPORTS THE WORLD HEALTH ORGANIZATION DEFINITION OF HEALTH AS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY. IN ADDITION TO THE EXAMPLES BELOW, THE HOSPITAL'S PUBLICLY AVAILABLE ANNUAL COMMUNITY BENEFIT REPORTS DESCRIBE SPECIFIC COMMUNITY BUILDING ACTIVITIES IN A SECTION TITLED ""OTHER PROGRAMS AND NON-QUANTIFIABLE BENEFITS."" COMMUNITY BUILDING ACTIVITIES PROVIDED BY MEDICAL CENTER STAFF IN THE LAST YEAR INCLUDE SUPPORTING THE COUNTY'S HOMELESS CONTINUUM OF CARE AND ITS PARTNERS IN STRATEGIES AROUND HOMELESSNESS, INCLUDING IDENTIFYING, ADVOCATING FOR, AND SUPPORTING THE SECURITY OF RESOURCES TO INCREASE DEVELOPMENT OF AFFORDABLE HOUSING AND IMMEDIATE HOUSING FOR THOSE EXPERIENCING HOMELESSNESS.OTHER ACTIVITIES AND ACCOMPLISHMENTS INCLUDE SUPPORTING ECONOMIC DEVELOPMENT THROUGH LEADERSHIP ON THE BUSINESS COUNCIL, SUPPORTING THE LOCAL PUBLIC HEALTH DEPARTMENT IN COVID-19 RESPONSE THROUGH OUTREACH, PPE DISTRIBUTION AND COMMUNICATIONS SUPPORT TO INCREASE VACCINATION RATES, CO-FUNDING AND CO-FACILITATING THE NEW TRAUMA TRAIN THE TRAINER PROGRAM IN ORDER TO TRAIN COMMUNITY PARTNERS AND THEIR TEAMS ON TRAUMA INFORMED CARE, COALITION BUILDING AND SUPPORT FOR COMMUNITY HEALTH WORKERS TO IMPROVE HEALTH OUTCOMES, TRAUMA GROUPS TO IDENTIFY STRATEGIES TO MITIGATE/REDUCE COMMUNITY TRAUMA AND VIOLENCE, HUMAN TRAFFICKING RESPONSE AND REDUCTION, AND PARK ACTIVATION AND BEAUTIFICATION IN RESPONSE TO THE COLLABORATIVE COMMUNITY HEALTH IMPROVEMENT PLAN, AS WELL AS WORKFORCE DEVELOPMENT THROUGH THE RECRUITMENT OF PHYSICIANS IN MEDICAL SHORTAGE AREAS OF THE COMMUNITY."

PART III, LINE 2:
THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE PART I, LINE 7) 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 FINANCIAL ASSISTANCE, AND ARE OTHERWISE UNINSURED. ANY PORTION OF A PATIENT BILL REMAINING AFTER APPLYING FINANCIAL, UNINSURED OR OTHER DISCOUNTS OR PAYMENTS RECEIVED ON THE ACCOUNT THAT ARE ULTIMATELY DETERMINED TO BE UNCOLLECTIBLE ARE WRITTEN OFF TO BAD DEBT.PORT CITY PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 250%, 251%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. PORT CITY ALSO PROVIDES PATIENTS OPTIONS FOR UNINSURED PATIENT DISCOUNT AND SELF-PAY DISCOUNTS. IN CALIFORNIA, PATIENTS WHO ARE UNINSURED OR WITH HIGH MEDICAL COSTS ARE ELIGIBLE TO RECEIVE DISCOUNTED CARE IN ADDITION TO AN INTEREST-FREE EXTENDED PAYMENT PLAN THAT WILL ALLOW PAYMENT OF THE DISCOUNTED AMOUNT OVER TIME. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE.

PART III, LINE 3:
THE DIGNITY HEALTH FINANCIAL ASSISTANCE POLICY WAS UPDATED AND RENAMED AS COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. DIGNITY COMMUNITY CARE HOSPITALS FOLLOW THIS POLICY.THE FILING ORGANIZATION MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. COMMONSPIRIT HEALTH'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. COMMONSPIRIT HEALTH 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, DIGNITY COMMUNITY CARE 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 III, LINE 4:
THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT HEALTH'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 HEALTH 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 COMPLIES WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE 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 TO BE 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.

PART III, LINE 9B:
PORT CITY ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. PORT CITY ALSO FOLLOWS COMMONSPIRIT HEALTH'S BILLING AND COLLECTION POLICY. COMMONSPIRIT HEALTH'S COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHOM THE ORGANIZATION KNOWS QUALIFY FOR CHARITY CARE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE HOSPITAL FACILITIES OR THE 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 FINANCIAL ASSISTANCE OR FOR ASSISTANCE UNDER DIGNITY 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, PORT CITY WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT.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 ACCOUNTS TO A COLLECTION AGENCY, PORT CITY REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.

PART VI, LINE 2:
ST. JOSEPH'S MEDICAL CENTER OF STOCKTON AND ST. JOSEPH'S BEHAVIORAL HEALTH:THE HOSPITALS TOGETHER HAVE VISIBILITY TO THE EMERGING HEALTH CARE NEEDS THROUGH THE COURSE OF SERVICE PROVISION OF FOLLOWING PROGRAMS; THE COMMUNITY HEALTH ADVOCATE PROGRAM AS A STRATEGY TO ADDRESS MULTIPLE IDENTIFIED UNMET NEEDS THROUGH A UNIVERSAL SCREENING OF THE SOCIAL DETERMINANTS OF HEALTH FOR PATIENTS IN THE HOSPITAL EMERGENCY DEPARTMENT; AND THE HOMECOMING PROGRAM THAT ASSESS THE HEALTH AND SOCIAL SERVICE NEEDS OF INDIVIDUALS POST HOSPITALIZATION BY PROVIDING SHORT-TERM CASE MANAGEMENT TO ENSURE A SAFE RECOVERY. ADDITIONALLY, THE CONNECTED COMMUNITY NETWORK OF SAN JOAQUIN IS A NETWORK OF HEALTH AND SOCIAL SERVICE PROVIDERS UNITED THROUGH A SHARED TECHNOLOGY PLATFORM THAT ALLOWS VISIBILITY TO COMMUNITY CARE COORDINATION AND HELPS TO ASSESS SERVICE GAPS AND CAPACITY ISSUES AMONG IN-NETWORK PROVIDERS.

PART VI, LINE 3:
INFORMATION ABOUT PORT CITY'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'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 THE PORT CITY'S FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES PORT CITY'S FACILITIES SERVE. 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, A STATEMENT INFORMING PATIENTS HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRES 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 WORKS, 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:
SAN JOAQUIN COUNTY, IN THE CENTRAL VALLEY OF CALIFORNIA, AND IS ROUGHLY 60 MILES EAST OF SAN FRANCISCO AND 35 MILES SOUTH OF SACRAMENTO. HISTORICALLY, AGRICULTURE HAS BEEN A STRONG DRIVER OF THE ECONOMY AND MANY MIGRANTS AND IMMIGRANTS HAVE SETTLED HERE TO WORK IN THE FIELDS AND HELP WITH AGRICULTURAL PROCESSING OR SHIPPING. THE COUNTY IS MOSTLY RURAL, WITH ONE LARGE URBAN CORE (STOCKTON) AND SEVEN SMALLER CITIES, AS WELL AS MANY RANCHING AND FARMING COMMUNITIES SCATTERED ACROSS THE COUNTY. SAN JOAQUIN COUNTY IS HOME TO A HIGH CONCENTRATION OF RESIDENTS AT ELEVATED RISK FOR COVID-19 AND WHO HAVE EXPERIENCED ENORMOUS IMPACTS FROM THE PANDEMIC. A QUARTER OF RESIDENTS ARE FOREIGN-BORN. OVERALL, 14.5% OF RESIDENTS LIVE IN POVERTY AND RESIDENTS AGED 65 YEARS AND OLDER HAVE A POVERTY RATE OF 9.9%. THE EDUCATIONAL ATTAINMENT OF SAN JOAQUIN COUNTY RESIDENTS IS MUCH LOWER THAN CALIFORNIA RESIDENTS. ONLY 18.8% OF COUNTY RESIDENTS AGED 25 AND OLDER HAVE A BACHELOR'S DEGREE OR HIGHER, COMPARED TO 33.9% OF CALIFORNIANS AGED 25 AND OLDER THAT HAVE A BACHELOR'S DEGREE OR HIGHER. THE DEMOGRAPHICS DATA BELOW REPRESENTS ONLY THE TOP 75% OF ST. JOSEPH'S HOSPITAL DISCHARGES (BASED ON ZIP CODE):TOTAL POPULATION: 330,246 ASIAN/PACIFIC ISLANDER: 16.2%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 10.1%HISPANIC OR LATINO: 52.6%WHITE NON-HISPANIC: 15.7%ALL OTHERS: 5.4%% BELOW POVERTY: 15.4%UNEMPLOYMENT: 7.5%NO HIGH SCHOOL DIPLOMA: 26.3%MEDICAID: 38.1%UNINSURED: 6.4%OTHER AREA HOSPITALS: 7WITHIN SAN JOAQUIN COUNTY THERE ARE A TOTAL OF SEVEN HOSPITALS, TWO BEHAVIORAL HEALTH HOSPITALS, AND TWO FEDERALLY QUALIFIED HEALTH CENTERS TO MEET THE ACCESS TO CARE NEEDS OF THOSE MEDICALLY UNDERSERVED.

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. HOSPITAL LEADERSHIP CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS - HOSPITAL LEADERS SIT ON MANY COMMUNITY BOARDS, STEERING COMMITTEES, AND OTHER COMMUNITY ADVISORY COMMITTEES INCLUDING THE SAN JOAQUIN BUSINESS COUNCIL, WOMEN'S CENTER YOUTH AND FAMILY SERVICES, CONTINUUM OF CARE, COMMUNITY PARTNERSHIP FOR FAMILIES OF SAN JOAQUIN, SAN JOAQUIN COMMUNITY FOUNDATION, SAN JOAQUIN HISPANIC CHAMBER OF COMMERCE AND REINVENT SOUTH STOCKTON COALITION.