4A (Expenses $ 363170610 including grants of $ 112034) (Revenue $ 431232403)
SAN ANTONIO REGIONAL HOSPITAL WAS FOUNDED BY DR. WILLIAM HOWARD CRAIG IN 1907 TO MEET THE HEALTHCARE NEEDS OF LOCAL RESIDENTS. AS THE COMMUNITY SURROUNDING THE HOSPITAL GREW, IT BECAME APPARENT THAT LARGER, MORE MODERN FACILITIES WERE NEEDED. COMMUNITY LEADERS RALLIED TO RAISE THE NEEDED CAPITAL AND THE HOSPITAL MOVED TO ITS CURRENT LOCATION ON SAN BERNARDINO ROAD IN 1924. THROUGH COMMUNITY SUPPORT, THE HOSPITAL GREW - FROM ITS MODEST BEGINNING WITH 18 BEDS, 5 PHYSICIANS, AND LIMITED STAFF - TO A 363-BED REGIONAL MEDICAL FACILITY WITH 2,200 EMPLOYEES, OVER 400 VOLUNTEERS, AND A MEDICAL STAFF OF NEARLY 600 PHYSICIANS REPRESENTING A WIDE SPECTRUM OF MEDICAL AND SURGICAL SPECIALTIES. IN 2021, THE HOSPITAL HAD APPROXIMATELY 15,758 ADMISSIONS, 122,026 OUTPATIENT VISITS, AND 79,616 EMERGENCY ROOM VISITS. ON JANUARY 6, 2017 THE HOSPITAL'S MAIN CAMPUS IN UPLAND OPENED THE LARGEST EXPANSION IN ITS HISTORY. THE 179,000 SQUARE FOOT ADDITION, WHICH INCLUDES A NEW 52-BED EMERGENCY DEPARTMENT AND 92-BED PATIENT TOWER, INCORPORATED THE LATEST HEALTHCARE ARCHITECTURAL DESIGN AND ADVANCED TECHNOLOGICAL FEATURES TO MEET THE NEEDS OF THE GROWING POPULATION IN THE WEST END OF CALIFORNIA'S INLAND EMPIRE. IN ADDITION TO THE MAIN CAMPUS, THE HOSPITAL HAS SATELLITE LOCATIONS IN RANCHO CUCAMONGA, FONTANA, AND EASTVALE, AND WILL SOON ADD A FOURTH URGENT CARE IN THE CITY OF ONTARIO. THESE FACILITIES PROVIDE OUTPATIENT CARE IN A CLOSE, CONVENIENT SETTING FOR THE REGION'S GROWING POPULATION. ADDITIONALLY, SAN ANTONIO OPENED A NEW 60,000-SQUARE-FOOT TWO-STORY AMBULATORY CARE FACILITY DIRECTLY ACROSS THE STREET FROM THE HOSPITAL IN 2019. THE SCHEU BUILDING HOUSES CITY OF HOPE'S COMPREHENSIVE CANCER CENTER ON THE FIRST FLOOR AND THE HOSPITAL'S OUTPATIENT SERVICES AND PROGRAMS ON THE SECOND FLOOR. THE WOMEN'S BREAST AND IMAGING CENTER, PRE-OPERATIVE AND PRE-PROCEDURE SERVICES, AND TARGETED PROGRAMS TO COMPLEMENT CITY OF HOPE'S CANCER CENTER ARE AMONG THE HOSPITAL'S OFFERINGS IN THIS LOCATION. LEADERSHIP - SAN ANTONIO REGIONAL HOSPITAL IS GOVERNED BY 14-MEMBER BOARD OF TRUSTEES. THE HOSPITAL'S MEDICAL STAFF PRESIDENT-ELECT, PRESIDENT, AND IMMEDIATE PAST PRESIDENT ARE MEMBERS OF THE BOARD BY VIRTUE OF THEIR OFFICES. AT LEAST TWO ADDITIONAL PHYSICIANS ARE ELECTED FROM THE MEDICAL STAFF, AND THE REMAINING MEMBERS ARE ELECTED FROM THE COMMUNITY AT-LARGE. THE BOARD OF TRUSTEES, WITH PHYSICIAN LEADERS COMPRISING A SIGNIFICANT PORTION OF ITS MEMBERSHIP, SETS THE DIRECTION FOR THE HOSPITAL'S COMMUNITY BENEFITS PROGRAM. THE EXECUTIVE MANAGEMENT GROUP DIRECTS THE HOSPITAL'S STRATEGIC PLANNING PROCESS AND ALLOCATES RESOURCES FOR COMMUNITY BENEFIT ACTIVITIES. THE EXECUTIVE MANAGEMENT GROUP INCLUDES THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, CHIEF OPERATING OFFICER, CHIEF NURSING OFFICER, CHIEF STRATEGY OFFICER, CHIEF HUMAN RESOURCE OFFICER, CHIEF INFORMATION OFFICER, AND PRESIDENT OF THE HOSPITAL FOUNDATION. DEPARTMENT DIRECTORS ARE RESPONSIBLE FOR THE OPERATION AND MANAGEMENT OF THE INDIVIDUAL DEPARTMENTS. THE DIRECTORS ENCOURAGE EMPLOYEE PARTICIPATION IN COMMUNITY BENEFIT ACTIVITIES, AND IT IS THIS SUPPORT THAT ENSURES THE ULTIMATE SUCCESS OF THE SARH'S COMMUNITY OUTREACH PROGRAM. OUR COMMITMENT- THE LEADERSHIP AT SAN ANTONIO REGIONAL HOSPITAL HAS AN UNWAVERING COMMITMENT TO THE HOSPITAL'S MISSION, VISION, VALUES, AND STRATEGIC PLAN, WHICH FOCUS ON IMPROVING THE REGION'S OVERALL HEALTH BY PROVIDING QUALITY PATIENT CARE IN A COMPASSIONATE AND CARING ENVIRONMENT. OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE WE SERVE. OUR VISION IS TO BE A LEADER IN CREATING HEALTHY FUTURES THROUGH EXCELLENCE AND COMPASSION. OUR VALUES ARTICULATE THE PRINCIPLES THAT HELP US TO FULFILL OUR MISSION AND VISION, AND OUR STRATEGIC PLAN SPECIFICALLY ADDRESSES THE DEVELOPMENT OF PROGRAMS AND SERVICES IN RESPONSE TO THE REGIONAL COMMUNITY NEEDS. SAN ANTONIO'S COMMITMENT TO PROVIDING QUALITY CARE FOR ALL MEMBERS OF OUR COMMUNITY HAS RECEIVED NATIONAL RECOGNITION. IN 2021, SARH WAS NAMED A RECIPIENT OF HEALTHGRADES AMERICA'S 50 BEST HOSPITALS FOR CARDIAC SURGERY. HEALTHGRADES IS A LEADING RESOURCE FOR CONNECTING CONSUMERS, PHYSICIANS, AND HEALTH SYSTEMS. EVERY YEAR, HEALTHGRADES EVALUATES HOSPITAL PERFORMANCE AT NEARLY 4,500 HOSPITALS NATIONWIDE FOR 31 OF THE MOST COMMON INPATIENT PROCEDURES AND CONDITIONS, INCLUDING CARDIAC SURGERY. HOSPITALS THAT HAVE ACHIEVED THE HEALTHGRADES AMERICA'S 50 BEST HOSPITALS FOR CARDIAC SURGERY AWARD HAVE DEMONSTRATED EXCEPTIONAL QUALITY OF CARE, ON AVERAGE, A 52.8% LOWER RISK OF DURING THAN IF THEY WERE TREATED IN HOSPITALS THAT DID NOT RECEIVE THE AWARD. SAN ANTONIO REGIONAL HOSPITAL WAS ALSO RECOGNIZED BY HEALTHGRADES FOR THE FOLLOWING ADDITIONAL CLINICAL ACHIEVEMENTS: CARDIAC SURGERY EXCELLENCE AWARD AND FIVE-STAR RECIPIENT FOR CORONARY BYPASS SURGERY. IN ADDITION, SARH' S STROKE CARE HAS BEEN RECOGNIZED WITH THE 2021 GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD FROM THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION. THE AWARD IS GIVEN TO HOSPITALS THAT DEMONSTRATE 85 PERCENT OR HIGHER COMPLIANCE IN EACH OF THE ASSOCIATION'S SEVEN GET WITH THE GUIDELINES - STROKE ACHIEVEMENT MEASURES. HOSPITALS WITH THE GOLD STATUS HAVE DEMONSTRATED THIS COMPLIANCE FOR 24 CONSECUTIVE MONTHS. SAN ANTONIO'S STROKE RESPONSE TEAM MEMBERS WORK DILIGENTLY TO REDUCE TREATMENT TIME - FROM THE MOMENT THE PATIENT ARRIVES IN OUR EMERGENCY DEPARTMENT UNTIL THE MEDICAL TEAM CAN DIAGNOSE A STROKE AND ADMINISTER THE LIFESAVING TPA CLOT-BUSTING DRUG. THIS REDUCES THE DISABLING EFFECTS OF STROKE AND SAVES LIVES. IN 2021, SAN ANTONIO REGIONAL HOSPITAL HAS BEEN RECOGNIZED BY ANTHEM BLUE CROSS WITH A BLUE DISTINCTION CENTERS+ (BDC+) FOR MATERNITY CARE DESIGNATION, AS PART OF THE BLUE DISTINCTION SPECIALTY CARE PROGRAM. THE BLUE DISTINCTION CENTERS FOR MATERNITY CARE PROGRAM WAS EXPANDED BEYOND TRADITIONAL OUTCOME MEASURES TO INCLUDE ASSESSMENTS OF INTERNAL QUALITY IMPROVEMENT, DATA COLLECTION, AND DISSEMINATION, AND INTERNAL PROTOCOLS THAT BETTER ADDRESS CLINICAL QUALITY AND EQUITY ISSUES IN MATERNITY CARE. SARH WAS ALSO RECOGNIZED WITH THE 2021 WOMEN'S CHOICE AWARD AS ONE OF AMERICA'S BEST HOSPITALS FOR ORTHOPEDICS, HEART, STROKE, AND CANCER. CARING FOR OUR COMMUNITY - SAN ANTONIO REGIONAL HOSPITAL IS COMMITTED TO IMPROVING THE HEALTH AND WELLNESS OF THE RESIDENTS THAT IT SERVES. AS SUCH, WE DO OUR BEST TO BUILD PARTNERSHIPS WITH OTHER ORGANIZATIONS THAT SHARE OUR VALUES AND MISSION. WE UNDERSTAND THAT COMMUNITY BENEFITS ARE MORE THAN JUST NUMBERS. THEY REPRESENT PEOPLE - CHILDREN, PARENTS, GRANDPARENTS, AND THOSE WHO MAY BE MARGINALIZED, DISADVANTAGED, AND DISENFRANCHISED. SAN ANTONIO REGIONAL HOSPITAL UNDERSTANDS THAT EACH COMMUNITY IT SERVES ALSO HAS ITS DISTINCTIVE CHALLENGES, BUT ALSO OPPORTUNITIES BY DELIVERING ESSENTIAL PATIENT CARE SERVICES TO PROMOTE HEALTHIER LIFESTYLES, EARLY DETECTION OF DISEASE, AND ENHANCED ACCESS TO BASIC HEALTHCARE SERVICES. AS A REGIONAL HEALTHCARE PROVIDER, SAN ANTONIO REGIONAL HOSPITAL IS COMMITTED TO MAINTAINING THE HIGHEST QUALITY OF CARE FOR THOSE WE SERVE. AS A NONPROFIT HOSPITAL, ALL OF OUR RESOURCES ARE DEVOTED TO PROVIDING HEALTHCARE SERVICES. WE STRIVE TO PROVIDE OUR COMMUNITY WITH THE BEST OF CARE BY ALLOCATING A PERCENTAGE OF HOSPITAL OPERATIONS BY PURCHASING NEW OR UPGRADED EQUIPMENT, EXPANDING SERVICES, AND PROVIDING CARE FOR THE VULNERABLE POPULATION WITH FREE OR LOW-COST SCREENINGS, SERVICES, AND HEALTH EDUCATION TO PREVENT CHRONIC DISEASES AND IMPROVE HEALTH OUTCOMES. WHILE THE INLAND EMPIRE IS A MATURING ECONOMIC MARKET, MANY INDIVIDUALS AND FAMILIES ARE AT SIGNIFICANT RISK DURING A MEDICAL CRISIS. OFTEN THIS IS DUE TO AN INABILITY TO ACCESS HEALTH INSURANCE OR THE RESULT OF INADEQUATE INSURANCE COVERAGE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PROVIDES RELIEF TO THE FAMILIES WHO WOULD OTHERWISE FACE MEDICAL BANKRUPTCY. IN 2021, $1,454,613 IN FINANCIAL ASSISTANCE WAS PROVIDED FOR PATIENTS ENTERING THE HOSPITAL'S EMERGENCY DEPARTMENT WHO WERE EITHER TREATED AND RELEASED OR REQUIRED AN INPATIENT STAY. THE HOSPITAL ABSORBED $34,920,980 IN UNREIMBURSED COSTS INCURRED IN PROVIDING CARE AND TREATMENT FOR MEDI-CAL PATIENTS, WHILE OTHER UNCOMPENSATED CARE (BAD DEBTS) TOTALED $13,340,290 IN ACTUAL COSTS INCURRED BY THE HOSPITAL TO TREAT THESE PATIENTS. IN ADDITION TO DIRECT MEDICAL CARE, SAN ANTONIO REGIONAL HOSPITAL REACHES OUT TO ITS COMMUNITY IN A VARIETY OF WAYS THAT GO WELL BEYOND THE TRADITIONAL CARE PROVIDED BY AN ACUTE CARE HOSPITAL. AN INVENTORY OF THESE PROGRAMS AND ACTIVITIES IS PROVIDED LATER IN THIS REPORT. IN MANY COMMUNITIES WITHIN THE HOSPITAL'S SERVICE AREA, NEEDS FAR EXCEED ACCESSIBLE RESOURCES. SAN ANTONIO REGIONAL HOSPITAL UNDERSTANDS THE POWER OF COLLABORATION AND SEEKS ALLIANCES WITH OTHER HEALTH AND SOCIAL SERVICE PROVIDERS TO DEVELOP COMMUNITY-BASED PROGRAMS WITH DEFINED GOALS AND MEASURABLE OUTCOMES. THESE PARTNERSHIPS HELP TO LEVERAGE THE COMMUNITY'S RESOURCES TO ACHIEVE THE M

Schedule H, Part V, Section B, Line 5
THE HOSPITAL CONDUCTED ITS COMMUNITY HEALTH NEEDS ASSESSMENT IN 2019 FOR THE CALENDAR YEARS OF 2020, 2021, AND 2022. SAN ANTONIO REGIONAL HOSPITAL (SARH) WELCOMED THE PARTICIPATION OF AND INPUT FROM OUR COMMUNITY MEMBERS. TO SUCCESSFULLY GATHER ROBUST PRIMARY DATA, NUMEROUS DEMOGRAPHIC GROUPS WERE PROVIDED AN ONLINE SURVEY AND DIVERSE SETS OF FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WERE CONDUCTED. THE COMMUNITY GROUPS SELECTED INCLUDED SENIORS, FAMILY PROGRAMS FOR PARENTS AND CHILDREN IN AT-RISK AREAS, FORMER PATIENTS, PUBLIC HEALTH PROFESSIONALS, AND CIVIC LEADERS. SARH'S TEAM ENDEAVORED TO GAIN A BETTER UNDERSTANDING OF THE CURRENT CONCERNS AND INTERESTS AMONG HIGHER NEED SEGMENTS OF THE HOSPITAL'S PRIMARY SERVICE AREA. FOCUS GROUPS WERE CONDUCTED WITH A RANGE OF GROUPS INCLUDING: CONSUMERS OF LOW-COST AND FREE SERVICES (MONOLINGUAL NON-ENGLISH-SPEAKING AND ENGLISH-SPEAKING), PARENTS, ELDERLY, AND PROFESSIONALS LEADING COMMUNITY-WIDE HEALTH INITIATIVES IN SARH'S SERVICE AREA. GENERAL HEALTH ISSUES FOR EACH GROUP OF PARTICIPANTS WERE USED TO CREATE A QUESTION OUTLINE SPECIFIC TO EACH GROUP. A THOROUGH EVALUATION AND SYNTHESIS OF THE RESULTS REVEALED SEVERAL MAJOR CONCERNS, WHICH FELL INTO FOUR PRIORITY AREAS: ACCESS TO HEALTHCARE, HEALTH LITERACY, HEALTH MANAGEMENT, AND A HEALTHY ENVIRONMENT. SAN ANTONIO REGIONAL HOSPITAL COLLABORATED WITH THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA TO PLAN AND EXECUTE THE 2019 INLAND EMPIRE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). TOGETHER WITH SEVEN OTHER HOSPITALS (DESERT REGIONAL MEDICAL CENTER, HI-DESERT MEDICAL CENTER, INLAND VALLEY MEDICAL CENTER, JFK MEMORIAL HOSPITAL, MOUNTAINS COMMUNITY HOSPITAL, RANCHO SPRINGS MEDICAL CENTER, AND REDLANDS COMMUNITY HOSPITAL), SAN ANTONIO REGIONAL HOSPITAL CONTINUED TO SHARE RESOURCES, COLLABORATE FOR COLLECTIVE IMPACT, AND BUILD UPON THE EXISTING BODY OF WORK THROUGH EXPANDED DATA COLLECTION FROM IMPORTANT VOICES IN OUR COMMUNITY. PRIMARY AND SECONDARY DATA SOURCES WERE INCLUDED IN THE CHNA. FROM NOVEMBER 12, 2018 TO JANUARY 18, 2019, MULTIPLE FOCUS GROUPS, KEY INFORMANT INTERVIEWS, AND ONLINE SURVEYS WERE ADMINISTERED. A TOTAL OF 228 PEOPLE WERE SURVEYED TO OBTAIN INPUT FROM THE COMMUNITY IN THE FORM OF 11 FOCUS GROUPS (WITH A TOTAL OF 97 FOCUS GROUP PARTICIPANTS), 32 KEY INFORMANT INTERVIEWS, AND 99 ONLINE SURVEYS (INCLUDING A SPANISH OPTION). THE MAIN OBJECTIVE IN ENGAGING THE COMMUNITY WAS TO UNDERSTAND THE GREATEST AREAS OF NEED AND TO DISCOVER STRATEGIES IN WHICH PARTICIPATING HOSPITALS COULD COLLABORATE TO BETTER SERVE COMMUNITIES AND ELEVATE THE HEALTH STATUS OF OUR REGION. PRIMARY DATA - THE HOSPITALS PARTICIPATING IN THE TWO-COUNTY ASSESSMENT WORKED TO IDENTIFY RELEVANT KEY INFORMANTS AND TOPICAL FOCUS GROUPS TO GATHER MORE INSIGHTFUL DATA AND TO AID IN DESCRIBING THE COMMUNITY. TO DETERMINE FOCUS GROUPS AND KEY INFORMANTS, MEMBERS OF THE INLAND EMPIRE REGIONAL CHNA TASKFORCE INDIVIDUALLY CREATED INTERVIEW LISTS. TASKFORCE MEMBERS CONSIDERED A VARIETY OF SECTORS TO BE REPRESENTED, INCLUDING COMMUNITY-BASED ORGANIZATIONS, LOCAL BUSINESSES, FOUNDATION/FUNDERS, SCHOOL BOARDS/DISTRICTS, CITY COUNCILS, PUBLIC HEALTH DEPARTMENTS, LAW ENFORCEMENT, LEGAL, FAITH-BASED ORGANIZATIONS, AND HOSPITAL LEADERS. IN ADDITION, THE FOLLOWING POPULATIONS WERE CONTEMPLATED FOR THE FOCUS GROUPS: THOSE DEALING WITH MENTAL HEALTH ISSUES OR SUBSTANCE ABUSE, MINORITIES, LOW INCOME, MEDICALLY UNDERSERVED/UNINSURED/UNDERINSURED, AND YOUTH. COMMUNITY VOICES - AN ONLINE SURVEY IN ENGLISH AND SPANISH WAS CREATED AND DISTRIBUTED FOR GREATER COMMUNITY INPUT. IT SHOULD BE NOTED THAT THE SURVEY RESULTS WERE NOT BASED ON A STRATIFIED RANDOM SAMPLE OF RESIDENTS THROUGHOUT RIVERSIDE AND SAN BERNARDINO COUNTIES. THE PERSPECTIVES CAPTURED IN THIS DATA SIMPLY REPRESENT THE COMMUNITY MEMBERS WHO AGREED TO PARTICIPATE AND HAVE AN INTEREST IN HEALTHCARE. IN ADDITION, THE ASSESSMENT RELIED ON SEVERAL NATIONAL AND STATE ENTITIES WITH PUBLICLY AVAILABLE DATA. ALL LIMITATIONS INHERENT IN THESE SOURCES WERE PRESENT FOR THE ASSESSMENT. PARTICIPANTS IN THE FOCUS GROUPS WERE END-USERS OF PROGRAMS AND SERVICES AS WELL AS VOLUNTEERS AND/OR AUXILIARY BOARD MEMBERS PROVIDED BY THE HOSPITALS PARTICIPATING IN THIS CHNA. POPULATIONS REPRESENTED BY FOCUS GROUP MEMBERS INCLUDED LOW-INCOME POPULATIONS, HOMELESS, SENIORS, WOMEN'S CANCER, SINGLE MOTHERS/MATERNAL HEALTH, AND SPANISH-SPEAKING PROMOTORAS. KEY INFORMANT INTERVIEWS CONSISTED OF KEY LEADERS IN OUR COMMUNITY FROM AN ARRAY OF AGENCIES, INCLUDING THOSE THAT SERVE CHILDREN, HOMELESS POPULATIONS, VETERANS, SENIORS, AND SPANISH-SPEAKING POPULATIONS. OTHER ORGANIZATIONS REPRESENTED INCLUDED PUBLIC HEALTH AGENCIES, LAW ENFORCEMENT, HEALTHCARE ORGANIZATIONS, FUNDERS, AND SCHOOL DISTRICTS. MOST OF THE KEY INFORMANTS HAD TITLES SUCH AS DIRECTOR OR EXECUTIVE DIRECTOR, PRESIDENT OR VICE PRESIDENT, OR WERE A PART OF THE MEDICAL STAFF OF THEIR ORGANIZATIONS. SEVEN RESPONDENTS MENTIONED WORKING FOR NONPROFIT ORGANIZATIONS. COMMUNITY HOSPITALS, PUBLIC AND/OR POPULATION HEALTH, WORKFORCE DEVELOPMENT, AFFORDABLE HOUSING, AND FIRE PROTECTION SERVICES WERE MOST FREQUENTLY STATED AS SERVICES PROVIDED. SECONDARY SOURCES INCLUDED PUBLICLY AVAILABLE STATE AND NATIONALLY RECOGNIZED DATA SOURCES AVAILABLE AT THE ZIP CODE, COUNTY AND STATE LEVEL. HEALTH INDICATORS FOR SOCIAL AND ECONOMIC FACTORS, HEALTH SYSTEM, PUBLIC HEALTH AND PREVENTION, AND PHYSICAL ENVIRONMENT WERE INCLUDED. THE TOP LEADING CAUSES OF DEATH AS WELL AS CONDITIONS OF MORBIDITY THAT ILLUSTRATE THE COMMUNICABLE AND CHRONIC DISEASE BURDEN ACROSS SAN BERNARDINO AND RIVERSIDE COUNTIES WERE ALSO INCLUDED. A SIGNIFICANT PORTION OF THE DATA FOR THE ASSESSMENT WAS COLLECTED THROUGH A CUSTOM REPORT GENERATED THROUGH COMMUNITY COMMON'S ENGAGEMENT NETWORK CHNA. OTHER SOURCES INCLUDE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, COUNTY HEALTH RANKINGS & ROADMAPS, AND CALIFORNIA ENVIRONMENTAL PROTECTION AGENCY'S OFFICE OF ENVIRONMENTAL HEALTH HAZARD ASSESSMENT. WHEN FEASIBLE, HEALTH METRICS WERE FURTHER COMPARED TO ESTIMATES FOR THE STATE OR NATIONAL BENCHMARKS, SUCH AS THE HEALTHY PEOPLE 2020 OBJECTIVES. INPATIENT HOSPITALIZATION DISCHARGE DATA FOR 2017 WAS DERIVED FROM THE CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) HOSPITAL DATASET UTILIZING THE SPEEDTRACK ANALYTICS PLATFORM. HOSPITALIZATION DISCHARGE DATA WAS STRATIFIED BY GENDER, RACE/ETHNICITY, AND AGE. THE FOCUS GROUPS, KEY INFORMANTS, AND SURVEYS CONTAINED QUESTIONS ABOUT THE MOST SIGNIFICANT HEALTH NEED IN THE COMMUNITY. BASED ON THOSE RESPONSES, PRIORITIZATION WAS GIVEN TO THE ISSUES MOST FREQUENTLY MENTIONED IN ALL THREE DATA SOURCES. FOLLOWING THE COMPLETION OF THE REGIONAL CHNA, SAN ANTONIO FINALIZED ITS 2019 CHNA AND EMBARKED ON A METHODICAL PRIORITIZATION PROCESS TO IDENTIFY THE MOST SIGNIFICANT HEALTH NEEDS TO BE ADDRESSED OVER NEXT THREE YEARS. THE RESULTS WERE SIMILAR TO THE REGIONAL PRIORITIZATION, WITH THE FOLLOWING AREAS OF NEED IDENTIFIED: MENTAL HEALTH, CHRONIC DISEASES, ACCESS TO HEALTH, AND PREVENTION AND WELLNESS.

Schedule H, Part V, Section B, Line 6a
OTHER HOSPITALS INCLUDED IN THE DEVELOPMENT OF THE HOSPITAL'S CHNA WERE DESERT REGIONAL MEDICAL CENTER, HI-DESERT MEDICAL CENTER, INLAND VALLEY MEDICAL CENTER, JFK MEMORIAL HOSPITAL, MOUNTAINS COMMUNITY HOSPITAL, RANCHO SPRINGS MEDICAL CENTER, AND REDLANDS COMMUNITY HOSPITAL.

Schedule H, Part V, Section B, Line 6b
OTHER ORGANIZATIONS INCLUDED IN THE DEVELOPMENT OF THE HOSPITAL'S CHNA WERE THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, THE HEALTH DEPARTMENT OF SAN BERNARDINO COUNTY AND THE HEALTH DEPARTMENT OF RIVERSIDE COUNTY.

Schedule H, Part V, Section B, Line 7a
WWW.SARH.ORG/ABOUT-US/COMMUNITY-CONNECTION/COMMUNITY-BENEFIT/

Schedule H, Part V, Section B, Line 11
THE RESULTS OF THE CHNA GUIDED THE CREATION OF SAN ANTONIO'S COMMUNITY BENEFIT IMPLEMENTATION STRATEGY BY PROVIDING THE FRAMEWORK FOR DETERMINING HOW WE CAN IMPROVE THE HEALTH OF OUR COMMUNITY, AND PARTICULARLY, THE MOST VULNERABLE AMONG US. USING THE CHNA AS BOTH CONTEXT AND THE LENS THROUGH WHICH THE COMMUNITY'S NEEDS WERE IDENTIFIED, SAN ANTONIO EMBARKED ON A FORMAL PRIORITIZATION PROCESS THAT INCLUDED INPUT FROM COMMUNITY STAKEHOLDERS. COMMUNITY HEALTH NEEDS ARE COMPLEX, OFTEN DIFFICULT TO DEFINE, AND MAY AFFECT DIVERSE POPULATIONS. EQUALLY CHALLENGING IS THE TASK OF CREATING INTERVENTIONS TO ADDRESS THESE NEEDS IN MEANINGFUL WAYS THAT ARE IMPACTFUL AND MEASURABLE. WITH THE COMPLETION OF THE CHNA AND THE PRIORITIZATION PROCESS, THE NEXT STEP WAS TO DEVELOP AND/OR EXPAND COMMUNITY BENEFIT PROGRAMS DESIGNED TO IMPROVE COMMUNITY HEALTH STATUS. DURING THE STRATEGIC PLANNING PROCESS, THE COMMUNITY BENEFIT TEAM DEVELOPED INITIATIVES WITHIN EACH OF THE IDENTIFIED PRIORITY AREAS WITH DEFINED GOALS, OBJECTIVES, AND EVALUATION METRICS. EACH INITIATIVE IN SAN ANTONIO REGIONAL HOSPITAL'S IMPLEMENTATION STRATEGY RELATES TO ONE OR MORE OF THE FOUR PRIORITY AREAS, THE SPECIFIC NEEDS IDENTIFIED IN THE 2019 CHNA, AND INPUT SOUGHT AND PROVIDED BY COMMUNITY STAKEHOLDERS. MENTAL HEALTH WAS ONE OF THE MOST FREQUENTLY MENTIONED HEALTH NEEDS IN NEARLY EVERY QUESTION BY THE FOCUS GROUPS, KEY INFORMANTS, AND SURVEY RESPONDENTS. CHILDREN AND THE AGING POPULATION WERE NOTED AS POPULATIONS WITH MENTAL HEALTH CONCERNS. ISSUES MENTIONED INCLUDED SHORTAGE OF STAFF, ADDICTION, LACK OF AVAILABLE SERVICES, TRAUMA, ISOLATION, AND SOCIAL FACTORS SUCH AS TRANSPORTATION, ALL OF WHICH LEAD TO CONTINUED UNMET NEEDS. SARH WILL ADDRESS THESE ISSUES BY SUPPORTING LOCAL AND REGIONAL MENTAL HEALTH POLICY AND EDUCATIONAL AWARENESS INITIATIVES TO INCREASE KNOWLEDGE AND ACCESS TO MENTAL HEALTH RESOURCES. THE TOP THREE LEADING CAUSES OF DEATH IN SAN BERNARDINO AND RIVERSIDE COUNTIES ARE CANCER, HEART DISEASE, AND CHRONIC LOWER RESPIRATORY DISEASE. ANALYSIS OF THE PREVENTION QUALITY INDICATORS (PQI) REVEAL THAT SAN BERNARDINO COUNTY HAS THE NUMBER OF HIGHEST HOSPITAL ADMISSIONS FOR DIABETES SHORT-TERM COMPLICATIONS, DIABETES LONG-TERM COMPLICATIONS, HYPERTENSION, UNCONTROLLED DIABETES, AND ASTHMA IN YOUNGER ADULTS. SARH WILL BE COMMITTED TO IMPROVE THE HEALTH STATUS OF AN AT-RISK POPULATION BY SCREENING FREQUENT EMERGENCY DEPARTMENT VISITORS AND CONDUCTING EVALUATIONS FOR PROGRAM PARTICIPATION. THE GOAL IS TO IMPROVE HEALTH STATUS OF ENROLLED CHIP MEMBERS. THE WHEALTH (ADOLESCENT WELLNESS & WORKFORCE DEVELOPMENT) PROGRAM PROVIDES A THREE PRONGED APPROACH INCLUDING CURRICULUM ON FITNESS, NUTRITION, AND MENTAL RESILIENCY. THE PROGRAM IS OFFERED IN PARTNERSHIP WITH LOCAL UNIVERSITIES AND SCHOOL DISTRICTS TO IMPROVE THE HEALTH AND WELL-BEING OF STUDENTS BY PROMOTING HEALTHY LIFESTYLES AND ACTIVITIES IN OUR YOUTH. EACH YEAR, AND AT THE CONCLUSION OF THE THREE-YEAR IMPLEMENTATION STRATEGY, SAN ANTONIO REGIONAL HOSPITAL EVALUATES THE EFFECTIVENESS OF ITS COMMUNITY BENEFIT PROGRAMS TO DETERMINE THE LEVEL OF MEASURABLE COMMUNITY HEALTH IMPACT. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, SAN ANTONIO REGIONAL HOSPITAL WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: TRANSPORTATION , POVERTY AND FOOD INSECURITY, AND AFFORDABLE HOUSING AND HOMELESSNESS. THE HOSPITAL CANNOT ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY; THEREFORE, IT WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. SAN ANTONIO REGIONAL HOSPITAL WILL LOOK FOR PARTNERSHIP OPPORTUNITIES THAT ADDRESS NEEDS NOT SELECTED WHERE IT CAN APPROPRIATELY CONTRIBUTE TO ADDRESSING THOSE NEEDS, OR WHERE THOSE NEEDS ALIGN WITH CURRENT STRATEGIES AND PRIORITIES.

Schedule H, Part V, Section B, Line 13h
SARH understands that certain patients may be non-responsive to the financial assistance application process. Under these circumstances, SARH may utilize other sources of information to make an individual assessment of financial need. The information will enable SARH to make an informed decision on the financial need of non-responsive patients utilizing the best estimates available in the absence of information provided directly by the patient. SARH may utilize a State approved third-party to conduct an electronic review of patient information to assess financial need. This review utilizes a healthcare industry recognized model that is based on public record databases. This predictive model is designed to assess each patient to the same standards and the traditional application process. The electronic technology will be deployed prior to bad debt assignment after in-house collection efforts and all other eligibility and payment sources have been exhausted. This process allows SARH to screen all patients for financial assistance prior to exploring any extraordinary collection actions. The data returned from this electronic eligibility review will constitute adequate documentation of financial need under this policy. A completed financial assistance application may not be required in certain circumstances. These circumstances are limited to situation when SARH determines it has sufficient patient financial information from which to make a financial assistance eligibility and qualification decision. Examples of circumstances not requiring a financial assistance application include, but are not limited to: 1. Patient is homeless; 2. Patient is a resident at a shelter including but not limited to prototypes and the American Recovery Center; 3. Patient's address is the address for the Department of Public Social Services; 4. Patient is unknown; 5. Patient is receiving General Relief, Cal WORKS or Cal Fresh (documentation required); 6. Patient qualified for Medi-Cal without a share of cost (SOC) during a portion of the confinement or subsequent to their discharge/visit (proof of eligibility required); 7. Non-covered and /or denied services provided to Medi-Cal eligible patients.

Schedule H, Part V, Section B, Line 16a
www.sarh.org/patients-and-visitors/billing/

Schedule H, Part V, Section B, Line 16b
www.sarh.org/patients-and-visitors/billing/

Schedule H, Part V, Section B, Line 16c
www.sarh.org/patients-and-visitors/billing/

Schedule H, Part V, Section B, Line 3e
THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.

Schedule H, Part VI
"Schedule H, Part I, Line 3c - SARH understands that certain patients may be non-responsive to the financial assistance application process. Under these circumstances, SARH may utilize other sources of information to make an individual assessment of financial need. The information will enable SARH to make an informed decision on the financial need of non-responsive patients utilizing the best estimates available in the absence of information provided directly by the patient. SARH may utilize a State approved third-party to conduct an electronic review of patient information to assess financial need. This review utilizes a healthcare industry recognized model that is based on public record databases. This predictive model is designed to assess each patient to the same standards and the traditional application process. The electronic technology will be deployed prior to bad debt assignment after in-house collection efforts and all other eligibility and payment sources have been exhausted. This process allows SARH to screen all patients for financial assistance prior to exploring any extraordinary collection actions. The data returned from this electronic eligibility review will constitute adequate documentation of financial need under this policy. A completed financial assistance application may not be required in certain circumstances. These circumstances are limited to situation when SARH determines it has sufficient patient financial information from which to make a financial assistance eligibility and qualification decision. Examples of circumstances not requiring a financial assistance application include, but are not limited to: 1. Patient is homeless; 2. Patient is a resident at a shelter including but not limited to prototypes and the American Recovery Center; 3. Patient's address is the address for the Department of Public Social Services; 4. Patient is unknown; 5. Patient is receiving General Relief, Cal WORKS or Cal Fresh (documentation required); 6. Patient qualified for Medi-Cal without a share of cost (SOC) during a portion of the confinement or subsequent to their discharge/visit (proof of eligibility required); 7. Non-covered and /or denied services provided to Medi-Cal eligible patients. Schedule H, Part I, Line 6a - SAN ANTONIO REGIONAL HOSPITAL PREPARED A COMMUNITY BENEFIT REPORT AS REQUIRED BY THE STATE OF CALIFORNIA. THE REPORT WAS PUBLISHED AND MADE AVAILABLE TO THE PUBLIC ONLINE AT WWW.SARH.ORG. Schdule H, Part I, Line 7 - THE COSTING METHODOLOGY USED ON 7A: CALCULATED USING WORKSHEETS 1&2 IN THE INSTRUCTIONS; THE COST TO CHARGE OPTION. THE COSTING METHODOLOGY USED ON 7B: CALCULATED USING WORKSHEET 3 IN THE INSTRUCTIONS; THE COST TO CHARGE OPTION. THE COSTING METHODOLOGY USED ON 7E TO 7I: CALCULATED USING ACTUAL COSTS FROM SARH'S GENERAL LEDGER. Sch H, Part II - THE LEWIS-SAN ANTONIO HEALTHY COMMUNITIES INSTITUTE (HCI) WAS ESTABLISHED IN APRIL 2016 TO IDENTIFY OPPORTUNITIES, SOLUTIONS, AND PARTNERS TO POSITIVELY IMPACT THE HEALTH OF OUR REGION. HCI SEEKS TO ADDRESS THE HEALTHCARE WORKER SHORTAGE AS WELL AS ELEMENTS OF THE EDUCATIONAL ATTAINMENT GAP THROUGH ITS WHEALTH PROGRAM. THE MISSION IS TO CREATE A PIPELINE OF STUDENTS, ESPECIALLY UNDERREPRESENTED POPULATIONS, WHO ARE INTERESTED IN, ENGAGED, AND PREPARED FOR COLLEGE AND HEALTH RELATED FIELDS. HCI IS CURRENTLY FOCUSING ON THREE PROGRAM AREAS: HEALTHCARE WORKFORCE, HEALTH POLICY EDUCATION, AND NON-CLINICAL HEALTHCARE INTERNSHIPS. HEALTH CARE WORKFORCE - SOUTHERN CALIFORNIA'S INLAND EMPIRE REGION INCLUDES SAN BERNARDINO, THE LARGEST US GEOGRAPHICAL COUNTY, AND RIVERSIDE COUNTIES. THIS REGION HAS POORER HEALTH STATUS AND A GREATER SHORTAGE OF HEALTHCARE PROFESSIONALS THAN SURROUNDING COMMUNITIES. LEWIS-SAN ANTONIO HEALTHY COMMUNITIES INSTITUTE (HCI) DEVELOPED TWO SCHOOL-BASED ADOLESCENT PROGRAMS CALLED ""WHEALTH"" (WELLNESS + HEALTHCARE) AND THE ""YOUNG HEALTHCARE PROFESSIONALS"" TO ADDRESS THESE TWO MAJOR NEEDS TO BUILD HEALTHIER OUTCOMES FOR THE FUTURE OF THE INLAND EMPIRE. WHEALTH - SUPPORTS STUDENTS IN THEIR HEALTH CAREER JOURNEY BY: 1) CREATING LEARNING OPPORTUNITIES AROUND CHRONIC DISEASE PREVENTION; 2) HELPING TO ESTABLISH LIFELONG HEALTHY HABITS; AND 3) SUPPORTING AN INTEREST IN HEALTHCARE CAREERS. THIS PROGRAM AIMS TO INCREASE KNOWLEDGE ON WELLNESS TOPICS AND HEALTHCARE PROFESSIONAL DEVELOPMENT TRAINING. THE WHEALTH CURRICULUM IS ADAPTED FROM HEALTHCORPS INC., A NATIONAL NONPROFIT, AND ALIGNS WITH THE NATIONAL HEALTH EDUCATION STANDARDS FOCUSING ON NUTRITION, FITNESS, AND MENTAL RESILIENCE. THE WHEALTH PROGRAM GOALS INCLUDE: 1) INCREASING KNOWLEDGE IN NUTRITION, PHYSICAL ACTIVITY, AND MENTAL RESILIENCE AMONG JUNIOR HIGH AND HIGH SCHOOL PARTICIPANTS USING HEALTHCORPS CURRICULUM; AND 2) INCREASING PROFESSIONAL DEVELOPMENT TRAINING FOR HEALTHCARE CAREER PREPAREDNESS AMONG HIGH SCHOOL PARTICIPANTS. THE CURRICULUM UTILIZES UNIVERSITY STUDENTS FROM ACROSS THE REGION TO INSTRUCT HIGH SCHOOL WELLNESS IN EIGHT CLASSROOM SESSIONS. PROFESSIONAL DEVELOPMENT THROUGH THE ""TRAIN-THE-TRAINER MODEL"" IS INTEGRATED THROUGHOUT THE PROGRAM ALONG WITH INSTRUCTION AND MENTORSHIP AMONG VARIOUS EDUCATIONAL LEVELS. THE UNIVERSITY STUDENTS ARE INSTRUCTORS ON THE WELLNESS CURRICULUM AND MENTORS TO THE HIGH SCHOOL STUDENTS AS THEY ANSWER QUESTIONS ON COLLEGE LIFE, MAJORS, AND CAREER PLANNING. ONCE THE HIGH SCHOOL STUDENTS COMPLETE THEIR EIGHT-WEEK HEALTHCORPS PROGRAM, THEY HAVE THE OPPORTUNITY TO TEACH THE CURRICULUM TO JUNIOR HIGH STUDENTS, WHILE GAINING PEER-TO-PEER TRAINING AND BUILDING PRESENTATION SKILLS FOR PROFESSIONAL DEVELOPMENT. FOLLOWING THE EIGHT SESSIONS, HIGH SCHOOL STUDENTS MAY SUBMIT APPLICATIONS TO THE ""TRAINER PROGRAM,"" WHICH OCCURS IN THE SECOND HALF OF THE SCHOOL YEAR. THIS PORTION OF THE PROGRAM INCLUDES PROFESSIONAL SKILLS WORKSHOPS ON RESUME-BUILDING, GROUP INTERVIEWS, DRESS FOR SUCCESS, SOCIAL MEDIA ETIQUETTE, AND TRAINING SESSIONS FOR TEAM BUILDING AND LESSON DEVELOPMENT. THE ORIGINAL INTENT FOR THIS MODEL IS FOR THE HIGH SCHOOL STUDENTS TO INSTRUCT A SIMPLIFIED VERSION OF THE HEALTHCORPS WELLNESS LESSONS TO JUNIOR HIGH STUDENTS. IN 2021, HOWEVER, THE ONGOING COVID-19 PANDEMIC BROUGHT ON ANOTHER YEAR OF CHALLENGES WITH REMOTE LEARNING AT ALL SCHOOL SITES. TO MAINTAIN SAFETY PRECAUTIONS, THE TRAINER PROGRAM WENT ON HIATUS. IN LIEU OF THE TRAINER PROGRAM, AN ADVOCACY PROJECT WAS PILOTED WITH 11TH AND 12TH GRADE STUDENTS FROM CHAFFEY HIGH SCHOOL (N=7). THE ADVOCACY PROJECT INCLUDED CAREER READINESS TRAINING AND PROVIDED STUDENTS WITH AN OPPORTUNITY TO CREATE CHANGE WITHIN THEIR SCHOOL COMMUNITY AS PEER HEALTH ADVOCATES. THE STUDENTS DEVELOPED A SOCIAL MEDIA CAMPAIGN TARGETING STRESS AND ANXIETY. THEY PROMOTED MENTAL WELLNESS TIPS AND COPING STRATEGIES TO THEIR PEERS THROUGH INSTAGRAM THROUGHOUT THE SPRING SEMESTER. FOR WHEALTH, THE SUMMER OF 2021 WAS DEVOTED TO PROGRAM PLANNING. IN FALL 2021, SCHOOL SITES RETURNED TO IN-PERSON LEARNING. THE WHEALTH PROGRAM CONTINUED ITS FIFTH YEAR IN-PERSON AT CHAFFEY HIGH SCHOOL (N=94) AND UPLAND HIGH SCHOOL (N=137). THE RETURN TO IN-PERSON LEARNING ALLOWED FOR THE EXPANSION OF THE WHEALTH PROGRAM TO TWO NEW SCHOOL SITES, MONTCLAIR HIGH SCHOOL (N=44) & ONTARIO HIGH SCHOOL (N=52). THE EXPANSION TO TWO NEW SITES WAS WELL RECEIVED BY BOTH THE STUDENTS AND TEACHERS. A MATH TEACHER FROM ONTARIO HIGH SCHOOL THAT PARTICIPATED IN THE PROGRAM SAW IMPROVEMENTS IN CLASSROOM PARTICIPATION AND ATTITUDES THROUGHOUT THE PROGRAM DURATION. AS WELL, STUDENT FEEDBACK FROM EACH OF THE FOUR SCHOOL SITES WAS OVERTLY POSITIVE. THE EXPANSION OF THE WHEALTH PROGRAM WOULD NOT HAVE BEEN POSSIBLE WITHOUT FUNDING FROM CHAFFEY JOINT UNIFIED HIGH SCHOOL DISTRICT'S STRONG WORKFORCE GRANT. HCI WAS SELECTED AS AN AWARDEE FOR THE GRANT WHICH ALLOWED FOR THE EXPANSION OF ITS PREMIER PROGRAM, WHEALTH; THE DEVELOPMENT OF A NEW PROGRAM; AND THE APPOINTMENT OF TWO NEW PART-TIME HEALTHY COMMUNITIES SPECIALISTS. YOUNG HEALTHCARE PROFESSIONALS - THE YOUNG HEALTHCARE PROFESSIONALS (YHP) PROGRAM DEVELOPED WITH FUNDING FROM THE STRONG WORKFORCE GRANT. THE YHP PROGRAM SUPPORTS STUDENTS IN THEIR HEALTH CAREER JOURNEY BY: 1) SUPPORTING AN INTEREST IN ALLIED HEALTHCARE CAREERS; 2) TRAINING STUDENTS FOR ENTRY-LEVEL HEALTHCARE POSITIONS IN THE REGION; 3) HELPING TO ESTABLISH LIFELONG HEALTHY HABITS; AND 4) MENTORING YOUTH AS THEY TRANSITION TO ADULTHOOD. THIS PROGRAM AIMS TO INCREASE KNOWLEDGE AND SKILLS FOR ALLIED HEALTHCARE PROFESSIONS, AS WELL AS INCREASE KNOWLEDGE OF HEALTHY LIVING STRATEGIES. THE YHP PROGRAM GOALS INCLUDE: 1) INCREASING THE NUMBER OF ADOLESCENTS PURSUING THE FIELD OF HEALTHCARE AS A CAREER; AND INCREASING KNOWLEDGE OF WELLNESS LIFESTYLE HABITS USING THE 8 DIMENSIONS OF WELLNESS BY THE SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA). THE CURRICULUM UTILIZES UNIVERSITY STUDENTS FROM ACROSS THE INLAND EMPIRE TO INSTRUCT HIGH SCHOOL STUDENTS OVER 5 SATURDAY SESSIONS. THE YOUNG HEALTHCARE PROFESSIONALS PROGRAM WAS PILOTED AS A HYBRID PROGRAM"