4A (Expenses $ 128400956 including grants of $ 56178) (Revenue $ 149456047)
ST JOSEPH HOSPITAL IS A 203-BED, COMMUNITY HOSPITAL THAT PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT MEDICAL, CRITICAL CARE AND SURGICAL SERVICES. ITS EMERGENCY DEPARTMENT CARES FOR MORE THAN 34,000 PATIENTS A YEAR. OTHER VITAL SERVICES INCLUDE AN AMBULATORY SURGERY UNIT, THE CENTER FOR SLEEP MEDICINE, HYPERBARIC MEDICINE AND WOUND HEALING, AN ENDOSCOPY UNIT, A DIABETES EDUCATION CENTER, A FULL SCOPE OF OUTPATIENT RADIOLOGY SERVICES, INCLUDING A CT SCANNER, MRI, AND NUCLEAR CAMERA.

PART V, SECTION B, LINE 3E
IN 2019, MEMBERS OF THE LONG ISLAND HEALTH COLLABORATIVE REVIEWED EXTENSIVE DATA SETS SELECTED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY AND CONFIRM HEALTH NEEDS PRIORITIES FOR THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT CYCLE. DATA ANALYSIS EFFORTS WERE COORDINATED THROUGH THE LONG ISLAND POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP), WITH THE PHIP SERVING AS THE CENTRALIZED DATA RETURN AND ANALYSIS HUB. COMMUNITY PARTNERS SELECTED THE FOLLOWING AREAS OF FOCUS FOR LONG ISLAND FROM THE NEW YORK STATE PREVENTION AGENDA PRIORITIES: (1) PREVENT CHRONIC DISEASE, FOCUS AREA 4: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT, AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, FOCUS AREA 2: MENTAL AND SUBSTANCE USE DISORDERS PREVENTION.

PART V, SECTION B, LINE 5
ST. JOSEPH HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ASSOCIATION WITH LONG ISLAND HEALTH COLLABORATIVE (LIHC) MEMBERS. THE LIHC IS A PARTNERSHIP OF LONG ISLAND'S HOSPITALS, COUNTY HEALTH DEPARTMENTS, HEALTH PROVIDERS, COMMUNITY-BASED SOCIAL AND HUMAN SERVICE ORGANIZATIONS, ACADEMIC INSTITUTIONS, HEALTH PLANS, LOCAL GOVERNMENT, AND THE BUSINESS SECTOR, ALL ENGAGED IN IMPROVING THE HEALTH OF LONG ISLANDERS. THE LIHC IS THE MAIN WORKING GROUP ASSOCIATED WITH CARRYING OUT THE GOALS OF THE LONG ISLAND POPULATION HEALTH IMPROVEMENT PROGRAM. IN 2019, MEMBERS OF THE LIHC REVIEWED EXTENSIVE DATA SETS SELECTED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY AND CONFIRM PREVENTION AGENDA PRIORITIES FOR THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT CYCLE. DATA ANALYSIS EFFORTS WERE COORDINATED THROUGH THE LIHC, WHICH SERVED AS THE CENTRALIZED DATA RETURN AND ANALYSIS HUB. PRIMARY DATA SOURCES INCLUDE THE LONG ISLAND AND EASTERN QUEENS COMMUNITY HEALTH ASSESSMENT SURVEY (CHAS) AND THE RESULTS FROM FOCUS GROUPS AND KEY COMMUNITY-BASED ORGANIZATION LEADER INTERVIEWS. SECONDARY DATA SOURCES COMPRISED PUBLICALLY-AVAILABLE DATA SETS WHICH WERE REVIEWED TO DETERMINE CHANGE IN HEALTH STATUS AND EMERGING ISSUES WITHIN NASSAU COUNTY. SOURCES OF SECONDARY DATA INCLUDED STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS), NEW YORK STATE PREVENTION AGENDA DASHBOARD, PREVENTION QUALITY INDICATORS (PQI), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), EXTENDED BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (EBRFSS), NEW YORK STATE COMMUNITY HEALTH INDICATOR REPORTS (CHIRS) AND NEW YORK STATE VITAL STATISTICS. THE ENGAGEMENT OF THE BROADER COMMUNITY, FOR ASSESSMENT PROCESSES, IS ACHIEVED THROUGH THE LIHC AND ITS PARTNERS' ONGOING DISTRIBUTION OF THE LONG ISLAND AND EASTERN QUEENS COMMUNITY HEALTH ASSESSMENT (CHAS) SURVEY. THIS SURVEY IS OFFERED ONLINE VIA A SURVEYMONKEY LINK AND IS AVAILABLE TO RESIDENTS AT PUBLIC EVENTS, WORKSHOPS, EDUCATIONAL PROGRAMS, INTERVENTIONS, ETC., WHICH ARE OFFERED BY LIHC PARTNERS. IT IS ALSO DISTRIBUTED AMONG PHYSICIAN OFFICES, HOSPITAL WAITING AREAS, LIBRARIES, SCHOOLS, FEDERALLY-QUALIFIED HEALTH CLINICS, INSURANCE ENROLLMENT SITES, AMONG OTHER PUBLIC VENUES. THE LIHC AGGRESSIVELY PROMOTES THE SURVEY THROUGH SOCIAL MEDIA AND A LINK TO THE SURVEY IS ALSO AVAILABLE ON THE ST. JOSEPH HOSPITAL WEBSITE. RESULTS FROM THE CHAS ARE ANALYZED TWICE A YEAR. FINDINGS ARE SHARED WITH ALL LIHC PARTICIPANTS, WITH THE MEDIA AND POSTED ON THE LIHC WEBSITE. SURVEYS WERE DISTRIBUTED BY PAPER AND ELECTRONICALLY, THROUGH SURVEY MONKEY, TO COMMUNITY MEMBERS FROM JANUARY 1, 2018 THROUGH DECEMBER 31, 2018 WITH 1,664 SURVEYS COLLECTED IN NASSAU COUNTY. A CERTIFIED TRANSLATION OF THE SURVEY IS AVAILABLE IN THE FOLLOWING LANGUAGES: SPANISH, POLISH AND HAITIAN CREOLE. LARGE PRINT COPIES ARE ALSO AVAILABLE TO THOSE LIVING WITH VISION IMPAIRMENT. FOR THIS ASSESSMENT CYCLE, THE LIHC ALSO ENGAGED THE COMMUNITY THROUGH FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH LEADERS OF COMMUNITY-BASED ORGANIZATIONS (CBO). THE RESEARCH FIRM EUREKAFACTS, LLC CONDUCTED THE FOCUS GROUPS AND CBO INTERVIEWS, INTERPRETED THE RESULTS, AND PRODUCED THE REPORT. FOCUS GROUPS WERE HELD IN LOW-INCOME COMMUNITIES, BELMONT AND HEMPSTEAD.

PART V, SECTION B, LINE 6A
ST. FRANCIS HOSPITAL, MERCY HOSPITAL, NORTHWELL HEALTH SYSTEM (GLEN COVE HOSPITAL, LONG ISLAND JEWISH VALLEY STREAM, LONG ISLAND JEWISH MEDICAL CENTER, NORTH SHORE UNIVERSITY HOSPITAL, PLAINVIEW HOSPITAL, SOUTH OAKS HOSPITAL, SYOSSET HOSPITAL), NASSAU UNIVERSITY MEDICAL CENTER, MOUNT SINAI SOUTH NASSAU HOSPITAL AND NYU WINTHROP HOSPITAL.

PART V, SECTION B, LINE 6B
THE HOSPITAL'S CHNA WAS ALSO CONDUCTED WITH NASSAU AND SUFFOLK HEALTH DEPARTMENTS, STONY BROOK UNIVERSITY AND MORE THAN 40 COMMUNITY-BASED ORGANIZATIONS, COLLECTIVELY KNOWN AS THE LONG ISLAND HEALTH COLLABORATIVE (LIHC).

PART V, SECTION B, LINE 11
COMMUNITY PARTNERS SELECTED THE FOLLOWING AREAS OF FOCUS FOR LONG ISLAND FROM THE NEW YORK STATE PREVENTION AGENDA PRIORITIES:(1)PREVENT CHRONIC DISEASE, FOCUS AREA 4: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT, AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, FOCUS AREA 2: MENTAL AND SUBSTANCE USE DISORDERS PREVENTION. THE WORK PLAN FOR ADDRESSING THE IDENTIFIED NEEDS CAN BE FOUND IN THE CHNA APPENDIX E, PUBLICLY AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://STJOSEPHHOSPITAL.CHSLI.ORG/ PRIORITY 1: PREVENT CHRONIC DISEASE: ST. JOSEPH OFFERS PREVENTIVE HEALTH SCREENINGS IN LOCAL COMMUNITIES, PARTICULARLY THOSE IN MEDICALLY-UNDERSERVED COMMUNITIES, INCLUDING BLOOD PRESSURE AND BODY MASS INDEX (BMI), GLUCOSE, CHOLESTEROL, MAMMOGRAPHY, WOUND AND VEIN SCREENING, AND FLU VACCINATIONS. A NATIONAL WALKING DAY EVENT WAS HELD AT THE HOSPITAL FOR COMMUNITY AND STAFF. BLOOD PRESSURE SCREENINGS, ALONG WITH SEPSIS AND DIABETES EDUCATION WERE OFFERED. A FREE PROSTATE SCREENING EVENT WAS HELD ON SEPTEMBER 11 FOR COMMUNITY MEMBERS. THERE WERE FOUR REGISTRANTS. A PINKTEMBER EVENT TO DISCUSS BREAST HEALTH AWARENESS TOOK PLACE ON SEPTEMBER 24TH WITH SURGEONS, RADIOLOGY STAFF AND EMPLOYEES. HEALTHY SUNDAYS' COMMUNITY OUTREACH EVENTS ARE HELD IN COLLABORATION WITH CHURCHES, HOUSES OF WORSHIP AND COMMUNITIES. EVENTS INCLUDE HEALTH SCREENINGS, EDUCATION AND REFERRALS TO CARE ALONG WITH SELECT PARTNERS OFFERING FREE OR DISCOUNTED SERVICES. HEALTHY SUNDAYS RESUMED IN MARCH 2021. A HEALTHY SUNDAYS EVENT WAS HELD ON JUNE 5 AT ST. KILIAN PARISH IN FARMINGDALE. AS THIS WAS ONE OF THE PARISH'S FIRST PUBLIC EVENTS AFTER THE COVID-19 PANDEMIC, ATTENDANCE WAS LIGHT WITH 5 PERSONS SEEKING SCREENINGS. AN ADDITIONAL EVENT IS SCHEDULED FOR NOVEMBER. ST. JOSEPH STAFF CONDUCTED A LIFE CHANGES SEMINAR AT THE OAKS AND DISCUSSED HEALTH CHOICES AND SEPSIS. BLOOD PRESSURE SCREENINGS WERE ALSO OFFERED. ST. JOSEPH CLINICAL VOLUNTEERS PROVIDED 57 FLU VACCINES, AND 26 INDIVIDUALS WITHOUT INSURANCE WERE REFERRED TO THE BISHOP MCHUGH HEALTH CENTER IN HICKSVILLE FOR FREE PRIMARY CARE. ST. JOSEPH OFFERS MONTHLY LECTURES, SYMPOSIUMS AND EDUCATION EVENTS.THE FRIEDBERG JEWISH COMMUNITY CENTER (JCC) IN OCEANSIDE IS A VERY ACTIVE COMMUNITY PARTNER. ST. JOSEPH WORKED WITH THE JCC TO CREATE A HEALTHY THURSDAY SERIES AND OFFERED VIRTUAL EDUCATION WEBINARS FEATURING DIABETES, MENTAL HEALTH ISSUES, AND LUNG CANCER AND STROKE DISCUSSIONS. THE HOSPITAL ALSO OFFERED A BIWEEKLY MEDICATION WEBINAR FOR 30 MINUTES. -A WOMEN'S HEALTH WEBINAR WAS PRESENTED IN MAY WITH FIVE FEMALE PHYSICIANS DISCUSSING DIABETES, STROKE, COLON HEALTH, BREAST HEALTH AND FALLS AND BALANCE. -A MEN'S HEALTH WEBINAR WAS PRESENTED IN JUNE WITH FOUR MALE PHYSICIANS DISCUSSING, SLEEP, COVID EFFECTS ON THE HEART, PROSTATE HEALTH AND SHOULDER PAIN. -A NATIONAL STROKE AWARENESS MONTH EVENT WAS HELD FOR COMMUNITY MEMBERS AND STAFF DISCUSSING NUTRITION AND STROKE. -COMMUNITY OUTREACH AND NURSING EDUCATION PARTNERED WITH THE TOWN OF OYSTER BAY AND NASSAU COUNTY POLICE MEDICS AT THE BETHPAGE POOL TO PROVIDE EDUCATION ON POOL SAFETY AND DROWNING PRECAUTIONS. -FITNESS FRIDAY WALKING EVENTS ARE HELD ON A REGULAR BASIS FOR TWO HOURS MID-DAY AND IS OPEN TO HOSPITAL STAFF AND COMMUNITY MEMBERS. THE WALKING EVENTS HIGHLIGHT THE POSITIVE EFFECTS OF EXERCISE IN DAILY LIFE. SMOKING CESSATION PROGRAM INFORMATION IS OFFERED TO REDUCE THE RISK OF DISEASES CAUSED BY OR AFFECTED BY SMOKING. PRIORITY 2: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: SUPPORT GROUPS BRING TOGETHER PEOPLE WHO ARE GOING THROUGH OR HAVE GONE THROUGH SIMILAR EXPERIENCES. ST. JOSEPH HOSPITAL OFFERS FREE SUPPORT GROUPS OPEN TO ALL COMMUNITY MEMBERS, INCLUDING A GENERAL BEREAVEMENT GROUP, NEXT STEPS BEREAVEMENT GROUP, AND LOSS OF CHILD. THE BEREAVEMENT SUPPORT GROUP STARTED IN OCTOBER AND RAN THROUGH DECEMBER. CATHOLIC HEALTH'S MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES GUIDE IS AVAILABLE FOR DOWNLOAD ON THE ST. JOSEPH WEBSITE. THE SHERPA PROGRAM, WHICH IS MADE UP OF PEER RECOVERY COACHES WHO MEET WITH OVERDOSE SURVIVORS AND THEIR FAMILIES IN THE EMERGENCY DEPARTMENT, CONTINUES WITH MORE THAN 110 INDIVIDUALS SERVED SINCE ITS INCEPTION IN JANUARY 2020. ST. JOSEPH HOSPITAL HOSTED AN OVERDOSE AWARENESS DAY ON AUGUST 31ST WITH A PRESENTATION ON THE HOSPTITAL'S SHERPA PROGRAM ALONG WITH NARCAN TRAINING TO INTERESTED ATTENDEES. ST. JOSEPH PARTICIPATED IN THE US DRUG ENFORCEMENT AGENCY (DEA)- SPONSORED NATIONAL PRESCRIPTION TAKE BACK DAY IN APRIL 2021 COLLECTING 191 POUNDS OF UNWANTED PRESCRIPTION DRUGS. ST. JOSEPH HOSPITAL ALSO PARTICIPATES IN COMMUNITY OUTREACH ACTIVITIES THAT ADDRESS OTHER NEW YORK STATE PREVENTION AGENDA PRIORITIES. FREE, EVIDENCE-BASED FALL PREVENTION PROGRAMS DESIGNED TO IMPROVE BALANCE AND STRENGTH AND HELP REDUCE FALLS AND BUILD CONFIDENCE IN OLDER ADULTS WERE OFFERED. A WOMEN'S HEALTH WEBINAR IN MAY FEATURED PHYSICAL THERAPY STAFF DISCUSSING FALLS AND BALANCE. THERE WERE 65 PARTICIPANTS IN THE WEBINAR, WHICH WAS ALSO POSTED ON LINE WITH MORE THAN 300 VIEWS. A FREE, DRIVE-THROUGH FLU VACCINATION EVENT WAS HELD IN NOVEMBER WITH COMMUNITY MEMBERS RECEIVING A VACCINE. FIVE THOUSAND COVID VACCINATIONS WERE PROVIDED TO COMMUNITY MEMBERS AND STAFF. AS A MEMBER OF CATHOLIC HEALTH, ST. JOSEPH OFFERS OUTREACH SERVICES AS PART OF THE CH MISSION AND SOCIAL DETERMINANTS OF HEALTH. ST. JOSEPH STAFF PARTICPATED IN THE AMERICAN HEART ASSOCIATION DIGITAL MOVE MORE CHALLENGE AND THE LONG ISLAND HEART WALK IN PERSON EVENT AT JONES BEACH ON SEPTEMBER 12. THE HOSPITAL ALSO PARTICIPATED IN THE AMERICAN CANCER SOCIETY MAKING STRIDES AGAINST BREAST CANCER WALK ON OCTOBER 17 AT JONES BEACH. ST. JOSEPH HOSTED 4 BLOOD DRIVES COLLECTING 145 PINTS OF BLOOD IN SUPPORT OF LONG ISLAND BLOOD SERVICES. A STOP THE BLEED TRAUMA TRAINING FOR COMMUNITY MEMBERS AND EMPLOYEES WAS HELD ON MARCH 5 WITH 27 ATTENDEES. THIS TRAINING PROVIDES ATTENDEES WITH INSTRUCTION ON HOW TO RECOGNIZE LIFE-THREATENING BLEEDING AND INTERVENE EFFECTIVELY. ST. JOSEPH ALSO CONDUCTS COLLECTION DRIVES FOR FOOD, CLOTHING, AND SCHOOL SUPPLIES AND ADOPT-A-FAMILY COLLECTIONS AT CHRISTMAS.

PART V, SECTION B, LINE 20E
ST. JOSEPH HAS POSTED MULTILINGUAL NOTICES ABOUT ITS CHARITY CARE POLICIES IN SEVERAL PROMINENT LOCATIONS WITHIN ST. JOSEPH INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, PATIENT ACCESS, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREA. SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH AND ARE CLEARLY VISIBLE TO THE PUBLIC. ST. JOSEPH HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE.

PART I, LINE 7 - RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET
RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2 ) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART I, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A, 7B AND 7C AND 7D. ALL OTHER LINES INCLUDE COSTS THAT WERE DERIVED BASED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS.

PART I, LINE 7A, COLUMN (D)
"DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S ""NEED"" CALCULATION. THIS CALCULATION CONSIDERS 100% OF A HOSPITAL'S ""NEED"" BASED ON A ""UNITS OF SERVICE"" METHODOLOGY FOR UNINSURED PATIENTS. THE CALCULATION ALSO MAKES ADJUSTMENTS BASED ON THE PROPORTION OF MEDICAID ELIGIBLE PATIENTS TREATED AT THE FACILITY. THE HOSPITAL HAS APPORTIONED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBT AND CHARITY CARE FOR 2021."

PART III, LINE 2,3 - BAD DEBT AS COMMUNITY BENEFIT
AS PART OF ITS TAX EXEMPT PURPOSE THE HOSPITAL PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. THE HOSPITAL TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE HOSPITAL IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY.

PART III, LINES 2 AND 4 - TEXT OF FOOTNOTE DISCUSSING BAD DEBT
PAGES 19 TO 24 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON PATIENT ACCOUNTS RECEIVABLE. THE FINANCIAL STATEMENTS ARE ATTACHED TO THIS RETURN.

PART III, SECTION B, LINE 8 - COSTING METHODOLOGY
THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2021 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY. AMOUNTS SHOWN FOR TOTAL REVENUE RECEIVED AND MEDICARE ALLOWABLE COSTS ARE NET OF ANY AMOUNTS ALREADY INCLUDED WITHIN PART I, LINE 7, PRIMARILY IN SUBSIDIZED HEALTH SERVICES.AMOUNTS ALREADY INCLUDED WITHIN PART I, LINE 7, PRIMARILY IN SUBSIDIZED HEALTH SERVICES.

PART III, LINE 8 - MEDICARE SHORTFALL AS COMMUNITY BENEFIT
LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. ST. JOSEPH BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY BUT ALSO DOING SO WITH NO RECOURSE IN OBTAINING PAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT. AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING EDGE CARE TO THE COMMUNITY INCREASES, THE HOSPITAL WILL CARRY THE BURDEN. AS A PARTICIPATING PROVIDER AND A CHARITABLE ORGANIZATION, MEDICARE PATIENTS, THE MAJORITY OF WHOM ARE ELDERLY AND DISABLED ARE NOT TURNED AWAY, SO ST. JOSEPH WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY.

PART III, LINE 9B
THE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INABILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED. ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE CH CHARITY CARE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARE CRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT FOR APPROPRIATE FOLLOW-UP. THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THE HOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET.

PART VI, LINE 4 - COMMUNITY INFORMATION
ST. JOSEPH HOSPITAL IS A 203-BED FACILITY LOCATED IN BETHPAGE, NEW YORK, APPROXIMATELY 25 MILES FROM MANHATTAN IN THE SOUTHEASTERN PART OF NASSAU COUNTY. THIS NOT-FOR-PROFIT HOSPITAL IS A MEMBER OF CATHOLIC HEALTH (CH). THE HOSPITAL PRIMARILY SERVES PATIENTS FROM THE SURROUNDING COMMUNITIES OF: BETHPAGE, MASSAPEQUA, FARMINGDALE, AMITYVILLE, LEVITTOWN, MASSAPEQUA PARK, WANTAGH, SEAFORD, BELLMORE, EAST MEADOW, LINDENHURST, COPIAGUE, BABYLON, HICKSVILLE, PLAINVIEW AND WOODBURY. APPROXIMATELY 90% OF HOSPITAL PATIENTS WHO ARE ADMITTED AND/OR PROVIDED CARE IN THE HOSPITAL'S EMERGENCY DEPARTMENT RESIDE IN THE AFOREMENTIONED SERVICE AREAS.

PART VI, LINE 2 - ASSESSMENT OF COMMUNITY NEEDS AND GOALS
COMMUNITY HEALTH NEEDS ARE ASSESSED ON A CONTINUAL BASIS, DURING MEETINGS OF THE HOSPITAL'S BOARD OF TRUSTEES AND EXECUTIVE LEADERSHIP COUNCIL, COMMUNITY HEALTH AND EDUCATION DEPARTMENT MEETINGS, AT COLLABORATIVE SESSIONS WITH MEMBER HOSPITALS OF CATHOLIC HEALTH (CH), AND WITH PARTNERS AT COMMUNITY AGENCIES AND ORGANIZATIONS THAT ARE PART OF THE LONG ISLAND HEALTH COLLABORATIVE (LIHC). THE LIHC COMMUNITY HEALTH ASSESSMENT SURVEYS ARE OFFERED YEAR-ROUND AT MULTIPLE OUTREACH SITES IN THE COMMUNITY. BY DISTRIBUTING COMMUNITY NEEDS SURVEYS (AVAILABLE IN ENGLISH, SPANISH, POLISH, HAITAIN CREOLE AND LARGE PRINT) TO PARTICIPANTS AT SCREENING SITES, EVERY POINT OF CONTACT SERVES AS AN OPPORTUNITY TO REQUEST FEEDBACK ON HOW THE HOSPITAL CAN BETTER MEET THE NEEDS OF THE COMMUNITY. THESE EVENTS ARE PROMOTED IN THE COMMUNITY SURROUNDING THE OUTREACH SITE AND ON CH'S WEBSITE. ST. JOSEPH CONTINUES TO COLLABORATE WITH OTHER HOSPITALS, LOCAL HEALTH DEPARTMENTS, HEALTH CARE PROVIDERS, PUBLIC HEALTH SPECIALISTS FROM ACADEMIC INSTITUTIONS AND COMMUNITY-BASED ORGANIZATIONS AT LIHC EVENTS. LIHC'S WEBSITE OFFERS COMPREHENSIVE INFORMATION TO PROMOTE GOOD HEALTH AND PREVENT CHRONIC DISEASE. IN ADDITION TO PROVIDING NUMEROUS RESOURCES SUCH AS HEALTH PROGRAM INVENTORIES, HEALTH INSURANCE INFORMATION AND EDUCATIONAL VIDEOS, LIHC AND ITS MEMBERS HAVE ORGANIZED WALKING PROGRAMS, AND DEVELOPED A UNIVERSAL SCREENING TOOL TO HELP MEASURE THE EFFECTIVENESS OF COMMUNITY HEALTH EFFORTS. MORE INFORMATION CAN BE FOUND AT WWW.LIHEALTHCOLLAB.ORG.

PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY
1. SINCE IT IS THE DUTY OF THE HOSPITAL TO ENSURE THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF THE HOSPITAL'S CHARITY CARE POLICY, ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS HAVE BEEN FULLY VERSED IN THE HOSPITAL'S CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVES. 2. THE HOSPITAL HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, PATIENT ACCESS, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREA. SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. 3. THE HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOW A SIXTH GRADE READING LEVEL. 4. THE HOSPITAL HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. 5. THE HOSPITAL PROVIDES ALL PATIENTS ACCESS TO INTERPRETERS TO ASSIST THEM IN UNDERSTANDING THE MEDICAL CENTER'S CHARITY CARE PROGRAM IN THE LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. 6. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, INFORMATION IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER DETAILS. THIS INFORMATION IS AVAILABLE AT OR BELOW A SIXTH GRADE READING LEVEL.

PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH
THE HOSPITAL LEADERSHIP IS ENGAGED AND COMMITTED TO LISTENING TO AND ADDRESSING COMMUNITY NEEDS TO FURTHER ST. JOSEPH'S MISSION OF PROVIDING HIGH-QUALITY CARE TO OUR PATIENTS AND IS VERY SUPPORTIVE OF THE NYS PREVENTION AGENDA, AIMED AT IMPROVING POPULATION HEALTH. ST. JOSEPH HOSPITAL'S COMMUNITY OUTREACH PROGRAMS INCLUDE SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION LECTURES, HEALTH FAIRS AND SCREENINGS, BLOOD DRIVES AND OTHER PATIENT-FOCUSED INITIATIVES. ST. JOSEPH IS SUPPORTIVE OF EDUCATIONAL INSTITUTIONS AND THEIR RESPECTIVE STUDENTS TO PROVIDE CLINICAL EXPERIENCE AND EDUCATION IN THE HOSPITAL ENVIRONMENT. ST. JOSEPH HOLDS MULTIPLE AFFILIATION AGREEMENTS WITH EDUCATIONAL FACILITIES SUCH AS LONG ISLAND UNIVERSITY, MOLLOY COLLEGE, TOURO COLLEGE SCHOOL OF HEALTH SCIENCES, ST. JOHN'S UNIVERSITY, FARMINGDALE STATE COLLEGE AND WESTERN SUFFOLK BOCES FOR ONSITE STUDENT TRAINING/MENTORING IN NURSING, RADIOLOGY TECHNOLOGY, HEALTH ADMINISTRATION AND FOR OTHER HEALTH CARE PROFESSIONS. ST JOSEPH IS ALSO A DESIGNATED SITE FOR TRAINING OF DOCTOR OF PHARMACY CANDIDATES THROUGH ST. JOHN'S UNIVERSITY. EVERY STUDENT PARTICIPATES IN A 5-WEEK ROTATION; CLINICAL PHARMACISTS SPEND 10 HOURS A WEEK WITH THE STUDENTS AND THE VP OF PATIENT SAFETY AND PHARMACY SPENDS 3 HOURS A WEEK EDUCATING THE STUDENTS. ST. JOSEPH HOSPITAL PARTICIPATES IN MANY FARMINGDALE AND BETHPAGE CHAMBER OF COMMERCE ACTIVITIES, INCLUDING HEALTH FAIRS AND COMMUNITY FESTIVAL DAYS. AT THESE EVENTS, THE HOSPITAL PROVIDES FREE EDUCATIONAL HEALTH CARE MATERIAL. ST. JOSEPH ALSO HOLDS AN ANNUAL HEALTH FAIR ON ITS PREMISES, INVITING ALL COMMUNITY MEMBERS TO RECEIVE HEALTH EDUCATION INFORMATION AND LEARN ABOUT HOSPITAL SERVICES. ALSO, IN COLLABORATION WITH THE MASSAPEQUA LIBRARY, FARMINGDALE LIBRARY, AND OTHER COMMUNITY-BASED ORGANIZATIONS, ST. JOSEPH HOSPITAL OFFERS FREE LECTURES, HEALTH SCREENINGS, AND OTHER OUTREACH PROGRAMS TO RESIDENTS OF NASSAU AND SUFFOLK COUNTIES, TARGETING MEDICALLY-UNDERSERVED COMMUNITIES NEAR THE HOSPITAL, INCLUDING FARMINGDALE, HICKSVILLE, AND WESTBURY.

PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM
ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS, ST. JOSEPH THROUGH ITS DAILY OPERATIONS, PROVIDES TO THE AREA ACUTE, EMERGENT, AND OUTPATIENT CARE. ST. JOSEPH IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH)(CH), A NEW YORK,NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CH IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. AS OF DECEMBER 31, 2021, CH COMPRISED SIX HOSPITALS (MERCY HOSPITAL, ST. FRANCIS HOSPITAL & HEART CENTER AND ST. JOSEPH HOSPITAL IN NASSAU COUNTY, AND GOOD SAMARITAN HOSPITAL, ST. CHARLES HOSPITAL AND ST. CATHERINE OF SIENA HOSPITAL IN SUFFOLK COUNTY), AS WELL AS THREE NURSING HOMES (ST. CATHERINE OF SIENA NURSING & REHABILITATION CENTER, GOOD SAMARITAN NURSING AND & REHABILITATIION AND OUR LADY OF CONSOLATION NURSING & REHABILITATION, ALL IN SUFFOLK COUNTY), GOOD SHEPHERD HOSPICE, AND A COMMUNITY-BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH MORE THAN 16,000 EMPLOYEES AND 4,600 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CH PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. OUR MISSION STATES: WE, AT CATHOLIC HEALTH, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. MEMBER ORGANIZATIONS OF CH OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICE, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. ALL OF CH'S MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO THEIR HISTORY AND THEIR DISTINCTIVE PERSONALITIES, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY. CH ENTITIES PROVIDE AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS AS WELL AS FREE HEALTH SCREENINGS THROUGH ITS HEALTHY SUNDAYS PROGRAMS, HEALTH FAIRS, AND OTHER PROGRAMS. SINCE 1907, CATHOLIC HEALTH HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND HUMAN SERVICE ORGANIZATIONS WITH THE PRIMARY OBJECTIVE OF IMPROVING THE COMMUNITY'S HEALTH.