4A (Expenses $ 136682457 including grants of $ 248) (Revenue $ 146487750)
"SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA2021 WAS MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSOVER THE LAST TWO YEARS, PROVIDENCE ADVANCED A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION, AND ENVIRONMENTAL STEWARDSHIP. WE UPDATED OUR INTEGRATED STRATEGIC & FINANCIAL PLAN TO MORE CLEARLY EXPRESS OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. IN 2021, OUR SUSTAINABLE AND INCLUSIVE PURCHASING PROGRAM COMMITTED TO INCREASE OUR SPEND WITH WOMEN AND MINORITY OWNED BUSINESS ENTERPRISES BY OVER $300 MILLION ACROSS THE NEXT FIVE YEARS. WE ALSO DEPLOY AN INVESTING PORTFOLIO WHICH INCLUDES SHAREHOLDER ADVOCACY, IMPACT INVESTING, AND SOCIALLY CONSCIOUS PORTFOLIO SCREENS. IN 2021, PROVIDENCE MADE PROGRESS TOWARDS ITS CLIMATE COMMITMENT TO BECOME CARBON NEGATIVE BY 2030. WE ARE IMPLEMENTING AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL.PETALUMA VALLEY HOSPITAL (""PVH"") AND HEALDSBURG HOSPITAL (""HDH"")PVH IS A COMMUNITY HOSPITAL FOUNDED IN 1980 BY THE PETALUMA HEALTHCARE DISTRICT, AND IS LOCATED IN PETALUMA, CA AND HAS 80 LICENSED BEDS AND A CAMPUS THAT IS 14.63 ACRES IN SIZE. PVH HAS A STAFF OF 501 EMPLOYEES AND PROFESSIONAL RELATIONS WITH MORE THAN 260 LOCAL PHYSICIANS. HDH IS A COMMUNITY HOSPITAL FOUNDED IN 1905 AND IS LOCATED IN HEALDSBURG, CA. PETALUMA VALLEY HOSPITAL CAME TOGETHER WITH PROVIDENCE HEALDSBURG TO FORM NORCAL HEALTHCONNECT.NORCAL HEALTHCONNECT AGREED TO PURCHASE PVH AND HDH TO ENSURE LOCAL RESIDENTS DO NOT LOSE ACCESS TO THEIR ACUTE CARE HOSPITALS WITH DEDICATED EMERGENCY SERVICES. WHILE NORCAL HEALTHCONNECT IS NEW, PROVIDENCE ST. JOSEPH HEALTH HAS DEEP ROOTS IN THE REGION. PVH HAS BEEN OPERATED BY A SUBSIDIARY OF PROVIDENCE ST. JOSEPH HEALTH FOR MORE THAN 20 YEARS AND HAS BEEN RECOGNIZED FOR ITS AWARD-WINNING CARE. NORCAL HEALTHCONNECT IS COMMITTED TO INVESTING IN THE FUTURE OF PVH AND HDH AND THE DESIRE TO FIND LONG-TERM STABILITY FOR THE SONOMA REGION.2021 PROGRAM SERVICE ACCOMPLISHMENTS: (JANUARY 1 - DECEMBER 31, 2021)CONTINUUM OF ORAL HEALTH SERVICES INCLUDE A FIXED SITE DENTAL CLINIC LOCATED IN SANTA ROSA THAT SERVES CHILDREN FROM THROUGHOUT THE COUNTY, THE MOBILE DENTAL CLINIC, THE MIGHTY MOUTH SCHOOL-BASED DENTAL DISEASE PREVENTION PROGRAM. THE CLINICS PRIORITIZE SERVICE TO CHILDREN AGES 0-16 YEARS, BUT ALSO SERVE ADULTS WITH URGENT NEEDS. THEY PROVIDE BASIC, PREVENTIVE, EMERGENCY AND COMPREHENSIVE DENTAL CARE WITH A STRONG FOCUS ON PREVENTION AND EDUCATION. DURING 2021, PATIENTS WERE SERVED OVER 237 ENCOUNTERS AT THE SJH DENTAL CLINIC. OUR MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PREVENTION PROGRAM COMPLETED 26 ENCOUNTERS.MOBILE MEDICAL CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN 2021, IN OUR SERVICE AREA, THE CLINIC SERVED PATIENTS OVER 54 ENCOUNTERS AT SEVERAL LOCATIONS, INCLUDING THE CITIES OF SONOMA/BOYES HOT SPRINGS, SANTA ROSA, AND WINDSOR. THE MOBILE HEALTH TEAM ALSO SERVED SEVERAL LOCAL HOMELESS SHELTERS, PROVIDING DIRECT PATIENT CARE IN THE SHELTERS.HOUSE CALLS PROGRAM TENDS TO THE PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS OF FRAIL ELDERLY SENIORS AND ADULTS WITH CHRONIC DISEASES BY PROVIDING PRIMARY MEDICAL CARE AT HOME. ELIGIBLE SENIORS HAVE LIMITED ACCESS TO CARE DUE TO IMPAIRED MOBILITY, UNDER-INSURANCE, AND LACK OF FUNDS. THE PROGRAM TEAM, WHICH INCLUDES NURSE PRACTICTIONERS, NURSES, CASE MANAGEMENT, AND HOME HEALTH ASSISTANCE, PROVIDED SERVICE TO PATIENTS AND COMPLETED OVER 186 ENCOUNTERS COUNTYWIDE, HELPING TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO EFFECTIVELY MANAGE CHRONIC DISEASE."

PETALUMA VALLEY HOSPITAL
PART V, SECTION B, LINE 2: NORCAL HEALTHCONNECT LLC, A DISREGARDED ENTITY WHOSE SINGLE MEMBER IS WESTERN HEALTHCONNECT, PURCHASED THE PETALUMA VALLEY HOSPITAL FACILITY, WHICH INCLUDED THE PETALUMA VALLEY HOSPITAL FACILITY HOSPITAL LICENSE.

HEALDSBURG HOSPITAL
PART V, SECTION B, LINE 2: NORCAL HEALTHCONNECT LLC, A DISREGARDED ENTITY WHOSE SINGLE MEMBER IS WESTERN HEALTHCONNECT, PURCHASED THE HEALDSBURG HOSPITAL FACILITY, WHICH INCLUDED THE HEALDSBURG HOSPITAL FACILITY HOSPITAL LICENSE.

PETALUMA VALLEY HOSPITAL
PART V, SECTION B, LINE 3J: PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS.

PETALUMA VALLEY HOSPITAL
PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS IS BASED ON THE UNDERSTANDING THAT HEALTH AND WELLNESS ARE INFLUENCED BY FACTORS WITHIN OUR COMMUNITIES, NOT ONLY WITHIN MEDICAL FACILITIES. IN GATHERING INFORMATION ON THE COMMUNITIES SERVED BY SRMH AND PVH, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, AND HEALTH BEHAVIORS. WE ALSO INVITED KEY STAKEHOLDERS AND COMMUNITY MEMBERS TO PROVIDE ADDITIONAL CONTEXT TO THE QUANTITATIVE DATA THROUGH QUALITATIVE DATA IN THE FORM OF INTERVIEWS AND LISTENING SESSIONS. AS OFTEN AS POSSIBLE, EQUITY IS AT THE FOREFRONT OF OUR CONVERSATIONS AND PRESENTATION OF THE DATA, WHICH OFTEN HAVE BIASES BASED ON COLLECTION METHODOLOGY.IN ADDITION, WE RECOGNIZE THAT THERE ARE OFTEN GEOGRAPHIC AREAS WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE SUBSTANTIALLY POORER THAN NEARBY AREAS. WHENEVER POSSIBLE AND RELIABLE, DATA ARE REPORTED AT THE ZIP CODE OR CENSUS BLOCK GROUP LEVEL. THESE SMALLER GEOGRAPHIC AREAS ALLOW US TO BETTER UNDERSTAND THE NEIGHBORHOOD LEVEL NEEDS OF OUR COMMUNITIES AND BETTER ADDRESS HEALTH DISPARITIES WITHIN AND ACROSS COMMUNITIES.WE REVIEWED DATA FROM THE AMERICAN COMMUNITY SURVEY AND LOCAL PUBLIC HEALTH AUTHORITIES. IN ADDITION, WE INCLUDE HOSPITAL UTILIZATION DATA TO IDENTIFY DISPARITIES IN UTILIZATION BY INCOME AND INSURANCE, GEOGRAPHY, AND RACE/ETHNICITY WHEN RELIABLY COLLECTED.COMMUNITY INPUT:TO BETTER UNDERSTAND THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS, REPRESENTATIVES FROM SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS CONDUCTED 11 STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, INCLUDING 12 PARTICIPANTS FROM JUNE TO JULY 2020. DURING THESE INTERVIEWS, NONPROFIT AND GOVERNMENT STAKEHOLDERS DISCUSSED THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF THE SERVICE AREA.THESE 2020 QUALITATIVE FINDINGS SUPPLEMENT THE QUALITATIVE DATA FROM THE 2019 SONOMA COUNTY COLLABORATIVE CHNA COLLECTED FROM AUGUST TO NOVEMBER 2018.OBTAINING ROBUST COMMUNITY INPUT DURING THE COVID-19 PANDEMIC WAS ESPECIALLY CHALLENGING AND PREVENTED SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS FROM COMPLETING ANY IN-PERSON CONVERSATIONS. WHILE STAKEHOLDER INTERVIEWS WERE EASILY ADAPTED TO A VIRTUAL SETTING THROUGH A VIDEO CONFERENCING PLATFORM, IT WAS NOT FEASIBLE TO HOST LISTENING SESSIONS COMPRISED OF COMMUNITY MEMBERS IN THIS SAME WAY. WHILE VIDEO CONFERENCING DOES FACILITATE INFORMATION SHARING, THERE ARE CHALLENGES CREATING THE LEVEL OF DIALOGUE THAT WOULD TAKE PLACE IN PERSON. ADDITIONALLY, DUE TO MANY COMMUNITY ORGANIZATIONS ENGAGING IN COVID-19 RESPONSE, SOME ORGANIZATIONS HAD LIMITED CAPACITY AND WERE NOT ABLE TO PARTICIPATE IN INTERVIEWS.NONPROFIT AND GOVERNMENT STAKEHOLDER INTERVIEWS:A TOTAL OF 11 STAKEHOLDER INTERVIEWS WERE COMPLETED BY REPRESENTATIVES FROM SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS. STAKEHOLDERS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. INCLUDED IN THE INTERVIEWS WAS A REPRESENTATIVE FROM THE SONOMA COUNTY HUMAN SERVICES DEPARTMENT.DATA LIMITATIONS AND INFORMATION GAPS:WHILE CARE WAS TAKEN TO SELECT AND GATHER DATA THAT WOULD TELL THE STORY OF THE HOSPITAL'S SERVICE AREA, IT IS IMPORTANT TO RECOGNIZE THE LIMITATIONS AND GAPS IN INFORMATION THAT NATURALLY OCCUR.- NOT ALL DESIRED DATA WERE READILY AVAILABLE, SO SOMETIMES WE HAD TO RELY ON TANGENTIAL OR PROXY MEASURES OR NOT HAVE ANY DATA AT ALL. FOR EXAMPLE, THERE IS LITTLE COMMUNITYLEVEL DATA ON THE INCIDENCE OF MENTAL HEALTH OR SUBSTANCE ABUSE.- DATA THAT ARE GATHERED THROUGH INTERVIEWS AND SURVEYS MAY BE BIASED DEPENDING ON WHO IS WILLING TO RESPOND TO THE QUESTIONS AND WHETHER THEY ARE REPRESENTATIVE OF THE POPULATION AS A WHOLE.- THE ACCURACY OF DATA GATHERED THROUGH INTERVIEWS AND SURVEYS DEPENDS ON HOW CONSISTENTLY THE QUESTIONS ARE INTERPRETED ACROSS ALL RESPONDENTS AND HOW HONEST PEOPLE ARE IN PROVIDING THEIR ANSWERS.- WHILE MOST INDICATORS ARE RELATIVELY CONSISTENT FROM YEAR TO YEAR, OTHER INDICATORS ARE CHANGING QUICKLY (SUCH AS PERCENTAGE OF PEOPLE UNINSURED) AND THE MOST RECENT DATA AVAILABLE ARE NOT A GOOD REFLECTION OF THE CURRENT STATE.- INFORMATION GATHERED DURING STAKEHOLDER INTERVIEWS AND CAREGIVER LISTENING SESSIONS IS DEPENDENT ON WHO WAS INVITED AND WHO PARTICIPATED. EFFORTS WERE MADE TO INCLUDE PEOPLE WHO COULD REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AND/OR WERE REPRESENTATIVE OF COMMUNITIES OF GREATEST NEED.

PETALUMA VALLEY HOSPITAL
PART V, SECTION B, LINE 6A: MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE HOSPITAL FACILITIES:- SUTTER HEALTH- KAISER PERMANENTE- SONOMA WEST MEDICAL CENTER

PETALUMA VALLEY HOSPITAL
PART V, SECTION B, LINE 6B: MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:- SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES- COMMUNITY CHILD CARE COUNCIL (4CS) OF SONOMA COUNTY- FIRST 5 SONOMA COUNTY- BURBANK HOUSING- COMMUNITY FOUNDATION SONOMA COUNTY- SONOMA COUNTY SHERIFF'S OFFICE- CITY OF SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP- COMMUNITY ACTION PARTNERSHIP OF SONOMA- SONOMA COUNTY ACES CONNECTION- SONOMA COUNTY ECONOMIC DEVELOPMENT BOARD- SONOMA COUNTY PERMIT & RESOURCE MANAGEMENT DEPARTMENT- SONOMA COUNTY ENVIRONMENTAL HEALTH & SAFETY- BUCKELEW PROGRAMS- SONOMA COUNTY OFFICE OF EDUCATION- SONOMA COUNTY COMMUNITY DEVELOPMENT COMMISSION- LA LUZ COMMUNITY CENTER- PETALUMA PEOPLE SERVICES CENTER- SANTA ROSA COMMUNITY HEALTH CENTERS- WEST COUNTY HEALTH CENTERS- PETALUMA HEALTH CARE DISTRICT- PETALUMA HEALTH CENTER- ALLIANCE MEDICAL CENTER- PALM DRIVE HEALTH CARE DISTRICT- NORTH SONOMA COUNTY HEALTH CARE DISTRICT- SONOMA VALLEY HEALTH CARE DISTRICT- RUSSIAN RIVER ARE RESOURCES AND ADVOCATES- COMMUNITY HEALTH INITIATIVE OF THE PETALUMA AREA- LATINO SERVICE PROVIDERS- SONOMA COUNTY HUMAN SERVICES DEPARTMENT- SONOMA COUNTY TASK FORCE ON THE HOMELESS- SONOMA COUNTY HEALTH CARE FOR THE HOMELESS COALITION- MENDOCINO COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES- HEALTH MENDOCINO

PETALUMA VALLEY HOSPITAL
"PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS PRIORITIZED:1) HOUSING INSTABILITY & HOMELESSNESS2) MENTAL HEALTH & SUBSTANCE USE3) HEALTH EQUITY: RACISM & DISCRIMINATION4) ACCESS TO HEALTH CAREHOUSING INSTABILITY & HOMELESSNESS:THE COST OF LIVING IN SONOMA COUNTY OUTPACES THE INCOME FOR MANY PEOPLE IN THE COMMUNITY, MAKING IT CHALLENGING FOR FAMILIES TO MEET THEIR BASIC NEEDS. HOUSING IS FOUNDATIONAL TO ONE'S HEALTH: PEOPLE WHO ARE STABLY HOUSED ARE BETTER ABLE TO CARE FOR THEIR PHYSICAL AND MENTAL HEALTH. THOSE MOST IMPACTED BY HOUSING STABILITY AND AFFORDABILITY ARE THE LATINO/A COMMUNITY DUE TO INCOME INEQUITIES; YOUTH EXPERIENCING HOMELESSNESS, ESPECIALLY THOSE IDENTIFYING AS LGBTQ+; AND OLDER ADULTS WHOSE FIXED INCOME LIMITS THEIR ABILITY TO AFFORD LOCAL HOUSING PRICES. THERE IS ALSO NEED FOR SUPPORTIVE HOUSING, USING A HOUSING FIRST APPROACH, FOR PEOPLE WITH MENTAL HEALTH CHALLENGES, SUBSTANCE USE DISORDERS, AND OTHER SPECIAL NEEDS. THERE ARE ESPECIALLY FEW RESOURCES FOR PEOPLE WHO ARE UNDOCUMENTED.MENTAL HEALTH & SUBSTANCE USE:ACCESSING QUALITY MENTAL HEALTH AND SUBSTANCE USE SERVICES CAN BE A CHALLENGE FOR MANY. TRAUMA FROM THE RECENT FIRES, COVID-19, AND THE CURRENT POLITICAL CLIMATE CONTRIBUTE TO THE COMMUNITY MENTAL HEALTH NEEDS. THERE IS A PARTICULAR NEED FOR MILD TO MODERATE MENTAL HEALTH SERVICES, PERINATAL MENTAL HEALTH SERVICES, MORE WRAPAROUND CASE MANAGEMENT FOR FAMILIES TO ADDRESS MENTAL HEALTH, AND MORE SUBSTANCE USE DISORDER TREATMENT SERVICES. THERE IS FURTHER NEED FOR MORE BILINGUAL AND BICULTURAL MENTAL HEALTH PROFESSIONALS TO SERVE THE LATINO/A COMMUNITY, INCLUDING THOSE THAT ARE UNDOCUMENTED. SCHOOL-AGE CHILDREN AND OLDER ADULTS ARE TWO ADDITIONAL GROUPS WITH UNMET MENTAL HEALTH NEEDS. MAJOR BARRIERS TO ACCESSING MENTAL HEALTH SERVICES INCLUDE INSURANCE COVERAGE LIMITATIONS, COST OF CARE, AND SHORTAGE OF PROVIDERS RESULTING IN LONG WAIT TIMES FOR APPOINTMENTS.HEALTH EQUITY: RACISM & DISCRIMINATION:STAKEHOLDERS DESCRIBED BEING AT AN ""INFLECTION POINT"" IN ACKNOWLEDGING AND ADDRESSING RACISM IN THE COMMUNITY, WITH MORE PEOPLE TALKING ABOUT THE ISSUE. THEY SHARED RACISM KEEPS PEOPLE IN POVERTY BY LIMITING EDUCATION AND JOB OPPORTUNITIES, LEADING TO MORE BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC) WORKING IN LOWER-WAGE JOBS, WITH PARTICULAR EMPHASIS ON THE LATINO/A COMMUNITY IN SONOMA COUNTY. HOUSING DISCRIMINATION PREVENTS THE LATINO/A COMMUNITY FROM ACCESSING GOOD-QUALITY, AFFORDABLE HOUSING. RACISM CONTRIBUTES TO INEQUITIES IN THE WAYS DIFFERENT SCHOOLS ARE FUNDED, CONTRIBUTING TO THE OPPORTUNITY GAP. STAKEHOLDERS SHARED PARTICULAR CONCERN FOR THE WAYS IN WHICH XENOPHOBIA AND RACIST POLICIES NEGATIVELY AFFECT THE MENTAL HEALTH AND ECONOMIC SECURITY OF THE LATINO/A COMMUNITY.ACCESS TO HEALTH CARE:STAKEHOLDERS DISCUSSED THE NEED FOR MORE AFFORDABLE HEALTH CARE, AS WELL AS CHALLENGES ACCESSING PRIMARY AND SPECIALTY CARE. THEY NOTED A PARTICULAR NEED FOR MORE CASE MANAGEMENT AND NAVIGATION RESOURCES, ESPECIALLY FOR SPANISH-SPEAKING PATIENTS AND NEW PARENTS. TRANSPORTATION TO CARE IS A CONSISTENT BARRIER FOR MANY, BUT ESPECIALLY OLDER ADULTS. FEARS OF IMMIGRATION ENFORCEMENT AND CHANGES IN PUBLIC CHARGE RULES MAY PREVENT MIXED STATUS HOUSEHOLDS FROM APPLYING FOR MEDI-CAL. A LACK OF CULTURALLY RESPONSIVE AND LINGUISTICALLY APPROPRIATE HEALTH CARE SERVICES AND DOCUMENTATION STATUS MAY PREVENT THE LATINO/A COMMUNITY FROM RECEIVING THE CARE THEY NEED.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO SINGLE HOSPITAL FACILITY CAN FULLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WHILE SANTA ROSA MEMORIAL WILL EMPLOY STRATEGIES TO ADDRESS EACH OF THE FOUR SIGNIFICANT HEALTH NEEDS THAT WERE PRIORITIZED DURING THE CHNA PROCESS, PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND GOVERNMENT AGENCIES ARE CRITICAL FOR ACHIEVING THE ESTABLISHED GOALS.PETALUMA VALLEY HOSPITAL WILL COLLABORATE WITH PETALUMA PEOPLE SERVICES CENTER, LA LUZ CENTER, WEST COUNTY COMMUNITY SERVICES, COMMUNITY ACTION PARTNERSHIP OF SONOMA COUNTY, AND A VARIETY OF LOCAL FAMILY RESOURCE CENTERS THAT ADDRESS THE COMMUNITY NEEDS TO COORDINATE CARE AND REFERRALS TO ADDRESS UNMET NEEDS.WITH RESPECT TO SOME OF THE OTHER NEEDS IDENTIFIED IN THE CHNA PROCESS THAT WERE NOT PRIORITIZED FOR ACTION THROUGH THIS PLAN, WE INTEND TO REMAIN ENGAGED IN ADDRESSING: ORAL HEALTH NEEDS THROUGH OUR ONGOING ST. JOSEPH HEALTH COMMUNITY DENTAL CLINIC AND MOBILE DENTAL CLINIC; CRIME AND SAFETY THROUGH OUR CONTINUED INVOLVEMENT ON THE SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP; AND INSURANCE AND COST OF CARE THROUGH OUR CONTINUED INVOLVEMENT ON THE COVERED SONOMA AND SONOMA HEALTH ACTION COMMUNITY HEALTH IMPROVEMENT COMMITTEES. WE ALSO INTEND TO INCORPORATE OTHER ISSUES SUCH AS EARLY CHILDHOOD DEVELOPMENT IN OUR BEHAVIORAL HEALTH STRATEGY AS IT IS SUCH A FUNDAMENTAL DETERMINANT OF MENTAL HEALTH LATER IN LIFE AND ECONOMIC INSECURITY IN OUR HOUSING CONCERNS STRATEGY AS IT IS A NECESSARY INGREDIENT IN HOUSING AFFORDABILITY. SIMILARLY, WITH RESPECT TO IMMIGRATION, WE LACK APPROPRIATE EXPERTISE OR COMPETENCY TO OFFER A PROGRAM. AND WHILE FOOD AND NUTRITION IS NOT TO BE DIRECTLY ADDRESSED BY OUR OWN PROGRAMMING, WE ANTICIPATE THAT OUR ONGOING SUPPORT OF LOCAL INITIATIVES AND ORGANIZATIONS INVOLVED IN CARDIOVASCULAR DISEASE PREVENTION WILL INCLUDES A CONSIDERATION AND INCLUSION OF STRATEGIES TO ADDRESS THIS NEED.FURTHERMORE, WE WILL CONTINUE FUNDING OTHER LOCAL NONPROFIT ORGANIZATIONS THROUGH GRANTS FROM OUR CARE FOR THE POOR PROGRAM MANAGED BY THE SRMH COMMUNITY HEALTH INVESTMENT DEPARTMENT, AND WE WILL ENCOURAGE AND ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT THE SRMH SERVICE AREAS."

PETALUMA VALLEY HOSPITAL
PART V, SECTION B, LINE 13H: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE.

PETALUMA VALLEY HOSPITAL
PART V, SECTION B, LINE 24: FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.

PART V, SECTION B, LINE 7A:
CHNA REPORT WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTS

PART V, SECTION B, LINE 10A:
IMPLEMENTATION STRATEGY WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTS

SCHEDULE H PART V, LINE 13A:
PETALUMA VALLEY HOSPITAL1/1/2021 - 09/17/2021 PETALUMA VALLEY HOSPITAL 100% DISCOUNT WAS UP TO 200% FPL AND 75% DISCOUNT BETWEEN 201% TO 500% FPL.EFFECTIVE 09/18/21 THROUGH 12/31/2021, PETALUMA VALLEY HOSPITAL 100% DISCOUNT WAS UP TO 300% FPL AND 75% DISCOUNT BETWEEN 301% TO 350% FPL.

SCHEDULE H, PART V, SECTION B, LINE 16A:
PETALUMA VALLEY HOSPITALFINANCIAL ASSISTANCE POLICYHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEHEALDSBURG HOSPITALFINANCIAL ASSISTANCE POLICYHTTPS://HEALDSBURGDISTRICTHOSPITAL.ORG/PATIENT-SUPPORT/

SCHEDULE H, PART V, SECTION B, LINE 16B:
PETALUMA VALLEY HOSPITALFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEHEALDSBURG HOSPITALFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCE

SCHEDULE H, PART V, SECTION B, LINE 16C:
PETALUMA VALLEY HOSPITALFAP PLAIN LANGUAGE SUMMARYHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEHEALDSBURG HOSPITALFAP PLAIN LANGUAGE SUMMARYHTTPS://HEALDSBURGDISTRICTHOSPITAL.ORG/PATIENT-SUPPORT/

SCHEDULE H PART V, LINE 22A AND 22D:
PETALUMA VALLEY HOSPITALPRIOR TO 9/18/2021 PETALUMA VALLEY HOSPITAL USED THE PROSPECTIVE MEDICARE OR MEDICAID AGB METHOD.EFFECITVE 9/18/2021 PETALUMA VALLEY HOSPITAL WENT LIVE ON EPIC AND MOVED TO THE LOOK BACK METHOD BASED ON CLAIMS ALLOWED BY MEDICARE FEE FOR SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE HOSPITAL FACILITY DURING A PRIOR 12 MONTH PERIOD.

PART I, LINE 3C:
IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.

PART I, LINE 6A:
PETALUMA VALLEY HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/PETALUMA-VALLEY-HOSPITAL/ABOUT-US#TABCONTENT-1-COLLAPSE-3

PART I, LINE 7:
THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.

PART I, LINE 7G:
NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BUILDING ACTIVITIES:CHI SONOMA COUNTY IDENTIFIED THE NEED TO HOLD HEALTHCARE AND COMMUNITY-BASED ORGANIZATIONAL WEEKLY CONVENINGS. THESE MEETINGS INCREASED COMMUNICATIONS BETWEEN HOSPITAL PARTNERS AND ASSISTED WITH THROUGHPUT FOR OUR PATIENTS REENTERING THE COMMUNITY AFTER HOSPITAL ADMISSIONS. PROVIDENCE CHI SONOMA STAFF HAS CONTINUED TO CONVENE AND FACILITATE THESE MEETINGS WHICH HAVE BECOME A STANDARD COMMUNICATION PIPELINE FOR SONOMA COUNTY CLINICIANS AND ORGANIZATIONS.

PART III, LINE 9B:
PETALUMA VALLEY HOSPITALCOLLECTION ACTIVITY:OUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THIS INFORMATION IS INCLUDED IN OUR CHARITY POLICY HOWEVER THIS DETAIL IS NOT ADDRESSED IN OUR COLLECTION POLICY.HEALDSBURG HOSPITALCOLLECTION ACTIVITY:PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.

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THROUGH A MIXED-METHODS APPROACH USING QUANTITATIVE AND QUALITATIVE DATA, THE CHNA PROCESS USED SEVERAL SOURCES OF INFORMATION TO IDENTIFY COMMUNITY NEEDS. ACROSS SONOMA COUNTY, INFORMATION COLLECTED INCLUDES PUBLIC HEALTH DATA REGARDING HEALTH BEHAVIORS, MORBIDITY AND MORTALITY, AND HOSPITAL-LEVEL DATA. IN 2019, ST. JOSEPH HEALTH SONOMA PARTNERED WITH SUTTER HEALTH AND KAISER PERMANENTE TO GATHER DATA FROM LISTENING SESSIONS AND INTERVIEWS WITH DIVERSE, LOW-INCOME AND MEDICALLY UNDERSERVED COMMUNITIES IN SONOMA COUNTY. IN 2020, INDIVIDUAL STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM ORGANIZATIONS THAT SERVE THESE POPULATIONS TO BETTER UNDERSTAND THE IMPACTS OF COVID-19 IN OUR COMMUNITIES.

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PETALUMA VALLEY HOSPITALPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ONE WAY PETALUMA VALLEY HOSPITAL (PVH) INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.HEALDSBURG HOSPITALPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ONE WAY HEALDSBURG HOSPITAL INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.

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PROMOTION OF COMMUNITY HEALTH:PETALUMA VALLEY HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. PETALUMA VALLEY HOSPITAL IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.

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CA

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"PETALUMA VALLEY HOSPITAL (PVH), FOUNDED BY THE SISTERS OF ST. JOSEPH OF ORANGE, HAS BEEN SERVING THE HEALTHCARE NEEDS OF FAMILIES IN THE COMMUNITY FOR MORE THAN 60 YEARS. DURING THIS TIME, ITS MISSION HAS REMAINED THE SAME: TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES SERVED. PART OF A LARGER HEALTHCARE SYSTEM KNOWN AS PROVIDENCE ST. JOSEPH HEALTH (PSJH), PVHH IS PART OF A COUNTYWIDE MINISTRY THAT INCLUDES TWO HOSPITALS, URGENT CARE FACILITIES, HOSPICE, HOME HEALTH SERVICES, AND OTHER FACILITIES FOR TREATING THE HEALTHCARE NEEDS OF THE COMMUNITY IN SONOMA COUNTY AND THE REGION. THE MINISTRY'S CORE FACILITIES ARE PETALUMA VALLEY HOSPITAL (PVH), AN 80-BED ACUTE CARE HOSPITAL, AND SRMH, A FULL SERVICE, STATE OF THE ART 330-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER. MAJOR PROGRAMS AND SERVICES INCLUDE CRITICAL CARE, CARDIOVASCULAR CARE, STROKE CARE, WOMEN'S AND CHILDREN'S SERVICES, CANCER CARE, AND ORTHOPEDICS. SRMH IS HOME TO THE NORMA & EVERT PERSON HEART & VASCULAR INSTITUTE AND THE UCSF NEONATAL INTENSIVE CARE NURSERY. PVH PROVIDES SOUTHERN MENDOCINO, NORTHERN MARIN, AND SONOMA COUNTIES' COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM UKIAH IN THE NORTH, MARSHALL IN THE SOUTH, SONOMA VALLEY IN THE EAST AND BODEGA BAY IN THE WEST. PVH'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF SANTA ROSA, PETALUMA, SEBASTOPOL, WINDSOR, HEALDSBURG, ROHNERT PARK, COTATI, SONOMA, CLOVERDALE, UKIAH, AND POINT ARENA.DEFINING THE COMMUNITY:SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE COUNTY'S TOTAL POPULATION WAS ESTIMATED AT 487,011 AT THE TIME OF THE CHNA. SINCE 2006, THE COUNTY POPULATION HAS GROWN AT AN OVERALL RATE OF 1.8% WITH THE CITIES OF SONOMA, SANTA ROSA AND WINDSOR EXPERIENCING THE FASTEST GROWTH RATES. ACCORDING TO PROJECTIONS FROM THE CALIFORNIA DEPARTMENT OF FINANCE, THE COUNTY POPULATION IS PROJECTED TO GROW BY 8.3% TO 546,204 IN 2020. THIS RATE OF GROWTH IS LESS THAN THAT PROJECTED FOR CALIFORNIA AS A WHOLE (10.1%). THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION ESTIMATED TO BE NEARLY 171,000 IN 2012 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. AT LEAST PART OF SONOMA COUNTY, CALIFORNIA, IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). THE AREA IS 0.8 SQUARE MILES AND IS LOCATED NEAR DOWNTOWN SANTA ROSA. THE CLOVERDALE AREA IN SONOMA COUNTY IS A DESIGNATED PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (PC-HSPA). THERE ARE 6,888 CIVILIAN RESIDENTS IN THIS AREA, WHICH IS 307.5 TOTAL SQUARE MILES. SRMH PROVIDES SONOMA COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL IS LOCATED IN DOWNTOWN SANTA ROSA, ABOUT 55 MILES NORTH OF SAN FRANCISCO JUST OFF THE HIGHWAY 101 CORRIDOR IN CENTRAL SONOMA COUNTY. PVH'S PRIMARY SERVICE AREA IS LIMITED TO A TIGHT RADIUS, BUT ITS SECONDARY SERVICE AREA COMPRISES THE ENTIRE COUNTY, PLUS NORTHERN MARIN COUNTY AND SOUTHERN MENDOCINO COUNTY. THE CHNA PROCESS AND DATA GATHERING ADDRESSES SONOMA COUNTY. FOR A COMPLETE COPY OF THE 2017 PVH CHNA SEE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSSONOMA COUNTY'S UNINCORPORATED AREAS ARE HOME TO 146,739 RESIDENTS, 30.1% OF THE TOTAL POPULATION. A SIGNIFICANT NUMBER OF THESE INDIVIDUALS LIVE IN LOCATIONS THAT ARE VERY RURAL AND GEOGRAPHICALLY REMOTE. RESIDENTS OF THESE AREAS MAY EXPERIENCE SOCIAL ISOLATION AND SIGNIFICANT BARRIERS IN ACCESSING BASIC SERVICES AND SUPPORTS SUCH AS TRANSPORTATION, HEALTH CARE, NUTRITIOUS FOOD AND OPPORTUNITIES TO SOCIALIZE. LOW INCOME AND SENIOR POPULATIONS LIVING IN REMOTE AREAS MAY FACE SPECIAL CHALLENGES IN MAINTAINING HEALTH AND QUALITY OF LIFE. OF THE COUNTY'S TOTAL SENIOR POPULATION, AGE 60 AND OLDER, 12,144 (12%) ARE CONSIDERED ""GEOGRAPHICALLY ISOLATED"" AS DEFINED BY THE OLDER AMERICANS ACT.PVH TOTAL SERVICE AREA:THE COMMUNITY SERVED BY PVH IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF PVH'S INPATIENTS. THE PVH TOTAL SERVICE AREA IS COMPRISED OF BOTH THE PRIMARY SERVICE AREA (PSA) AS WELL AS THE SECONDARY SERVICE AREA (SSA) AND IS ESTABLISHED BASED ON THE FOLLOWING CRITERIA:- PSA: 70% OF DISCHARGES (EXCLUDING NORMAL NEWBORNS)- SSA: 71%-85% OF DISCHARGES (DRAW RATES PER ZIP CODE ARE CONSIDERED AND PSA/SSA ARE MODIFIED ACCORDINGLY)- INCLUDES ZIP CODES FOR CONTINUITY- NATURAL BOUNDARIES ARE CONSIDERED (I.E., FREEWAYS, MOUNTAIN RANGES, ETC.)- CITIES ARE PLACED IN PSA OR SSA, BUT NOT BOTH THE PSA IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF PVH'S PATIENTS ORIGINATE. THE CITIES AND TOWNS IN THE PVH PSA INCLUDE SANTA ROSA, SEBASTOPOL, WINDSOR, FORESTVILLE, ROHNERT PARK AND COTATI/PENNGROVE. THE SSA IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE SSA INCLUDES ALL OF SONOMA COUNTY, UKIAH TO THE NORTH IN MENDOCINO COUNTY, AND NORTHERN MARIN COUNTY TO THE SOUTH. THE POPULATION OF THE SERVICE AREA IS 835,741, OF WHICH 328,005 ARE IN THE PSA AND 507,736 RESIDE IN THE SSA.COMMUNITY NEED INDEX (ZIP CODE LEVEL) BASED ON NATIONAL NEED:THE COMMUNITY NEED INDEX (CNI) WAS DEVELOPED BY DIGNITY HEALTH AND TRUVEN HEALTH ANALYTICS. THE CNI IDENTIFIES THE SEVERITY OF HEALTH DISPARITY FOR EVERY ZIP CODE IN THE UNITED STATES AND DEMONSTRATES THE LINK BETWEEN COMMUNITY NEED, ACCESS TO CARE, AND PREVENTABLE HOSPITALIZATIONS. CNI AGGREGATES FIVE SOCIOECONOMIC INDICATORS THAT CONTRIBUTE TO HEALTH DISPARITY (ALSO KNOWN AS BARRIERS):- INCOME BARRIERS (ELDER POVERTY, CHILD POVERTY AND SINGLE PARENT POVERTY)- CULTURE BARRIERS (NON-CAUCASIAN LIMITED ENGLISH);- EDUCATIONAL BARRIERS (% POPULATION WITHOUT HS DIPLOMA);- INSURANCE BARRIERS (INSURANCE, UNEMPLOYED AND UNINSURED);- HOUSING BARRIERS (HOUSING, RENTING PERCENTAGE).THIS OBJECTIVE MEASURE IS THE COMBINED EFFECT OF FIVE SOCIOECONOMIC BARRIERS (INCOME, CULTURE, EDUCATION, INSURANCE AND HOUSING). A SCORE OF 1.0 INDICATES A ZIP CODE WITH THE FEWEST SOCIOECONOMIC BARRIERS, WHILE A SCORE OF 5.0 REPRESENTS A ZIP CODE WITH THE MOST SOCIOECONOMIC BARRIERS. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATIONS FOR MANAGEABLE CONDITIONS SUCH AS EAR INFECTIONS, PNEUMONIA OR CONGESTIVE HEART FAILURE COMPARED TO COMMUNITIES WITH THE LOWEST CNI SCORES. (REF ROTH R, BARSI E., HEALTH PROG. 2005 JUL-AUG; 86(4):32-8.) THE CNI IS USED TO A DRAW ATTENTION TO AREAS THAT NEED ADDITIONAL INVESTIGATION SO THAT HEALTH POLICY AND PLANNING EXPERTS CAN MORE STRATEGICALLY ALLOCATE RESOURCES. FOR EXAMPLE, THE ZIP CODE 95407 ON THE CNI MAP IS SCORED 4.2, MAKING IT A HIGH NEED COMMUNITY.OTHER HOSPITALS IN SERVICE AREATHE MINISTRY'S SERVICE AREA IS ALSO SERVED BY SUTTER SANTA ROSA REGIONAL HOSPITAL AND KAISER PERMANENTE SANTA ROSA MEDICAL CENTER AND MEDICAL OFFICES."

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AFFILIATED HEALTH CARE SYSTEM:AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE HEALTH CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:- PROVIDENCE ACROSS SEVEN WESTERN STATES- COVENANT HEALTH IN WEST TEXAS- PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA.- KADLEC IN SOUTHEAST WASHINGTON- PACIFIC MEDICAL CENTERS IN SEATTLE, WA.- SWEDISH HEALTH SERVICES IN SEATTLE, WA.2021 WAS A YEAR MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT